Policy & Compliance
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January 23, 2025
Georgia Pain Doctor To Pay Feds $3.5M In FCA Settlement
A Georgia doctor and his pain management clinic have agreed to pay $3.5 million to end a yearslong civil probe into False Claims Act allegations of billing fraud and violations of opioid prescription protocols, the U.S. Department of Justice said Thursday.
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January 23, 2025
Conn. Lawmakers Target Healthcare After Hospital's Ch. 11
In the lead-up to and aftermath of California hospital operator Prospect Medical Holdings Inc.'s $1 billion bankruptcy, Connecticut lawmakers are considering new regulatory powers, promising and penning oversight bills for hospitals owned by private equity firms and real estate trusts while seeking to stabilize the state's healthcare markets.
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January 23, 2025
UnitedHealthcare Settles Proton Beam Coverage Suit
UnitedHealthcare has agreed to resolve a proposed class action claiming it unlawfully denied coverage of a proton beam cancer treatment after wrongly labeling it as experimental, the insurance company and plan participants told a Massachusetts federal court.
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January 23, 2025
15 States Reach $7.4B Settlement With Sackler Family
A bipartisan coalition of states on Thursday announced a $7.4 billion settlement in principle with the Sackler family and their company Purdue Pharma Inc., representing the largest settlement to date with the family accused of contributing significantly to the opioid epidemic.
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January 22, 2025
RFK Filings Show Biopharma Stakes, Millions In Firm Income
Robert F. Kennedy Jr. plans to sell off his stakes in two biopharmaceutical companies and step back from lucrative roles at a handful of law firms if he is confirmed to lead the U.S. Department of Health and Human Services, according to new financial disclosures.
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January 22, 2025
Med Mal Experts Need Only 1 Specialty, NJ Justices Rule
When a doctor accused of malpractice has more than one specialty, the plaintiff needs only to produce an affidavit of merit from a physician who is certified in one of the specialties, the New Jersey Supreme Court ruled Wednesday, overturning a state appellate court ruling.
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January 22, 2025
Wash. City Beats Fired Workers' Suit Targeting Vax Mandate
A Washington federal judge tossed a suit brought by city workers claiming they were illegally fired for opposing a COVID-19 vaccine mandate, ruling that the city they worked for didn't violate any of their rights by requiring them to get immunized or lose their jobs.
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January 22, 2025
Feds Trim Spine-Implant Kickback Case Ahead Of Trial
A Massachusetts federal judge has granted a motion by prosecutors to drop bribery charges against a maker of spinal implant devices and whittle down the case against two of its former executives.
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January 22, 2025
Logistics Cos. Say Workers' Tobacco Fee Suit Filed Too Late
A pair of logistics companies are asking a Connecticut federal court to throw out a proposed class action alleging they violated federal law by not fully reimbursing employees who paid an additional tobacco-use fee on their healthcare, saying all the claims in the suit are barred by statutes of limitation.
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January 21, 2025
4th Circ. Won't Undo Doctor's Conviction For Reusing Devices
A former North Carolina ear, nose and throat doctor staring down 25 years in prison for healthcare fraud lost an appeal Tuesday seeking to overturn her conviction, with the Fourth Circuit finding that the lower court did not commit any reversible error that would favor a shot at redemption.
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January 21, 2025
What To Know About Trump's Medicare Drug Price Order
In his first day in office, President Donald Trump rescinded a Biden directive for health officials to create new drug-pricing models for Medicare and Medicaid recipients. Here's what you need to know about the status of the pricing plans and what comes next.
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January 21, 2025
Minn. Agency Beats Worker's COVID Testing Policy Suit
A Minnesota state agency defeated a Catholic employee's lawsuit claiming it unlawfully refused to grant him a religious exemption from its COVID-19 vaccination and testing policies, with a federal judge ruling Tuesday that the worker had failed to show the agency knew about his religious objections.
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January 21, 2025
Outgoing HHS Official On The Thorny Issues Of Child Welfare
In an interview with Law360 Healthcare Authority, the now-former head of HHS' Administration on Children, Youth, and Families stresses the importance of preventive services and weighs in on the promise and perils of mandated reporting laws.
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January 21, 2025
DACA Health Coverage, Gilead IP Deal And PBM Insulin Case
Several state attorneys general are looking to defend immigrants' Affordable Care Act coverage, while a group of pharmacy benefit managers failed to oust the FTC's Democratic members from a case alleging collusion to inflate insulin prices. Law360 Healthcare Authority looks at the cases and decisions that shaped the industry over the last week.
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January 21, 2025
With Circuits Split, Mass. Judge Backs Tough Fraud Standard
An influential judge with a history of shaping False Claims Act litigation weighed in decisively on a debate that has split circuit judges and may eventually reach the Supreme Court. Attorneys across the country are evaluating the impact.
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January 17, 2025
Law360 Names Practice Groups Of The Year
Law360 would like to congratulate the winners of its Practice Groups of the Year awards for 2024, which honor the attorney teams behind litigation wins and significant transaction work that resonated throughout the legal industry this past year.
