Policy & Compliance

  • July 16, 2026

    Walgreens Sues Mass. Medicaid Program Over Drug Rates

    Walgreens says administrators of the Massachusetts Medicaid program cannot rely on drug prices negotiated with pharmacy benefit managers to determine reimbursement rates, in a challenge to the state's effort to claw back $242,000 in alleged overpayments.

  • July 16, 2026

    Arnall Golden Brings On Arnold & Porter Litigator In DC

    Arnall Golden Gregory LLP has added an Arnold & Porter Kaye Scholer LLP partner in the firm's Washington, D.C., office and named him chair of the firm's Foreign Agents Registration Act compliance practice.

  • July 16, 2026

    Aramark Asks Full 5th Circ. To Nix Aetna ERISA Arbitration Bid

    Food services company Aramark urged the full Fifth Circuit to deny Aetna's request to arbitrate allegations that it cost Aramark millions by bungling health benefits claims, arguing that the insurer is attempting to twist U.S. Supreme Court precedent to kick the case out of court.

  • July 16, 2026

    Diagnostics Co. Labcorp Settles FCA Claims For $14.5M

    Diagnostics testing company Labcorp will pay $14.5 million to settle False Claims Act allegations that it submitted unnecessary Medicare claims for urine drug tests, the Massachusetts U.S. attorney's office announced.

  • July 15, 2026

    Albertsons Slow To Review Wash. Opioid Sales, Judge Told

    Albertsons conducted few reviews of opioid dispensing by its Washington pharmacies for years after establishing a controlled substances compliance team, according to testimony played on Day 3 of a bench trial in the state's lawsuit accusing the company and its Safeway subsidiary of exacerbating Washington's opioid epidemic.

  • July 15, 2026

    Acorda Can't Add $66M To Award In Ampyra Royalty Fight

    The Second Circuit on Wednesday refused to alter an arbitral award issued to Acorda Therapeutics to include nearly $66 million beyond the $16.6 million it won in a multiple sclerosis drug dispute, saying the company "slept on its rights" and couldn't change the result now.

  • July 15, 2026

    2nd Circ. Revives NY Provider's BCBS Underpayment Suit

    The Second Circuit on Wednesday revived a New York healthcare provider's suit accusing out-of-state Blue Cross Blue Shield licensees of underpaying insurance claims, saying the carriers' long-standing business relationship with a New York licensee to obtain preferential prices in the state supports jurisdiction there.

  • July 15, 2026

    Local Gov'ts Seek To Bar HHS Teen Health Program Changes

    A group of local governments and health nonprofits urged a D.C. federal court Wednesday to block recent federal mandates requiring Teen Pregnancy Prevention Program grant recipients to incorporate abstinence education and other changes to their reproductive health programming, arguing the changes are arbitrary and capricious.

  • July 15, 2026

    NC Panel Nixes Nurse Noncompetes For Being 'Too Broad'

    A medical clinic provider couldn't convince a North Carolina state appeals court to overturn a ruling that noncompete agreements for two former nurses were unenforceable, after a split panel ruled Wednesday that the terms were overly broad and voidable under public policy.

  • July 15, 2026

    United Owes $630K In Fight Over Teen's Mental Health Care

    United Healthcare must pay $630,000 to a mother who challenged the insurance company's decision to deny coverage for her son's residential mental health treatment, a Utah federal judge ordered, after rejecting the company's bid to slim her requests for interest and attorney fees.

  • July 15, 2026

    Mass. Says UnitedHealth FCA Case Belongs In State Court

    Massachusetts asked a federal judge to send its $100 million state False Claims Act lawsuit alleging overbilling by UnitedHealthcare back to state court, accusing the insurer of forum shopping with a theoretical defense touching on federal law.

  • July 15, 2026

    DC Circ. Affirms Ratings For Alignment Medicare Plans

    The D.C. Circuit sided with the Centers for Medicare & Medicaid Services regarding its decision not to discard certain unfavorable surveys for Alignment Healthcare's Medicare Advantage plans, saying there is no indication of an administrative error.

  • July 14, 2026

    Albertsons Probed On Pharmacy Compliance Staffing At Trial

    Two former Albertsons pharmacy compliance executives testified in video depositions played Tuesday before a Washington judge considering whether Albertsons failed to prevent the diversion of opioids in the state, acknowledging the nationwide compliance team consisted of just six staffers between 2015 and 2020 despite heightened scrutiny amid the opioid epidemic.

