Policy & Compliance
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February 13, 2026
States' Generic Drugs Antitrust Case Headed Toward Trial
A Connecticut federal judge has mostly refused to side with pharmaceutical companies facing states' generic drug price-fixing litigation against them, ruling that there are genuine disputes of material fact as to drug distribution chains and the states' antitrust standing and teeing up the case for trial.
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February 13, 2026
Docs Urge Judge To Block CDC's Childhood Vaccine Changes
Doctors organizations Friday urged a Massachusetts federal judge to stop the government from implementing its new, shorter list of recommended vaccines for children and prevent the next meeting of a committee they say has been tainted by anti-vaccine influence.
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February 13, 2026
Iowa AG Urges 8th Circ. To Unblock Parts Of State PBM Law
The state of Iowa urged the Eighth Circuit on Friday to lift a preliminary block on parts of a law limiting pharmacy benefit managers' power to set drug prices in the Hawkeye State, arguing a lower court judge erred in holding that parts of the policy were federally preempted.
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February 13, 2026
Breast Surgery Patients Want ERISA Class Cert. Rethink
A United Healthcare plan member asked a New Jersey federal judge to rethink her decision denying class certification in a suit alleging the insurer systematically refused to cover postmastectomy breast reconstruction claims, arguing the court overlooked evidence showing that common issues could be resolved on a classwide basis.
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February 13, 2026
FDA Removes Boxed Warnings From HRT Products
Six menopause hormone therapies will no longer have warnings on their label about heart disease, breast cancer and dementia, after the U.S. Food and Drug Administration said it removed them so that women can make decisions "free from exaggeration or fear."
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February 12, 2026
Trump Admin. Blocked From Cutting $600M In Health Funding
An Illinois federal judge on Thursday temporarily blocked the Trump administration from terminating more than $600 million in public health funding to four Democratic-led states, saying the states will likely succeed in showing they are unconstitutionally being targeted due to political or policy objectives.
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February 12, 2026
Feds Charge 2 Foreign Nationals Over $10M Healthcare Fraud
Federal officials in Chicago announced healthcare fraud charges Thursday against two natives of Pakistan who allegedly made $10 million by using fake medical companies to submit Medicare and other health benefit claims for items and services they never provided.
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February 12, 2026
DC Circ. Judge Rips Into Insurer In CMS Rating Case
A Louisiana insurer found a tough critic in one D.C. Circuit judge Thursday as it argued that the Centers for Medicare & Medicaid Services used an unfair method to assess its "star ratings" for insurance plans, with the jurist saying the company seemed like it "just wanted whatever interpretation will give you a higher score."
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February 12, 2026
Ex-Pharma Exec Fights AGs' Quick Win Bid In Antitrust Case
A former pharmaceutical marketing executive urged a Connecticut federal court to reject summary judgment sought against him by state attorneys general pursuing wider price-fixing litigation against most of the generic drug industry, arguing key cooperating witnesses' questionable credibility makes a trial necessary.
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February 12, 2026
Goodwin Expands Healthcare Team With Ex-Reed Smith Atty
A healthcare attorney specializing in guiding clients through regulatory and transactional matters has moved her practice to Goodwin Procter LLP's Philadelphia office after more than 11 years with Reed Smith LLP.
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February 11, 2026
AbbVie Sues Medicaid, HHS Over Botox Fair Price Controls
AbbVie Inc. on Wednesday asked a D.C. federal court to block the Centers for Medicare and Medicaid Services from controlling the price of Botox under the Inflation Reduction Act, arguing the cosmetic drug and migraine treatment should be excluded from the controls because it's a "plasma-derived" product.
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February 11, 2026
Ex-Lt. Col. Sues Hegseth Over Son's Benefits Denial
A former U.S. Army lieutenant colonel sued Defense Secretary Pete Hegseth and the Defense Health Agency on Wednesday, alleging his son was wrongfully denied health care coverage for continued inpatient mental health treatment, leaving in limbo more than $270,000 in costs.
