Policy & Compliance

  • March 13, 2026

    4th Circ. Brings Back Allergan Medicaid Overcharging Suit

    A split Fourth Circuit panel on Friday revived a whistleblower suit accusing an Allergan Sales LLC predecessor of overcharging Medicaid by more than $680 million, saying the whistleblower plausibly alleged the company knowingly improperly aggregated discounts into "best prices" for drugs.

  • March 13, 2026

    Sandoz Appealing Ruling Over Amgen's Enbrel Biosimilar

    Sandoz Inc. is appealing after a Virginia federal court ruled it should have brought claims accusing Amgen of blocking competition for the Enbrel biosimilar in a previous patent dispute, according to a Friday notice. 

  • March 13, 2026

    Texas Justices Clear Way For State's Trans Care Probe

    An LGBTQ+ advocacy organization must produce documents as part of an investigation from the Texas attorney general's office into transgender treatments for minors, the Texas Supreme Court ruled on Friday, saying that the state's ban on gender-affirming care for minors is the law and must be followed. 

  • March 13, 2026

    EPA Aims To Lift Biden-Era Ethylene Oxide Limits

    The U.S. Environmental Protection Agency on Friday proposed rolling back limits on emissions of ethylene oxide, a carcinogenic chemical used in the sterilization of medical devices.

  • March 12, 2026

    Ariz. Docs Ink $4.75M FCA Deal Over Unnecessary Treatment

    An Arizona-based physician group that offers cardiology and vascular services has inked a $4.75 million settlement to resolve False Claims Act allegations they performed unnecessary vein ablations and submitted claims for payment to government healthcare programs for reimbursement, the U.S. Department of Justice said Thursday.

  • March 12, 2026

    Top Texas Court Upholds Death Sentence For ICU Nurse

    The Texas Court of Criminal Appeals on Thursday affirmed the death sentence of a former cardiovascular nurse convicted of intentionally murdering patients recovering from operations, finding that Texas prosecutors' accusation that defense counsel engaged in "misdirection and deception" was "mild."

  • March 12, 2026

    Wash. Justices OK Jury Instruction In TB Malpractice Case

    The Washington State Supreme Court declined Thursday to flip a family's loss in a case blaming an Evergreen State doctor for failing to address signs of an intestinal tuberculosis infection that led to a patient's death, rejecting a challenge to a jury instruction on the physician's exercise of judgment.

  • March 12, 2026

    Colo. Panel Clarifies Workers Comp Law On Maintenance Care

    In interpreting the Colorado Workers' Compensation Act, the Colorado Court of Appeals ruled for the first time Thursday that employers and their insurers cannot limit maintenance medical benefits to any specific treatment in a final admission of liability.

  • March 12, 2026

    US Chamber Report Warns Of Risks To IP Protection

    While the U.S. has ranked at the top of the U.S. Chamber of Commerce's list measuring how countries worldwide are enforcing intellectual property laws, the group said problems with free trade agreements and efforts to reduce pharmaceutical prices could cause problems on the horizon domestically.

  • March 12, 2026

    Doc's Hands Aren't Property, Texas Panel Rules In Death Suit

    A state-employed doctor's hands are not "tangible personal property," a Texas appeals court ruled Thursday, dismissing a wrongful death suit from the family of a patient who contracted a fatal infection during her hospital stay. 

  • March 11, 2026

    New Wyoming Abortion Law Faces Familiar Legal Challenge

    Just a day after it was signed into law, Wyoming's new anti-abortion law triggered a legal challenge from the same health clinic that successfully sued over the state's previous abortion limits.

  • March 11, 2026

    La. Fights Dismissal Bid In Abortion Regulation Dispute

    The state of Louisiana urged a federal court to deny motions by GenBioPro Inc. and Danco Laboratories seeking dismissal of its suit challenging federal regulation on mail-order abortion drugs, arguing it has established harms stemming from the regulations.

  • March 11, 2026

    Ohio Hospital Defeats DaVita's Dialysis Discrimination Suit

    An Ohio hospital and its health benefit plan did not discriminate against patients with end-stage renal disease by eliminating in-network coverage for dialysis, a federal court ruled, finding that dialysis provider DaVita Inc. failed to show the plan intended to harm participants.

  • March 11, 2026

    VA, DOJ Cut Deal To Make Attys Mental Health Guardians

    Under a new initiative, attorneys at the U.S. Department of Justice will serve as legal guardians for some homeless veterans, the Trump administration announced on Wednesday, though some veterans advocates expressed concern that the new program could involuntarily coerce veterans experiencing mental health issues into institutional care.

  • March 11, 2026

    Aetna Will Pay $117.7M To Resolve False Billing Suit

    Aetna Inc. has agreed to pay $117.7 million to settle claims that the company violated the False Claims Act by submitting, and failing to correct, false diagnosis codes for its Medicare Advantage plan customers in order to boost cash flow from the federal insurance program, the U.S. attorney's office in Philadelphia said Wednesday.

  • March 10, 2026

    A Look At The Real Impact Of The FTC's PBM Settlements

    It may all come down to the details in a landmark settlement between the Federal Trade Commission and one of the biggest pharmacy benefit managers in the U.S., as delayed timelines and a key carveout provision threaten to dampen sweeping changes to the larger system.

  • March 10, 2026

    5th Circ. Revives J&J Sales Rep's Wage Dispute

    A Texas federal court did not take into consideration relevant factors to determine whether a former Johnson & Johnson sales representative's failure to retain local counsel in his wage and hour suit represented excusable neglect, the Fifth Circuit ruled on Tuesday.

  • March 10, 2026

    Sanofi Says Judge Botched Insulin Device Patent Listings

    Sanofi-Aventis sparred with drug wholesalers over a Massachusetts federal magistrate judge's pronouncements that the parties should go to trial on claims the pharmaceutical giant used improper insulin device patent listings to anticompetitively protect the blockbuster Lantus insulin pen from competition.

  • 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.

  • 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.

  • 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.

  • 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.

  • 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. 

  • 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.

  • 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.

Expert Analysis

  • Mulling Differing Circuit Rulings On Gender-Affirming Care

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    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.

  • State AGs May Extend Their Reach To Nat'l Security Concerns

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    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.

  • Unique Aspects Of Texas' Approach To AI Regulation

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    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.

  • Surveying The Healthcare Policy Landscape Post-Shutdown

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    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.

  • FDA Biosimilar Guidance Should Ease Biologics Development

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    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.

  • Prison Body Cams Raise Health Privacy Compliance Issues

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    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.

  • Employer Considerations After 11th Circ. Gender Care Ruling

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    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.

  • How Healthcare Practices Can Prepare For ICE Visits

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    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.

  • Adapting To Calif.'s Enhanced Regulation Of PE In Healthcare

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    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.

  • Lessons From 7th Circ. Decision Affirming $183M FCA Verdict

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    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.

  • Calif. Justices Continued Anti-Arbitration Trend This Term

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    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.

  • Steps For Healthcare Providers After Cigna ERISA Settlement

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    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.

  • What's New In FDA's Latest Cell And Gene Therapy Guidance

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    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.