  • July 14, 2026

    3rd Circ. Revives Providers' Underpayment Suit Against Cigna

    The Third Circuit partially revived several New Jersey-based healthcare practices' Employee Retirement Income Security Act suit alleging Cigna improperly underreimbursed them for covered healthcare services provided to Cigna's subscribers, ruling Monday the plaintiffs sufficiently alleged they were underpaid for some out-of-network services when compared to their normal charges for similar services.

  • July 14, 2026

    Patent Eligibility Bill Divides Senators Over Health Costs

    Several U.S. senators expressed strong support at a hearing Tuesday for a bill aimed at expanding which inventions are eligible for patents, while others appeared to have reservations about the potential effect of the proposed changes on healthcare costs.

  • July 14, 2026

    Medical Device Co. Settles FCA Claims

    A company that sells compression devices to reduce swelling in patients with certain medical conditions will pay $551,000 to settle allegations that it obtained Medicare reimbursement with falsified medical records, the U.S. attorney's office in Massachusetts announced Tuesday.

  • July 14, 2026

    FDA Resumes Drug Denial Letters Amid Secrecy Clash

    Drugmakers are examining a new batch of drug application rejection letters released by the U.S. Food and Drug Administration this month — the first disclosure since regulators paused the releases amid industry outcry.

  • July 14, 2026

    CVS Caremark Settles Out Of FTC Suit Over Insulin Pricing

    The Federal Trade Commission reached a settlement on Tuesday with CVS Caremark that includes a number of changes to its business practices, the second deal in a case accusing the country's largest pharmacy benefit managers of inflating insulin prices through unfair rebate schemes.

  • July 14, 2026

    The Latest Medicare Star Lawsuits: What You Need To Know

    Following a win in a Georgia federal court for a health plan challenging a Medicare Advantage Star Ratings calculation, Law360 Healthcare Authority looks at a recent batch of insurer lawsuits seeking to capitalize on the ruling.

  • July 14, 2026

    1st Circ. Backs CDC Ban On Importing Dogs Under 6 Months

    The First Circuit has upheld a rule requiring all dogs imported into the U.S. to be at least six months of age, saying the federal Centers for Disease Control and Prevention had shown it was a reasonable measure to fight rabies.

  • July 14, 2026

    DOJ Asks 9th Circ. Undo Trans Health Ruling Against Premera

    The federal government has backed Premera Blue Cross in its bid at the Ninth Circuit to overturn a Washington federal court's judgment that held the insurance company's coverage policy for gender dysphoria surgery is discriminatory, arguing the decision is out of line with U.S. Supreme Court precedent.

  • July 14, 2026

    Clinics Want Medicaid Abortion Stay Lifted After Pa. Court Win

    Allegheny Reproductive Health Center and other healthcare providers on Tuesday asked a Commonwealth Court judge to unfreeze money for Medicaid-funded abortions in Pennsylvania following the court's landmark ruling that the state's coverage exclusions for such abortions were unconstitutional.

  • July 14, 2026

    Kroger Says Flimsy Claims Doom Tobacco Fee Suit

    Grocery giant Kroger urged an Ohio federal judge to toss a suit challenging the legality of an extra health plan fee it charged tobacco users, stating it complied with federal benefits law by giving workers a 90-day window each year to dodge the fee by enrolling in a wellness program.

  • July 14, 2026

    HHS Wields Checkbook To Pressure State Fraud Units

    Cutting off federal funding to Medicaid fraud units in New York and Hawaii could reshape the enforcement priorities of similar units across the country. The HHS watchdog has made clear the agency wants states to lean in on criminal Medicaid fraud cases.

  • July 14, 2026

    Amgen Colo. Win May Chill States' Push To Cap Drug Prices

    A Colorado injunction blocking a prescription drug pricing statute may have thrown a wrench into efforts in other states to limit drug costs for consumers through a new crop of state oversight boards.

Expert Analysis

  • Previewing FDA Preapproval Access In Psychedelics EO

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    The second of two pathways for psychedelic drug access outlined in President Donald Trump's recent executive order constitutes an unprecedented expansion of the Right to Try Act, which could fundamentally alter the psychedelic access landscape while presenting significant regulatory, operational and legal challenges, say attorneys at Husch Blackwell.

