Policy & Compliance

  • February 26, 2026

    $95M Kaiser Row Tees Up Challenge For Fund Returns

    Kaiser Foundation Health Plan’s lawsuit seeking $95 million in coverage for a recently settled whistleblower action raises an important challenge to policy language that limits coverage for claims related to returning funds received from government agencies, as policyholder attorneys call for a broad interpretation of the policy language.

  • February 26, 2026

    Feds Back Pharma In 340B Contract Pharmacy Disputes

    State laws that block drugmakers from imposing restrictions on federally funded hospitals and the contract pharmacies they use to dispense discounted drugs under the 340B drug discount program are violating federal law, the Trump administration said, siding with manufacturers in their bid to strike down these laws.

  • February 25, 2026

    Online Abortion Pill Provider Illegally Ships To Texas, AG Says

    Texas Attorney General Ken Paxton sued Aid Access, its founder and a California doctor in state court Tuesday alleging they operate an "abortion-by-mail enterprise" that ship abortion-inducing drugs to Texas residents, which is endangering the lives of unborn children and their mothers. 

  • February 25, 2026

    White House Cites Fraud, Freezes $259M In Minn. Medicaid

    The Trump administration on Wednesday said it would hold back $259.9 million in Medicaid funding for Minnesota as part of what it called an unprecedented effort to combat fraud in programs that support low-income families.

  • February 25, 2026

    Fla. Court Blocks Doctor Dispensing Rules For Worker Claims

    A Florida panel on Wednesday set aside a state agency's proposed rules that would include doctors in a workers' compensation law that gives patients an "absolute choice" over which pharmacist can fill their prescriptions, saying the proposals go beyond what lawmakers intended.

  • February 25, 2026

    Centene Says Filed Rate Doctrine Dooms RICO, Fraud Claims

    Centene Corp. urged an Illinois federal judge Tuesday to grant it partial judgment in a proposed class action by patients alleging the company violated racketeering laws and cheated them out of billions with bogus policies, arguing the filed rate doctrine bars the refunds they seek for alleged overcharges.

  • February 25, 2026

    Pakistan Native Pleads Not Guilty To $10M Healthcare Fraud

    A native of Pakistan who is living in Texas pled not guilty Wednesday to a Chicago indictment claiming he participated in an alleged $10 million healthcare fraud and money laundering scheme involving fake medical companies that filed claims for items and services they never provided.

  • February 25, 2026

    9th Circ. Rules K-12 Mental Health Grants Must Continue

    The U.S. Department of Education must fund K-12 mental health grants given to public schools to help students cope with school shootings, the Ninth Circuit ruled, denying the agency's emergency request to pause a lower court's permanent injunction pending an appeal. 

  • February 24, 2026

    Ariz., Calif. Lead Suit Over 'Senseless' HHS Vaccine Overhaul

    Arizona and California are leading a coalition of states challenging the U.S. Department of Health and Human Services' decision to cut vaccine recommendations for American children, alleging in a lawsuit Tuesday that the "unprecedented attack" stems from HHS Secretary Robert F. Kennedy Jr.'s "unscientific hostility to vaccines."

  • February 24, 2026

    6th Circ. Affirms Dismissal Of Sotera Toxic Gas Investor Suit

    The Sixth Circuit on Tuesday affirmed a lower court's dismissal of an investor lawsuit accusing Sotera Health Co. of concealing the carcinogenic nature of a gas used at its sterilization plants, finding Sotera did not make any actionable false or misleading statements to investors.

  • February 24, 2026

    Texas Panel Skeptical That Doctor's Hands Are Property

    A Texas appellate court appeared dubious at a claim that a doctor's hands count as personal property in a case accusing a state-owned hospital of healthcare negligence, asking Tuesday what to do with the state Supreme Court's instruction to narrowly construe waivers of sovereign immunity.

  • February 24, 2026

    Abortion Pill Access, Tariff Questions And More In Court

    Law360 Healthcare Authority looks at drugmakers' intervention in federal litigation concerning mail-order abortion medication, questions left open by the U.S. Supreme Court's decision striking down tariffs and other significant litigation developments this week.

  • February 24, 2026

    How To Read FDA's Flip-Flop On Moderna Flu Vaccine

    An unusual FDA reversal on a new flu vaccine is raising alarm bells for health experts and attorneys.

