Policy & Compliance

  • August 18, 2026

    At DC Circ., Pharma's Latest Pricing Loss Has Silver Linings

    The pharmaceutical industry's far-flung crusade against Medicare's new negotiation powers suffered a fresh setback Tuesday as the D.C. Circuit joined sister circuits in upholding the landmark pricing program, but the defeat contained consolation prizes that will fuel further litigation.

  • August 18, 2026

    Ex-NFL Player Sues Disability Benefits Plan Over Denial

    A former National Football League player who reportedly suffered brain injuries from nearly two decades of playing the sport hit the league's disability benefit plan with a lawsuit Tuesday, telling a Maryland federal judge that the plan wrongfully denied his application for total and permanent disability benefits despite his own doctor's diagnosis.

  • August 18, 2026

    Courts Rule On DOJ Trans Care Subpoena, Abortion And More

    Law360 Healthcare Authority looks at a split Ninth Circuit decision backing the U.S. Department of Justice's administrative subpoena of a gender-affirming care provider, a Seventh Circuit ruling preserving Planned Parenthood's ability to providing referrals to out-of-state abortion care and other rulings impacting the healthcare industry this week.

  • August 18, 2026

    Iowa Board Opens Door For Doctor Self-Defense Arguments

    An Iowa medical board's decision to dismiss disciplinary charges against a doctor who claimed the state's "stand your ground" law enabled him to defend himself against a violent patient could open the door to other providers protecting themselves from lawsuits on similar grounds, experts say.

  • August 18, 2026

    DOJ Targets Small Pharmacies With Novel FCA Claims

    The Justice Department in recent weeks has indicated that it's willing to use the False Claims Act to bring stronger charges and levy stiffer fines against smaller pharmacies accused of violating controlled substances laws by contributing to the opioid crisis, legal experts say.

  • August 18, 2026

    Aetna Says It Doesn't Use Repricing Tools In Antitrust Case

    Aetna Inc. urged a Massachusetts federal court to toss it from an antitrust case accusing insurance companies of using repricing tools to reduce reimbursements paid to healthcare providers, arguing that a subsidiary, not Aetna, used the tools at issue.

  • August 18, 2026

    NC Doc Gets Prison For Opioid Recovery Prescription Scheme

    A federal judge has sentenced a North Carolina doctor to half a year in prison for letting administrative staff at a nonprofit where he worked as medical director use his credentials to prescribe the opioid use disorder medication buprenorphine to thousands of patients.

  • August 18, 2026

    Marriott Gets Trim Of Worker's Tobacco Health Fee Suit

    A Maryland federal judge on Tuesday refused to completely toss a Marriott worker's proposed class action alleging the hotel giant's $15 weekly health fee on employees who use tobacco violated federal benefits law, but trimmed the dispute of some claims as insufficiently backed up. 

  • August 18, 2026

    What To Know: AMA Faces Medical Coding Copyright Suit

    A healthcare transparency group is asking a judge for permission to publish the medical codes that help determine the billing for medical procedures, setting up a confrontation with the American Medical Association, which developed the coding system. Here, Law360 takes a closer look at the case and the broader transparency debate.

  • August 17, 2026

    Albertsons Judge Hears $44B Opioid Abatement Plan In Wash.

    Addressing harm caused by prescription opioid abuse in Washington would cost nearly $44.4 billion, an expert testified Monday during a bench trial in the state's case accusing Albertsons and its Safeway subsidiary of exacerbating Washington's overdose crisis by failing to curb the flow of controlled substances.

  • August 17, 2026

    Blue States Say FTC Can't Regulate Trans Youth Health

    A group of left-leaning states, including Massachusetts and California, asked a Texas federal court to toss a Federal Trade Commission suit against the World Professional Association for Transgender Health, saying Monday that the FTC's suit constitutes a "federal attack on state-regulated transgender healthcare."

  • August 17, 2026

    AIG Exclusion Doesn't Bar Multiplied Damages, Judge Says

    A California federal judge in a narrow ruling declared that a portion of Kaiser Foundation Health Plan's insurance policy does not automatically bar coverage for a portion of a $581 million False Claims Act settlement attributable to multiplied damages, but will decide later whether the agreement actually included such damages. 

