Policy & Compliance
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January 15, 2026
5th Circ. Revives Allstate's Fraud Suit Over Car Crash Billing
The Fifth Circuit on Wednesday revived Allstate's racketeering suit alleging doctors and personal injury lawyers unleashed a barrage of unnecessary treatments for car accident patients and caused Allstate to pay $4.7 million in claims, finding the insurer sufficiently pled details about the conspiracy and specifics surrounding each allegedly fake medical billing.
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January 15, 2026
Trump Admin Defies Funding K-12 Mental Health Grants
The Trump administration is fighting an effort by a coalition of U.S. states to preserve at least six months of funding for K-12 mental health grants meant to help students process gun violence, arguing that an earlier court ruling doesn't require the feds to fund the grants.
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January 15, 2026
Colo. Eye Clinics Settle Medicaid Double-Billing Claims
The Colorado attorney general's office announced Thursday that it reached a settlement totaling $520,000 with two eye care clinics that the state claimed were double-billing a Medicaid vision program for more than five years.
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January 15, 2026
NC Attys Can Withdraw From 'Unworkable' Nurses' Pay Row
Two attorneys who said they had "irreconcilable differences" with nurse practitioners who did not meet their contractual financial obligations can withdraw their representation in a minimum wage lawsuit against their employer, a North Carolina federal magistrate judge ruled.
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January 15, 2026
CVS Ducks Antitrust But Not Biz Interference Claim At 5th Circ.
A Fifth Circuit panel has largely sided with CVS Pharmacy and its Caremark affiliate by preserving a district court's dismissal of federal antitrust claims over a Mississippi pharmacy's rejection from participating in the pharmacy benefit manager's network, although the judges did revive state law claims.
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January 14, 2026
Pharmacy Wields Antitrust Law In Challenge To GLP-1 Giants
Eli Lilly & Co. and Novo Nordisk are using their dominant positions in the market for weight loss and diabetes medications to squash potential competitors, including through unlawful exclusivity agreements with telehealth providers, a compounding pharmacy alleged Wednesday in what it calls a landmark antitrust lawsuit.
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January 14, 2026
6th Circ. Skips Rethink, But Still Spars Over Indirect Buyer Bar
A decision by the full Sixth Circuit not to rehear a lawsuit over an alleged allergy testing and treatment provider boycott has turned into an internal dustup about the limits of who can seek damages under federal antitrust law, with one judge calling for U.S. Supreme Court intervention.
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January 14, 2026
NJ Judge Orders Mediation In Merck-Cencora Indemnity Fight
Cencora Inc. can't derail a Merck third-party complaint arguing a prior settlement between the parties requires the drug wholesaler to indemnify Merck in antitrust litigation by Humana, a New Jersey federal court ruled Wednesday, ordering the parties to go to mediation over the dispute.
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January 14, 2026
Vizient Beats Spurned Medical Tape Supplier At 5th Circ.
A Fifth Circuit panel refused to revive an antitrust suit accusing medical supplies group purchasing giant Vizient of locking in hospital customers, agreeing with a district court that a spurned would-be supplier failed at the threshold question of showing a market in which Vizient could be dominant.
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January 14, 2026
GOP Senators Say Patients Must See Docs For Abortion Meds
Republicans on a Senate health panel Wednesday called for the U.S. Food and Drug Administration to reinstate a requirement that pregnant women seeking an abortion via medication must have the drug administered in a doctor's office, not through telehealth or remotely.
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January 13, 2026
Ark. Official Urges 7th Circ. Not To Revive Pharma Rule Fight
An Illinois federal judge correctly upheld an Arkansas insurance regulation designed to protect local pharmacies, the state's insurance commissioner told the Seventh Circuit on Monday, asking the court to toss a Teamsters healthcare plan's bid to renew its challenge to the regulation.
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January 13, 2026
EEOC Disability Bias Win Stands, But Damages Shrink
A Florida federal judge declined a senior living facility's bid for a new trial in a U.S. Equal Employment Opportunity Commission disability bias suit claiming it wouldn't hire a veteran who has PTSD, but cut a $400,000 jury verdict to $50,000 in line with a damages cap.