  • February 24, 2026

    Ariz. Bill To Limit 'No Surprises' Arbitration Offers Put On Hold

    A powerful Arizona state lawmaker this week agreed to pause his proposal to establish limits on how much medical providers can seek under the No Surprises Act arbitration system, saying the legislation needs more work and he'll bring it back next year.

  • February 24, 2026

    FDA Expert Panels May Exploit A Legal 'Loophole,' Atty Says

    Law360 Healthcare Authority talks to attorney Joseph Daval about the rise of FDA expert panels, federal law, and blurring the lines between expert and stakeholder.

  • February 24, 2026

    Mallinckrodt's Ch. 11 Blocks Antitrust Payouts, Judge Rules

    A Connecticut federal judge has ruled that drugmaker Mallinckrodt PLC shrugged off monetary claims brought by states in a sprawling generic drug antitrust enforcement action when the company emerged from bankruptcy in 2022.

  • February 24, 2026

    United Wants Partial Fraud Suit Win Against Billing Co.

    TeamHealth has been submitting fraudulent claims to get UnitedHealthcare to overpay it by more than $100 million, the insurer argued as it asked a Tennessee federal judge to grant it a partial early win in its suit against the emergency room staffing and billing company.

  • February 24, 2026

    Philips Unit Escapes CPAP Machine Whistleblower Case

    Philips Respironics, a unit of Koninklijke Philips NV, fended off a whistleblower suit alleging it provided kickbacks to CPAP suppliers that bought its products, with a Pennsylvania federal judge ruling that a former Philips manager failed to show that the company willfully engaged in illegal conduct.

  • February 24, 2026

    PE-Owned Doc Staffing Raises ER Fraud Risk

    As private equity firms scoop up physician staffing companies, healthcare litigators say emergency rooms and referrals are fertile ground for fraud and False Claims Act enforcement.

  • February 24, 2026

    AstraZeneca Drug Price Challenge Falls Short In Hawaii

    A federal judge in Hawaii temporarily upheld the state's law that prevents drug manufacturers from blocking safety-net hospitals from contracting with an unlimited number of outside pharmacies to dispense discounted prescription drugs under the 340B Drug Discount Program. 

  • February 24, 2026

    Mintz Lands IP Pro From Wilson Sonsini In San Francisco

    Mintz Levin Cohn Ferris Glovsky and Popeo PC. announced Tuesday that it has added a patent litigation attorney who was at Wilson Sonsini Goodrich & Rosati PC for more than two decades to bolster its intellectual property division.

  • February 23, 2026

    DC Circ. Talks Sharks, Moats In Vertex HHS Kickback Appeal

    Sharks and moats were top of mind Monday morning for one judge on the D.C. Circuit, as gene therapy drugmaker Vertex Pharmaceuticals attempted to convince the court that its fertility preservation program does not violate the Anti-Kickback Statute.

  • February 23, 2026

    Zynex Faces Securities Suit Following Arrest Of Former Execs

    After being arrested last month on charges of securities fraud and conspiracy, the former CEO and ex-chief compliance officer of bankrupt medical device maker Zynex have been hit with a securities class action that alleges they and others caused the company to engage in fraudulent billing practices that inflated its stock price and led to investor losses once the truth came to light.

  • February 23, 2026

    Ferguson Braswell Adds Healthcare Practice With 2 In Texas

    Ferguson Braswell Fraser Kubasta PC announced Monday that it has opened a healthcare practice with a pair of new shareholders in Houston, expanding the firm's corporate platform.

  • February 20, 2026

    DOJ Says Ohio Health System's Contracts Violate Antitrust

    The U.S. Department of Justice and Ohio's attorney general's office sued OhioHealth Corp. Friday in federal court, accusing the healthcare system of using contractual restrictions to block insurers from offering plans that include lower-cost rivals.

Expert Analysis

  • Trans Care Enforcement Landscape Is Evolving Quickly

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    The recent coordinated federal effort to reshape pediatric gender-affirming care through enforcement and funding pressure has created a rapidly evolving regulatory environment marked by shifting risk assessments and potential downstream market effects for healthcare institutions and life sciences companies, say attorneys at Arnall Golden.