  • August 17, 2026

    Hospital Employees Seek Class Cert. In Retirement Funds Suit

    Employees of a faith-based nonprofit Colorado hospital urged a federal judge to grant class certification in their lawsuit alleging the hospital mismanaged employees' retirement funds and ultimately cost participants tens of millions of dollars.

  • August 17, 2026

    Mass. Judge Vacates ACA Gender-Affirming Care Restriction

    A Massachusetts federal judge handed a coalition of 21 states a win on their claim that the U.S. Department of Health and Human Services unlawfully issued Affordable Care Act reforms barring marketplace plans from requiring coverage for medical procedures used in gender-affirming care.

  • August 17, 2026

    7th Circ. Reverses Alcoa Union Retirees' Lifetime Benefits Win

    The Seventh Circuit reversed an Indiana federal court's decision holding that certain union retirees of aluminum giant Alcoa and their beneficiaries had a vested right to health benefits for life, finding error with the lower court's judicial estoppel analysis that formed the basis for its judgment on liability.

  • August 14, 2026

    AstraZeneca Joins States Aiming To Block Ill. 340B Drug Law

    AstraZeneca on Friday joined some other large pharmaceutical companies in urging an Illinois federal court to block a new state law that prohibits drugmakers from restricting the types or number of pharmacies healthcare providers can contract with to provide medications under a federal discount drug program.

  • August 14, 2026

    United, Ga. Providers Settle Out-Of-Network Benefits Pay Fight

    United Healthcare has settled claims that three Georgia medical providers that are outside the insurer's network requested "exorbitantly high" reimbursements for care provided to United customers, according to documents filed in Georgia federal court.

  • August 14, 2026

    NC County Sues Bankrupt Hospital Operator For $10M

    North Carolina's Martin County has sued CHS/Community Health Systems Inc. for $10 million in North Carolina federal court, alleging the company failed to honor its obligations to run Martin General Hospital after its affiliate filed for Chapter 7 in 2023.

  • August 14, 2026

    Idaho Abortion Ban Needs Health Exceptions, Judge Finds

    An Idaho federal judge barred the state from criminalizing abortions in cases where continuing a pregnancy puts a patient at risk of lasting harm or death via self-harm, finding that the 14th Amendment establishes a fundamental right to health- and life-preserving abortion care.

  • August 13, 2026

    Albertsons Didn't Flag Suspicious Opioid Orders, Judge Hears

    Albertsons failed to report its pharmacies' unusual opioid orders to the U.S. Drug Enforcement Administration despite explicit instructions from the agency to do so, the retailer's vice president of pharmacy compliance testified Thursday during a bench trial in Washington's lawsuit accusing the chain of exacerbating the state's opioid epidemic.

  • August 13, 2026

    Blue Cross Affiliates Get Trim Of Aramark Health Benefits Row

    A Pennsylvania federal judge on Thursday trimmed but refused to toss a federal benefits lawsuit from food service giant Aramark against a Blue Cross affiliate that administered the company's employee health benefit plans, opening discovery on allegations that improper claims management cost tens of millions and breached fiduciary duties.

  • August 13, 2026

    J&J Says No To Reviving Stelara Case

    Johnson & Johnson has asked the Fourth Circuit not to revive CareFirst's antitrust suit alleging the company tried to monopolize the market for the immunosuppressive drug Stelara.

  • August 13, 2026

    Wash. Halts Conversion Therapy Ban For Therapist Amid Suit

    Washington state has agreed not to enforce its ban on a practice commonly known as conversion therapy against a therapist while his First Amendment challenge to the prohibition plays out in federal court, according to a stipulation entered Thursday.

  • August 13, 2026

    Vaccine Challengers Slam Connecticut's 'One-Party Rule'

    Challengers to Connecticut's mandatory school vaccination laws have accused political leaders of exercising "one-party rule" over state government, claiming the House speaker, governor and attorney general, who are all Democrats, tweaked or defended state laws specifically to stymie their religious freedom claims.

  • August 13, 2026

    Employers Expecting Bump In Health Plan Costs, Survey Says

    GLP-1 medications and catastrophic coverage claims are two leading factors employers anticipate will push health plan costs up 10% in 2027, according to new data released Thursday by the International Foundation of Employee Benefit Plans.