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February 11, 2026
Anesthesia Group Looks To End FTC Rollup Suit
U.S. Anesthesia Partners has urged a Texas federal court to end the Federal Trade Commission's case accusing the group of buying competing practices through a so-called rollup strategy, asserting that enforcers have no evidence of any harm to competition.
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February 11, 2026
Judge Won't Review Tossed ERISA Claim In Benefits Dispute
An Ohio federal court refused Wednesday to reconsider a recent decision dismissing a woman's Employee Retirement Income Security Act claims against her husband's employer and several UnitedHealth Group Inc. companies that administered the couple's employee health benefits.
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February 11, 2026
HHS Says RFK Jr. Trans Care Policy View Not Legally Binding
Health and Human Services Secretary Robert F. Kennedy Jr.'s declaration supporting the Trump administration's move to cut funding to hospitals that provide gender-affirming care is a nonbinding policy view, his agency told an Oregon federal court, and doesn't trigger provider exclusions from federal health programs.
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February 11, 2026
Organ Donor Network Must Face Veteran's Waitlist Bias Suit
A Black veteran who alleges his kidney transplant timeline was delayed because the United Network for Organ Sharing artificially inflated his kidney function scores can proceed with his Title VI lawsuit, a Georgia federal judge ruled, denying the network's bid to have the suit tossed.
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February 11, 2026
Trans Health And Pediatric Groups Challenge FTC Subpoenas
A major transgender medical group and a pediatric healthcare organization are seeking to end what they call "unlawful" consumer protection investigations from the Federal Trade Commission that want information pertaining to the medical groups' claims made in their marketing and advertising for gender-affirming care for minors.
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February 11, 2026
Mass. AG Charges Medical Transport Co. With Billing Fraud
A nonemergency medical transportation provider and its former owner are facing criminal charges for allegedly billing Massachusetts' Medicaid program for tens of thousands of fake rides and laundering the proceeds to accounts in Uganda, according to a Wednesday announcement.
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February 11, 2026
Kaiser Will Pay $30M To End DOL Mental Health Investigations
Kaiser Permanente has agreed to fork over at least $30 million and change its practices to end multiple U.S. Department of Labor investigations into the adequacy of the healthcare organization's mental health and substance use disorder treatment networks in California, the DOL said.
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February 10, 2026
US Says Abbott Lied, Must Repay Funds Spent On Formula
Abbott Laboratories must face the federal government's lawsuit over the 2022 infant formula crisis caused by the discovery of potentially deadly bacteria in a facility that made baby formula, prosecutors told a Michigan federal court, saying the company "repeatedly lied" about the cleanliness of its plant.
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February 10, 2026
Ex-DOJ Fraud Prosecutors Launch DC White Collar Boutique
Two former U.S. Department of Justice fraud prosecutors are opening their own Washington, D.C., boutique firm to represent clients in complex fraud and white collar cases, they said Tuesday.
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February 10, 2026
PBMs Enter New Era Of Legal Scrutiny
The recent government funding bill includes extensive reforms for the embattled pharmacy benefit manager industry. It may presage a new wave of agency scrutiny, regulatory action and lawsuits, including from PBMs.
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February 10, 2026
Abortion Rules, Vaccine Recommendations And More In Court
Abortion restrictions in Arizona are facing a new legal challenge, and an interstate clash over abortion pills is heating up. Here, Law360 Healthcare Authority takes a look at the week's top healthcare news.
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February 10, 2026
Wash. Panel Says Healthcare Cost-Share Group Is An Insurer
A Utah-based healthcare cost-sharing nonprofit operates as and must register as an insurer under Washington state law, a state appeals panel ruled, upholding a $50,000 fine from the state's insurance commissioner that found the nonprofit ran afoul of Washington insurance law.
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February 10, 2026
Pa. Emerges As Battleground Over State False Claims Laws
Momentum is growing to pass a False Claims Act law in Pennsylvania, the most populous U.S. jurisdiction without one already on the books. It's also reigniting debate over the value of anti-fraud statutes around the country.
