Policy & Compliance
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March 10, 2026
Lab's Aetna Payment Suit Survives, But With Deep Cuts
A Connecticut federal judge ruled Aetna and its parent company, CVS Health Corp., must face a pared down lawsuit from a medical laboratory alleging it is owed $20.6 million in unpaid invoices.
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March 10, 2026
Wash. To Set Its Own Vaccine Schedule Under New State Law
Washington Gov. Bob Ferguson has signed legislation that requires health plans to cover vaccines and other preventive care recommended by the state rather than the federal government, joining a movement toward states setting their own recommendations.
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March 10, 2026
4th Circ. Backs W.Va.'s Trans Care Coverage Exclusion
The Fourth Circuit said Tuesday that West Virginia's Medicaid coverage exclusion for gender-affirming care passes constitutional muster and does not discriminate based on sex, basing its conclusion on a U.S. Supreme Court ruling that upheld Tennessee's ban on gender-affirming care for minors.
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March 10, 2026
CVS Can't 'Relitigate' Price-Gouging Class Cert.
A Rhode Island federal judge refused to narrow the certified classes of health plans alleging CVS schemed with pharmacy benefit managers to overcharge insured health plans for generic drugs, finding that PBM Express Scripts' refusal to produce its contracts changes nothing about how the classes will be assessed.
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March 10, 2026
2nd Circ. Revives Geico's Suit Over Acupuncture Referrals
A lower court erred in granting summary judgment to Geico after the insurer sued over reimbursements to an acupuncturist involved in what Geico said was a kickback scheme, the Second Circuit ruled Tuesday, finding the district court misinterpreted a state law detailing requirements for referrals and no-fault payments.
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March 10, 2026
Minn. Medicaid Funds Case A Test For CMS Tactic
Minnesota’s fight over $243 million in Medicaid funding frozen by the Trump administration sets up an unusual, politically tinged legal clash that may shape the government’s anti-fraud tactics in other states.
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March 10, 2026
Wyoming Abortion Ruling Sets Off Lawmaker Backlash
Lawmakers in Wyoming won't let judges have the final word on abortion and have considered slashing judicial security funding and shrinking the top court. This week, the governor signed a new "heartbeat" abortion ban likely to see new legal challenges.
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March 10, 2026
Former Conn. Prosecutor Can Stay On Generic-Drug Case
Connecticut's former assistant attorney general can continue to represent insurers Humana and Molina Healthcare Inc. in multidistrict litigation over alleged price-fixing of generic drugs, after the Pennsylvania federal judge overseeing the case agreed Monday with a report that the attorney has no information that had not already been shared.
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March 10, 2026
AFSCME Sues Trump Admin Over $600M Health Funding Cuts
The American Federation of State, County and Municipal Employees is seeking to block a federal government directive to cancel more than $600 million in public health grants administered by the Centers for Disease Control and Prevention, alleging that the directive was issued to target Democratic-led states.
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March 10, 2026
Abortion Ban, Drug Pricing: Health Litigation Week In Review
Indiana's abortion ban and religious freedom, a proposed class action over Express Scripts pricing, and a deal over abortion pill ads. Law360 looks at big legal developments from the past week.
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March 09, 2026
Texas AG Gets Temporary Ban On Chest Binder Sales
A Texas state judge has issued a temporary restraining order against a New York-based online retailer of undergarments and chest binders for young women and teens from selling its clothing in the Lone Star State.
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March 09, 2026
Vehicle Manufacturer Strikes Deal In Tobacco Surcharge Suit
Commercial vehicle manufacturer International Motors LLC has agreed to end a proposed class action claiming it unlawfully charges employees who use tobacco products an additional $600 per year for health insurance without providing an alternative to the fee, according to a filing in Illinois federal court.
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March 09, 2026
NC Providers Sue UnitedHealth Over 'Devastating' Cyberattack
UnitedHealth Group Inc. and several of its subsidiaries are facing a proposed class action in North Carolina state court over a 2024 data breach that took its claims processing platform offline and allegedly delayed billions of dollars in reimbursements to providers.
