Policy & Compliance

  • March 17, 2026

    9th Circ. Backs Rare FCA Theory In Huge Drug Prices Program

    In a novel and potentially far-reaching decision, the Ninth Circuit on Tuesday revived a major hospital chain's False Claims Act suit accusing large pharmaceutical companies of massive overcharges in a prominent drug discount program where pricing disputes are common.

  • March 17, 2026

    Dr. Oz Claims Florida Also Has Healthcare Fraud Problem

    Dr. Mehmet Oz, the administrator for the Centers for Medicare & Medicaid Services, announced Tuesday that he is taking his efforts to combat healthcare-related fraud to Florida, where he says millions of dollars have been wasted on schemes involving durable medical equipment.

  • March 17, 2026

    Chaperones Alone Not Enough To Prevent Abuse, Sidley Says

    A BigLaw team interviewed more than 120 witnesses as part of an investigation into failures that allowed an OB-GYN to sexually assault patients for 25 years. The report contains broader lessons on how to better protect patients.

  • March 17, 2026

    Ex-Database Administrator Settles OT Claim

    A former database administrator who accused Express Scripts and two other companies of misclassifying him as an independent contractor reached a $30,000 deal with the entities to settle his federal law claim, the parties told a New York federal court.

  • March 17, 2026

    State Lawmakers Take On Practice Limits: 3 Bills To Know

    Law360 Healthcare Authority looks at some of the latest moves by state lawmakers to relax practice restrictions in Florida, New York and Minnesota.

  • March 17, 2026

    Bipartisan Bill To Waive $100K H-1B Fee Gets AMA Backing

    Medical organizations and a bipartisan group of lawmakers are backing federal legislation introduced Tuesday that would exempt physicians and other healthcare workers from the Trump administration's $100,000 fee on H-1B visas.

  • March 16, 2026

    1st Circ. Affirms Block Of Trump's 'Unprecedented' Aid Freeze

    The First Circuit on Monday mostly upheld a lower court's order blocking the Trump administration from enacting a "sweeping and unprecedented categorical 'freeze' of federal financial assistance," ruling that the states involved in the suit will likely successfully show that the federal government acted arbitrarily and capriciously.

  • March 16, 2026

    Judge Tosses Kaiser Whistleblowers' Claims After $556M Deal

    A California federal court on Monday officially dismissed False Claims Act lawsuits from the federal government and three people alleging that Kaiser Permanente affiliates engaged in Medicare fraud, on the heels of Kaiser's $556 million settlement reached in January.

  • March 16, 2026

    Mich. Jury Awards $10M To Med Resident Fired During Leave

    A Michigan state jury has awarded more than $10 million to a former medical student who said she was fired from a hospital's OB-GYN residency program after being forced to take a required licensing exam while on maternity leave.

  • March 16, 2026

    HHS' Childhood Vaccine Policy Changes Put On Ice

    A Massachusetts federal judge on Monday blocked the Trump administration's modified childhood vaccine schedule and put all decisions made by Health Secretary Robert F. Kennedy Jr.'s federal vaccine policy committee on hold, finding they veered sharply from normal procedure and likely violated the law.

  • March 16, 2026

    Mass. City Accused Of Bias In Mental Health 911 Response

    The city of Worcester, Massachusetts, was hit with a suit Monday claiming that its 911 response is inadequate and discriminatory towards people with mental disabilities because the armed police who usually show up are ill-equipped to deal with those calls and often make matters worse.

  • March 13, 2026

    'Swinging Dicks' Dissent Stirs Uproar Across 9th Circ. Bench

    A raunchy dissent in litigation over transgender spa patrons prompted dozens of Ninth Circuit judges to denounce the "vulgar barroom talk" of a colleague, who returned fire by ridiculing his peers for adopting the "fastidious sensibilities of a Victorian nun."

  • 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.

Expert Analysis

  • Federal Grantees May Soon Face More Limitations On Speech

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    If courts accept the administration’s new interpretation of preexisting case law, which attempts to graft onto grant recipients the existing limitations on government contractors' free speech, a more deferential standard may soon apply in determining whether an agency’s refusal or termination of a grant was in violation of the First Amendment, say attorneys at Venable.