  • Previewing FDA National Priority Vouchers In Psychedelics EO

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    President Donald Trump's recent executive order on psychedelic drug access represents a watershed moment in federal drug policy, but its significance lies in two distinct regulatory pathways, the first being the Commissioner's National Priority Vouchers, which offer a significant opportunity to compress U.S. Food and Drug Administration review, say Kimberly Chew at Husch Blackwell and Odette Hauke at Odette Alina.

  • AG Watch: Texas Charts A Course On Investigative Authority

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    The Texas Supreme Court's recent decision in Texas v. PFLAG affirmed, and arguably expanded, the Texas attorney general's civil investigative demand authority, providing a road map that other courts evaluating state attorney general CIDs may find instructive, amid a lack of precedent, say attorneys at Kelley Drye.

  • Initial Virginia AG Actions Signal Focus On Multistate Efforts

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    Now that Virginia Attorney General Jay Jones has reached the 100-day mark in office, his first set of actions reveals a clear preference for coalition with regional and national counterparts, which means the primary risk for businesses is no longer just the fact of enforcement, but the speed at which investigations can escalate, says Lauren Cooper at Hogan Lovells.

  • How CMS Fraud Priorities Complicate Provider Acquisitions

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    As the Centers for Medicare & Medicaid Services steps up usage of its affiliates authority and post-transaction audits, parties contemplating the acquisition or sale of home health and hospice providers should take steps to avoid the potential suspension of Medicare billing privileges, say attorneys at Alston & Bird.

  • Mapping Philly US Atty's White Collar Enforcement Push

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    Attorneys at Blank Rome discuss the U.S. Attorney for the Eastern District of Pennsylvania David Metcalf’s commitments and priorities, survey early results from his first year, and suggest practical action items for companies operating under the office's jurisdiction.

  • How The Coming Months Will Shape State Drug Price Boards

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    The future of state prescription drug affordability boards may be determined in the next few months, between an upcoming court decision in a challenge against state authority to set drug prices, and pending state decisions about whether to use federal Medicare maximum fair prices as reference, say Michael Kolber, Steven Chen and Kelechi Ezealaji at Manatt.

  • Steps To Consider As DOJ Launches Fraud Division

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    The establishment this month of the National Fraud Enforcement Division within the U.S. Department of Justice is a significant reorganization that suggests an increase in enforcement activity involving federally funded programs but leaves a number of important questions unanswered, say attorneys at Crowell & Moring.

  • Court's HRSA Policy Reversal Leaves 340B Rules Murky

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    A D.C. federal court's recent decision in Premier v. U.S. Department of Health limits the Health Resources and Services Administration's ability to enforce long-standing Section 340B interpretations through subregulatory guidance, leaving open core statutory questions about purchasing models, inventory classification and program oversight, says Martha Cramer at Hooper Lundy.

  • Fresenius Ruling May Shift Anti-Kickback Enforcement

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    The Ninth Circuit's recent decision in Fresenius v. Bonta suggests that businesses have a First Amendment right to donate to certain charities, even if those donations are motivated by economic self-interest, potentially calling into question years of Anti-Kickback Statute proceedings against pharmaceutical manufacturers for making similar donations, says Jonah Knobler at Patterson Belknap.

  • The Challenge Of Stabilizing Rural Hospitals On The Brink

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    The outlook for rural hospitals has grown more concerning, as recent policy and regulatory developments are decreasing hospital revenues and increasing the cost of uncompensated care, which may result in additional hospital closures, service reductions, or mergers and acquisitions, say Omur Celmanbet, Kristy Piccinini and Sabiha Quddus at FTI Consulting.

  • Fraud Enforcement, Sentencing Face Unusual Convergence

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    The Trump administration’s newly created task force to eliminate fraud and the U.S. Sentencing Commission’s recent proposals to scale back certain elements of the federal sentencing framework seem to point in opposite directions, creating a collision of policy priorities that may reshape how fraud cases are charged, negotiated and sentenced for years to come, says David Tarras at Tarras Defense.

  • Peptide Policy Is Shifting Toward Sanctioned Compounding

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    The policy landscape for peptides is undergoing a significant shift under the Trump administration, moving toward a complex system of verified compounding and complementary enforcement that will likely bring peptides firmly back into the sphere of legitimate consumer products, say attorneys at Sheppard.