  • 11th Circ. May Bring Tectonic Shift To FCA Qui Tam Actions

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    The Eleventh Circuit's upcoming decision in Zafirov v. Florida Medical Associates, assessing whether the False Claims Act permits ordinary citizens to stand as officers of the federal government, could significantly limit private relators' ability to bring FCA actions, say attorneys at Saul Ewing.

  • To Survive FCA Actions, Small Cos. Must Take Offensive Steps

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    A fumbled response to False Claims Act allegations can doom lower-middle-market businesses, and with FCA enforcement hitting record levels for two years, smaller companies must have offensive strategies ready that focus their limited resources on defeating civil qui tam and federal criminal actions, says Derrelle Janey at Olshan Frome.

  • Record FCA Recoveries Signal Intensified Healthcare Focus

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    In its recently released False Claims Act statistics, the U.S. government's emphasis on record healthcare recoveries and government-initiated healthcare matters last year indicates robust enforcement ahead, though the administration's focus on current policy objectives also extends beyond the healthcare sector, say attorneys at Epstein Becker.

  • A Potential Shift In FDA's Approach To Drug Trial Design

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    Recent guidance released by the U.S. Food and Drug Administration clarifying how Bayesian approaches — which combine prior knowledge with new data — may be used in clinical trials reflects the agency's continued interest in innovative trial designs that may accelerate drug approvals, say attorneys at Alston & Bird.

  • What FDA Guidance Means For Future Of Health Software

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    Two significant final guidance documents released by the U.S. Food and Drug Administration last month reflect a targeted effort to ease innovation friction around specific areas, including singular clinical decision support recommendations and sensor-based wearables, while maintaining established regulatory boundaries, say attorneys at Covington.

  • How State FCA Activity May Affect Civil Fraud Enforcement

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    A growing trend of state attorneys general enforcing their False Claims Act analogues independently of the U.S. Department of Justice carries potential repercussions for civil fraud enforcement and qui tam litigation considerations, say Li Yu at Bernstein Litowitz, Ellen London at London & Naor and Gwen Stamper at Vogel Slade.

  • Wage-Based H-1B Rule Amplifies Lottery Risks For Law Firms

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    Under the wage-based H-1B lottery rule taking effect Feb. 27, law firms planning to hire noncitizen law graduates awaiting bar admission should consider their options, as the work performed by such candidates may sit at the intersection of multiple occupational classifications with differing chances of success, says Jun Li at Reid & Wise.

  • Assessing Compliance Risks Around TrumpRx Participation

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    As there are novel compliance obligations and potential political opposition related to the new TrumpRx online drug platform, companies intending to participate on the site should consider the pressure points that are likely to draw enforcement scrutiny, say attorneys at Sheppard.

  • Predicting Actual Impact From CDC's New Vaccine Guidance

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    Recent federal changes to the childhood immunization schedule, reducing the number of vaccine recommendations from 18 to 11, do not automatically create enforceable obligations for parents, schools or healthcare providers, but may spur litigation and other downstream effects on school policies and state guidelines, says Mehdi Sinaki at Michelman & Robinson.

  • What Rescheduling Means For Cannabis Labels, Marketing

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    The proposed reclassification of cannabis is expected to bring heightened scrutiny of labeling, advertising and marketing from the U.S. Food and Drug Administration and the Federal Trade Commission, but the brands that tighten evidence, standardize operations and professionalize marketing controls now will see fewer surprises and better outcomes, say attorneys at Wilson Elser.

  • What's At Stake In Possible Circuit Split On Medicaid Rule

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    A recent Eleventh Circuit decision, reviving Florida's lawsuit against a federal rule that reduces Medicaid funding based on agreements between hospitals, sets up a potential circuit split with the Fifth Circuit, with important ramifications for states looking to private administrators to run provider tax programs, say Liz Goodman, Karuna Seshasai and Rebecca Pitt at FTI Consulting.

  • Courts' Rare Quash Of DOJ Subpoenas Has Lessons For Cos.

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    In a rare move, three federal courts recently quashed or partially quashed expansive U.S. Department of Justice administrative subpoenas issued to providers of gender-affirming care, demonstrating that courts will scrutinize purpose, cabin statutory authority and acknowledge the profound privacy burdens of overbroad government demands for sensitive records, say attorneys at ArentFox Schiff.