  • HHS Wound Care Report Highlights Need For Payment Reform

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    The U.S. Department of Health and Human Services' recent report on potential abuse in Medicare Part B payments for skin substitutes highlights specific fraud schemes, but more importantly emphasizes that broader changes are needed for the wound care sector's fundamentally flawed payment system, say attorneys at Paul Hastings.

  • Assessing The Future Of The HIPAA Reproductive Health Rule

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    In light of a Texas federal court's recent decision to strike down a U.S. Department of Health and Human Services rule aimed to protect the privacy of patients seeking abortions and gender-affirming care, entities are at least temporarily relieved from compliance obligations, but tensions are likely to continue for the foreseeable future, says Liz Heddleston at Woods Rogers.

  • DOJ's Tracing Rule For Pandemic Loan Fraud Is Untenable

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    In conducting investigations related to COVID-19 relief fraud, the government's assertion that loan proceeds are nonfungible and had to have been segregated from other funds is unsupported by underlying legislation, precedent or the language establishing similar federal relief programs, say Sharon McCarthy, Jay Nanavati and Lasya Ravulapati at Kostelanetz.

  • New Health AI Guidance Features A Provider-Centric Approach

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    New guidance from the Joint Commission and Coalition for Health AI regarding the responsible use of artificial intelligence in healthcare deviates from preexisting guidance by recommending a comprehensive framework for using AI tools, focusing on healthcare provider organizations rather than on AI developers, say attorneys at Ropes & Gray.

  • Mass. Ruling May Pave New Avenue To Target Subpoenas

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    A Massachusetts federal court’s recent decision to quash a subpoena seeking information on gender-affirming care at Boston Children’s Hospital is a significant departure from courts' deferential approach to subpoena enforcement, and may open a new pathway for practitioners challenging investigative tools in the future, say attorneys at Gibson Dunn.

  • What To Expect After FDA Warnings To GLP-1 Compounders

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    The U.S. Food and Drug Administration's recent warning letters to companies advertising compounded versions of GLP-1 medications raise questions not just about the enforcement outlook for marketing such products, but also about the future of drug compounding as a whole, say attorneys at Spencer Fane.

  • How Financial Cos. Can Prep As NYDFS Cyber Changes Loom

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    Financial institutions supervised by the New York State Department of Financial Services can prepare for two critical cybersecurity requirements relating to multifactor authentication and asset inventories, effective Nov. 1, by conducting gap analyses and allocating resources to high-risk assets, among other steps, say attorneys at Pillsbury.

  • How Courts May Interpret Data-Driven Healthcare Fraud Suits

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    As the U.S. Department of Justice and other agencies increasingly turn to data mining as an enforcement tool, courts will have to determine how far data alone can take a fraud case, and sound theory, clinical expertise and institutional context will play an important role, say Jaime Jones at Sidley and Andrée-Anne Fournier and Atang Gilika at Analysis Group.

  • How Gov't Shutdown Will Affect Federal Health Agencies

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    Federal health agencies' contingency plans indicate that many major programs will remain insulated from disruption during the ongoing government shutdown, but significant policy proposals will likely be delayed and the Trump administration's emphasis on reduction-in-force plans distinguishes this shutdown from past lapses, says Miranda Franco at Holland & Knight.

  • Assessing Legal, Regulatory Hurdles Of Healthcare Offshoring

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    The offshoring of administrative, nonclinical functions has emerged as an increasingly attractive option for healthcare companies seeking to reduce costs, but this presents challenges in navigating the web of state restrictions on the access or storage of patient data outside the U.S., say attorneys at McDermott.

  • 5 Years In, COVID-19 Fraud Enforcement Landscape Is Shifting

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    As the government moves pandemic fraud enforcement from small-dollar individual prosecutions to high-value corporate cases, and billions of dollars remain unaccounted for, companies and defense attorneys must take steps now to prepare for the next five years of scrutiny, says attorney David Tarras.

  • Courts Keep Upping Standing Ante In ERISA Healthcare Suits

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    As Article III standing becomes increasingly important in litigation brought by employer-sponsored health plan members under the Employee Retirement Income Security Act, several recent cases suggest that courts are taking a more scrutinizing approach to the standing inquiry in both class actions and individual matters, say attorneys at Crowell & Moring.