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January 13, 2026
La. Moves To Extradite Calif. Doc Over Abortion Pill Trafficking
Louisiana Gov. Jeff Landry on Tuesday said he would authorize an extradition request for a California doctor accused of illegally mailing abortion pills to a Louisiana resident, further escalating a legal battle over the reach of state bans in the post-Roe era.
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January 13, 2026
Oak Street Exec's Ex-Partner Must Forfeit $617K In Assets
Federal authorities can delve into the assets of a man who made illegal insider trades of CVS stock based on information from his domestic partner so that they can recover $617,000 he agreed to forfeit as part of a plea deal, a Pennsylvania federal judge said Tuesday.
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January 13, 2026
Healthcare Litigation Week In Review
Law360 Healthcare Authority looks at the past week's top healthcare news.
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January 13, 2026
Workers Seek $126M In Seattle Hospital System Wage Row
Seattle-area hospital system Swedish Health Services should shell out about $126 million to settle wage violations, after a state court found that the system failed to provide a second meal break on longer shifts and that its rounding practices led to unpaid wages, the workers said.
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January 13, 2026
Blue States Say HHS Conditions Funding On Anti-Trans Bias
A dozen Democratic state attorneys general sued the U.S. Department of Health and Human Services on Tuesday, claiming the agency's threat to withhold billions of dollars in funding from states that don't hew to an executive order declaring that gender is immutable conflicts with antidiscrimination law.
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January 13, 2026
Gov't Didn't Allege Formula Was Contaminated, Abbott Says
Abbott Laboratories has urged a Michigan federal judge to throw out a suit brought by the federal government over the 2022 infant formula shortage, saying the government is trying to recoup a "belated windfall" and no tainted formula left its plant's doors.
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January 13, 2026
Federal Drug Pricing Policies Irk Biotech Insiders
As the federal government targets drug and other healthcare costs, biotech insiders say they're getting exasperated.
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January 13, 2026
Justices Seem Poised To Greenlight Transgender Athlete Bans
The conservative wing of the U.S. Supreme Court voiced skepticism of allowing transgender athletes to compete in women's and girls' sports Tuesday, while also signaling a willingness to keep its ruling narrowly tailored.
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January 13, 2026
Blip Or Trend? FDA Guidance Fell Off Steeply In 2025
The U.S. Food and Drug Administration issued far less industry guidance last year after President Donald Trump returned to office. The change has pharmaceutical attorneys bracing for more unpredictability.
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January 12, 2026
The Curious, Very Long Delay In A Pioneering Drug Prices Suit
When Merck & Co. launched a fiery challenge to Medicare's landmark drug price negotiations, it blazed a trail for many similar suits. But 31 months later, the challenge is stalled where it started as Merck begs for a ruling, other suits speed along the path it created and huge costs now seem unavoidable.
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January 12, 2026
Feds To Drop Appeal In 340B Rebate Pilot Challenge
The U.S. Department of Health and Human Services on Monday suggested it will end its appeal of a First Circuit order temporarily blocking it from instituting a rebate program that would change how the agency distributes payments in the federal 340B drug discount program that provides medications at reduced costs to low-income Americans.
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January 12, 2026
ERISA Recovery Suit Against UnitedHealth Proceeds With Trims
A UnitedHealth plan participant who was injured in a car crash may pursue claims under the Employee Retirement Income Security Act's civil enforcement provision, an Ohio federal court ruled Friday, while also allowing his wife, who was involved in a separate accident, to proceed with certain state-law claims.
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January 12, 2026
Yale Asks Judge To Rethink $32M Baby Formula Death Verdict
Yale University and the affiliated Yale New Haven Hospital have asked a Connecticut state court judge to reconsider a verdict of nearly $32 million over the death of a premature baby, contending that she failed to grasp battery and informed consent law when issuing her decision after a bench trial.
Expert Analysis
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A Look At Key 5th Circ. White Collar Rulings So Far This Year
In the first half of 2025, the Fifth Circuit has decided numerous cases of particular import to white collar practitioners, which collectively underscore the critical importance of meticulous recordbuilding, procedural compliance and strategic litigation choices at every stage of a case, says Joe Magliolo at Jackson Walker.