Expert Analysis

  • How Home Infusion Providers Can Adapt To Enrollment Pause

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    Recent Centers for Medicare & Medicaid Services moratoria on new enrollments of home health agencies, medical equipment companies and hospices make home infusion providers' compliance obligations more complex and ambiguous, requiring new careful consideration of specific enrollment requirements and limitations, say attorneys at Quarles & Brady.

  • AI Data Mining Is Changing FCA Enforcement

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    With False Claims Act investigations increasingly emerging from statistical anomalies identified by data miners, companies need to consider what conclusions an outsider armed with artificial intelligence might draw from public-facing data and be ready to explain any anomalies if questions arise, say attorneys at Cohen & Gresser.

  • Lessons From 5 Months Of DOJ Corporate Policy Deals

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    Recent declinations and prosecution agreements between the U.S. Department of Justice and corporations since the March unveiling of the corporate enforcement and voluntary disclosure policy provide takeaways for management considering how to respond to corporate misconduct, says Brendan Quigley at Baker Botts.

  • A New Era Of Scrutiny For China-Linked Pharma Deals

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    As Congress considers bipartisan legislation that would heighten regulatory scrutiny for life sciences deals involving Chinese biotech entities, companies should reassess the risks and due diligence requirements that will come with using heavily China-dependent pipelines, says Jen Maki at Ankura.

  • Justices' FTC Ruling Weakens Qui Tam's Constitutional Base

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    The U.S. Supreme Court’s holding in Trump v. Slaughter, expanding presidential control over those exercising executive power, suggests that courts may be receptive to arguments challenging the constitutional foundations of the False Claims Act’s qui tam mechanism, says Daniel Passeser at Wiggin.

  • Calif. Drug Ruling Affirms Defect-Centric Liability Framework

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    The California Supreme Court's decision in Gilead Tenofovir Cases this week rejects a novel duty-to-innovate theory of negligence that could have reshaped product liability exposure well beyond the pharmaceutical industry, instead signaling that negligence claims premised on nondefective products are unlikely to succeed, say attorneys at Dechert.

  • DOJ's FCA Push Creates Risks For Construction Contractors

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    The construction industry may be uniquely vulnerable to a new generation of False Claims Act enforcement driven by the U.S. Department of Justice's increasing usage of the FCA to target a much broader category of conduct than it has in decades past, specifically compliance certifications and regulatory representations, say attorneys at Cozen O'Connor.

  • Feds' Mixed Cues On Medicaid Fraud Signal States To Step Up

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    While the federal government has recently delivered four distinct and mutually inconsistent messages regarding Medicaid fraud enforcement, states should focus on improving enforcement, regardless of which federal posture proves correct, says Ken Levine at Stone & Magnanini.

  • A Shift In How Policymakers Are Approaching PBM Regulation

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    Recent federal and state legislative and regulatory activity involving pharmacy benefit managers represent a change in focus from transparency to PBM compensation structures, vertical integration and competitive effects, say attorneys at Barclay Damon.

  • Workplace Menopause Laws Demand New HR Playbooks

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    A recent wave of state and local legislation that makes menopause an expressly protected condition in the workplace creates new compliance obligations amid an already ambiguous federal framework, and demands a workplace culture where employees feel safe asking for support, says Elliot Griffin at Ballard Spahr.

  • States Should Reconsider Forced PBM Divestiture Laws

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    State legislatures are attempting to enact policies intended to force pharmacy benefit managers to divest from pharmacies, but these laws would have the practical effect of reducing patient access and competition, potentially violating the U.S. Constitution in the process, says former Utah Attorney General John Swallow.

  • Noncompete Laws Show States Focusing On Bans, Healthcare

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    The first half of 2026 confirms that state legislatures are driving the most consequential changes in noncompete law, including a few state bans and several healthcare-specific laws, making a one-size-fits-all approach increasingly untenable for multistate employers, say attorneys at Faegre Drinker.

  • Where The Justices Aligned In Appellate Authority Ruling

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    The real story of the U.S. Supreme Court’s recent ruling in T.M. v. University of Maryland Medical System Corp., finding that a doctrine designed to curtail duplicative litigation prevents federal district courts from reviewing state court decisions, is in how the justices together revisited an obscure, century-old jurisdictional doctrine, says Alex Dimitrief at Zeughauser Group.