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March 09, 2026
JPMorgan Trims But Can't Escape ERISA Drug Costs Suit
A New York federal judge pared claims Monday against JPMorgan Chase & Co. in a suit from workers who alleged they paid too much for prescription drugs, but opened discovery on allegations that the bank's contract with its pharmacy benefit manager caused transactions prohibited by federal benefits law.
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March 06, 2026
ExThera Exec Hid Patient Deaths To Keep $10M Deal, DOJ Says
Medical device company ExThera concealed the deaths of two U.S. patients treated with its unapproved blood filtration device at a clinic in Antigua, according to federal prosecutors, with the company agreeing to forfeit nearly $5.7 million and one executive facing up to three years in prison.
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March 06, 2026
Health Groups Back Bid To Bar Noncitizen Benefit Restrictions
A group of public health organizations and scholars Friday urged a Rhode Island federal court to make permanent its order blocking the Trump administration from enacting a policy change basing access to a host of federally funded services on immigration status.
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March 06, 2026
FDA Vaccine Chief Prasad To Exit Agency For 2nd Time
Dr. Vinay Prasad, the U.S. Food and Drug Administration's top vaccine regulator, will leave the agency in the coming weeks, FDA Commissioner Marty Makary said Friday.
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March 06, 2026
9th Circ. Mulls Whether Politics Tainted DOJ Trans Care Probe
A Ninth Circuit panel on Friday grappled with where to draw the line between a legitimate law enforcement investigation and a politically motivated crusade, as the U.S. Department of Justice sought to revive a subpoena against a telehealth provider of gender-affirming medical care.
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March 06, 2026
Mass. Judge Told Vax Committee Must Be Fairly Balanced
A key federal vaccine committee remains subject to statutory requirements that its membership be fairly balanced, a Massachusetts federal judge heard from both U.S. Department of Health and Human Services Secretary Robert F. Kennedy Jr. and medical organizations challenging his overhaul of the group.
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March 06, 2026
Dentist Says She Was Fired For Exposing Medicaid Fraud
A dentist filed suit against several West Michigan dental practices and a dental management company, claiming she was fired after reporting that the clinics billed Medicaid for dental procedures that were never performed.
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March 05, 2026
Telehealth Co. Swaps In Gordon Rees In Novo's GLP-1 Fight
A telehealth platform facing allegations from Novo Nordisk that it falsely advertised Ozempic alternatives has picked new counsel in the dispute, withdrawing attorneys from Foley & Lardner LLP and Miller Nash LLP and substituting in two lawyers from Gordon Rees Scully Mansukhani LLP.
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March 05, 2026
Pharma Co. Investors Secure Class Cert. Over FDA Obstacles
A Pennsylvania federal judge has granted certification to a group of Verrica Pharmaceuticals Inc. investors who claim the company defrauded them by hiding obstacles it faced in obtaining approval from the U.S. Food and Drug Administration for its lead product, though she made a slight change to the class definition to avoid what she called a "heads I win, tails you lose strategy."
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March 05, 2026
9th Circ. Denies Bail Pending Nurse Wage-Fixing Appeal
A Ninth Circuit panel summarily refused to allow a Las Vegas home nursing executive to avoid prison while appealing the U.S. Department of Justice's first-ever criminal wage-fixing conviction.
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March 05, 2026
9th Circ. Judge 'Frustrated' At DOJ Position On Anti-Trans EOs
A Ninth Circuit judge said Thursday he's "very frustrated" with the Trump administration's argument that a district court judge acted prematurely by partly blocking executive orders to end funding for gender-affirming care, saying it's "pretty clear" the government was poised to do exactly that.
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March 05, 2026
BCBS Can't Nix NC Plan Member From Cancer Treatment Row
A North Carolina federal judge ruled a Blue Cross Blue Shield unit must face proposed class action claims over its administration of a state employee health plan from a participant alleging it arbitrarily characterized a proton beam cancer radiation treatment as experimental to deny coverage.
Expert Analysis
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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.
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Adapting To Enforcement Focus On Wound Care Fraud
As federal agencies target wound care industry fraud as a top enforcement priority, attorneys advising industry stakeholders should evaluate business relationships for Anti-Kickback Statute violations, emphasize appropriate product use and documentation, and use internal data analytics to monitor billing patterns, say David Tarras at Tarras Defense and Jay McCormack at Verrill Dana.