Expert Analysis
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Mulling Differing Circuit Rulings On Gender-Affirming Care
Despite the Eleventh Circuit's recent holding in Lange v. Houston County that a health plan's exclusion for gender-affirming surgery did not violate Title VII, employers should be mindful of other court decisions suggesting that different legal challenges may still apply to blanket exclusions for such care, say attorneys at Smith Gambrell.
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State AGs May Extend Their Reach To Nat'l Security Concerns
Companies with foreign supply-chain risk exposure need a comprehensive risk-management strategy to address a growing trend in which state attorneys general use broadly written state laws to target conduct that may not violate federal regulations, but arguably constitutes a national security threat, say attorneys at Wiley.
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Unique Aspects Of Texas' Approach To AI Regulation
The Texas Responsible AI Governance Act — which will soon be the sole comprehensive artificial intelligence law in the U.S. — pulls threads from EU and Colorado laws but introduces more targeted rules with fewer obligations on commercial entities, say attorneys at MVA Law.
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Surveying The Healthcare Policy Landscape Post-Shutdown
With last week's agreement to reopen the federal government, at least through the end of January, key healthcare legislation that has been in limbo since a December 2024 spending bill fell apart may recapture the attention of Congress, say attorneys at Faegre Drinker.
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FDA Biosimilar Guidance Should Ease Biologics Development
New draft guidance from the U.S. Food and Drug Administration, indicating that the agency may no longer routinely require comparative efficacy studies when other evidence provides sufficient assurance of biosimilarity, underscores the FDA's trust in analytical technology as a driver of biologics access, say attorneys at Hogan Lovells.
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Prison Body Cams Raise Health Privacy Compliance Issues
The increasing use of prison staff body cameras to enhance transparency and safety presents correctional healthcare partners with new risk management questions where they must carefully reconcile the benefits of surveillance with the imperative to protect patient privacy, say attorneys at Gordon Rees.
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Employer Considerations After 11th Circ. Gender Care Ruling
The Eleventh Circuit's en banc decision in Lange v. Houston County, Georgia, finding that a health plan did not violate Title VII by excluding coverage for gender-affirming care, shows that plans must be increasingly cognizant of federal and state liability as states pass varying mandates, say attorneys at Miller & Chevalier.
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How Healthcare Practices Can Prepare For ICE Visits
Healthcare providers that may face encounters with immigration enforcement should familiarize themselves with compliance obligations beyond ensuring employment authorization, and mitigate risk by establishing clear policies and specific procedures that safeguard patient rights and manage staff interactions with agents, say attorneys at Roetzel & Andress.
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Adapting To Calif.'s Enhanced Regulation Of PE In Healthcare
New California legislation enhances oversight on the role of private equity groups and hedge funds in healthcare transactions, featuring both a highly targeted nature and vague language that will require organizations to carefully evaluate existing practices, says Andrew Demetriou at Husch Blackwell.
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Lessons From 7th Circ. Decision Affirming $183M FCA Verdict
The Seventh Circuit's decision to uphold a $183 million False Claims Act award against Eli Lilly engages substantively with recurring materiality and scienter questions and provides insights into appellate review of complex trial court judgments, say Ellen London at London & Naor, Li Yu at Bernstein Litowitz and Kimberly Friday at Osborn Maledon.
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Calif. Justices Continued Anti-Arbitration Trend This Term
In the 2024-2025 term, the California Supreme Court justices continued to narrow arbitration's reach under state law, despite state courts' extreme caseload backlog and even as they embraced contractual autonomy in other contexts, says Josephine Petrick at The Norton Law Firm.
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Steps For Healthcare Providers After Cigna ERISA Settlement
Following the Cigna class action's settlement, where Employee Retirement Income Security Act violations arose from Cigna's online provider directory advertising providers as in-network who were actually out-of-network, providers should routinely audit their contract status and directory listings, and proactively coordinate with plans and payor partners, say attorneys at ArentFox Schiff.
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What's New In FDA's Latest Cell And Gene Therapy Guidance
New draft guidance from the U.S. Food and Drug Administration, along with other recent initiatives, come together to promote cell and gene therapy product development by streamlining development and review pathways, say attorneys at Holland & Knight.