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What US Medicine Onshoring Means For Indian Life Sciences
Despite the Trump administration's latest moves to onshore essential medicine manufacturing, India will likely remain an indispensable component of the U.S. drug supply chain, but Indian manufacturers should prepare for stricter compliance checks, says Jashaswi Ghosh at Holon Law Partners.
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FCA Working Group Reboot Signals EHR Compliance Risk
The revival of the False Claims Act working group is an aggressive expansion of enforcement efforts by the Justice Department and the U.S. Department of Health and Human Services targeted toward technology-enabled fraud involving electronic health records and other data, say attorneys at ArentFox Schiff.
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FDA's Hasty Policymaking Approach Faces APA Challenges
Though the U.S. Food and Drug Administration has abandoned its usual notice-and-comment process for implementing new regulatory initiatives, two recent district court decisions make clear that these programs are still susceptible to Administrative Procedure Act challenges, says Rachel Turow at Skadden.
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The Metamorphosis Of The Major Questions Doctrine
The so-called major questions doctrine arose as a counterweight to Chevron deference over the past few decades, but invocations of the doctrine have persisted in the year since Chevron was overturned, suggesting it still has a role to play in reining in agency overreach, say attorneys at Crowell & Moring.
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A Rapidly Evolving Landscape For Noncompetes In Healthcare
A wave of new state laws regulating noncompete agreements in the healthcare sector, varying in scope, approach and enforceability, are shaped by several factors unique to the industry and are likely to distort the market, say attorneys at Seyfarth.
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Arguing The 8th Amendment For Reduction In FCA Penalties
While False Claims Act decisions lack consistency in how high the judgment-to-damages ratio in such cases can be before it becomes unconstitutional, defense counsel should cite the Eighth Amendment's excessive fines clause in pre-trial settlement negotiations, and seek penalty decreases in post-judgment motions and on appeal, says Scott Grubman at Chilivis Grubman.
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$95M Caremark Verdict Should Put PBMs On Notice
A Pennsylvania federal judge’s recent ruling that pharmacy benefits manager CVS Caremark owes the government $95 million for overbilling Medicare Part D-sponsored drugs highlights the effectiveness of the False Claims Act, as scrutiny of PBMs’ outsized role in setting drug prices continues to increase, say attorneys at Duane Morris.
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DOJ Actions Signal Rising Enforcement Risk For Health Cos.
The U.S. Department of Justice's announcement of a new False Claims Act working group, together with the largest healthcare fraud takedown in history, underscore the importance of sophisticated compliance programs that align with the DOJ's data-driven approach, say attorneys at Debevoise.
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Spotlight On Medicare Marketing Practices Enforcement Trend
Recent U.S. Department of Justice actions, including its recent Medicare kickback allegations in Shea v. eHealth, demonstrate increasing enforcement scrutiny on Medicare Advantage marketing practices, say Ellen London at London & Naor, Li Yu at Bernstein Litowitz and Erica Hitchings at the Whistleblower Law Collaborative.
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Federal Regs Order May Spell Harsher FDCA Enforcement
A recent executive order aimed at reducing criminal prosecutions of those who unknowingly violate complex federal regulations may actually lead to more aggressive felony indictments under the Federal Food, Drug and Cosmetic Act, but companies and executives can mitigate risks by following several key principals, say attorneys at McGuireWoods.
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What High Court's Tenn. Trans Care Ruling Means Nationally
The U.S. Supreme Court's decision in U.S. v. Skrmetti, upholding a Tennessee ban on gender-affirming medical care for minors, is fairly limited in scope and closely tailored to the specific language of Tennessee's law, but it may have implications for challenges to similar laws in other states, say attorneys at Hall Render.
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High Court ACA Ruling May Harm Preventative Care
The U.S. Supreme Court's decision in Kennedy v. Braidwood last week, ruling that the U.S. Department of Health and Human Services secretary has authority over an Affordable Care Act preventive care task force, risks harming the credibility of the task force and could open the door to politicians dictating clinical recommendations, says Michael Kolber at Manatt.