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January 17, 2025
Law360 Names Firms Of The Year
Eight law firms have earned spots as Law360's Firms of the Year, with 54 Practice Group of the Year awards among them, steering some of the largest deals of 2024 and securing high-profile litigation wins, including at the U.S. Supreme Court.
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January 17, 2025
Unified Care Services To Pay $18M To Settle PPP Case
Skilled nursing chain Unified Care Services LLC and its owner have agreed to shell out $18 million to put to rest a whistleblower suit alleging the California-based company and its affiliates knowingly included false information on Paycheck Protection Program loan applications, according to an announcement made Friday.
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January 17, 2025
Walgreens Knowingly Filled Invalid Prescriptions, Feds Say
The U.S. Department of Justice has accused Walgreens of knowingly filling millions of prescriptions for opioids and other controlled substances that did not have a legitimate medical purpose or were not valid, intervening in cases brought by four whistleblowers in Illinois federal court.
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January 17, 2025
Bayer, J&J Minimized Drug Reaction Data, 3rd Circ. Told
A doctor urged the Third Circuit on Friday to revive his whistleblower suit against Bayer Corp. and Johnson & Johnson, arguing that the drugmakers' regulatory approval applications played down the side effects of the antibiotics Cipro and Levaquin.
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January 17, 2025
MultiPlan Wants Antitrust Claims Over Pricing Tools Tossed
MultiPlan and several major insurance companies urged an Illinois federal court to toss claims that they schemed to fix reimbursement rates, saying the pricing tools at issue do not hurt the healthcare providers that are bringing the case.
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January 17, 2025
Trade Group Sues To Stop Federal Mental Health Parity Regs
A benefits-focused employer trade group sued the U.S. Department of Labor and other federal agencies in D.C. federal court Friday, seeking to block recently finalized mental health parity regulations the group alleges are unconstitutional and violate administrative procedure laws.
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January 17, 2025
4 Battles Over Gender-Affirming Care To Watch In 2025
The U.S. Supreme Court will rule on the federal government's challenge to Tennessee's ban on gender-affirming care for minors, and the Eleventh Circuit is considering a bid to upend federal rules extending the Affordable Care Act's nondiscrimination protections to transgender patients. Here, Law360 looks at four cases that could have ramifications for benefits law in 2025.
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January 17, 2025
1st Circ. Revives Biotech Worker's COVID-19 Vax Challenge
The First Circuit on Thursday resuscitated religious discrimination claims brought by a former pharmaceutical company employee who alleged her employer's COVID-19 vaccination mandate during the pandemic was in conflict with her sincerely held religious beliefs.
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January 16, 2025
Texas Judge Says 3 States Can Pursue Mifepristone Suit
A Texas federal judge said Thursday that Idaho, Missouri and Kansas can continue to challenge federal approvals for the abortion medication mifepristone in Texas federal court after private plaintiffs dropped their claims.
The Legal And Practical Questions Around Trump's WHO Exit
President Donald Trump’s first-day order setting in motion the United States’ withdrawal from the World Health Organization could leave the nation less prepared for global health threats and trigger legal clashes over the president’s authority to act unilaterally.
Whistleblowing Compliance Pro Secures 4th FCA Settlement
A repeat whistleblower has cost hospitals more than $43 million in federal settlements over the last 18 years, illustrating the increased use of data analysis and other trends in False Claims Act litigation.
Child Advocates Push For Mandatory Reporting Law Reform
An effort to reform mandatory reporting laws for suspected child abuse or neglect is gaining momentum amid concerns that too many families are being needlessly entangled in welfare investigations.
Expert Analysis
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Takeaways From FDA's Updated Confirmatory Trial Guidance
The U.S. Food and Drug Administration's latest draft guidance about accelerated drug approval indicates the FDA's intent to address the significant lag time between accelerated approval and full approval of drugs and may help motivate the industry to complete confirmatory trials, say attorneys at Sheppard Mullin.
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A Look At FDA's Plans To Establish New OTC Drug Category
The U.S. Food and Drug Administration's recently finalized rule, creating a new over-the-counter pathway for drugs when patients satisfy certain conditions, may be useful for off-patent drugs with established safety records, though switching to OTC comes with additional costs and considerations, say attorneys at Skadden.
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2024 Was A Significant Year For HIPAA Compliance
The Office of Civil Rights' high level of Health Insurance Portability and Accountability Act activity in 2024 and press releases about its specific focus on certain cybersecurity issues make it abundantly clear that the OCR is not going to tolerate widespread compliance complacency, says Nathan Kottkamp at Williams Mullen.
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How 2025 NDAA May Affect DOD Procurement Protests
A bid protest pilot program included in the 2025 National Defense Authorization Act shifts litigation costs onto unsuccessful bid protesters and raises claim-filing thresholds, which could increase risks to U.S. Department of Defense contractors who file protests, and reduce oversight of DOD procurement awards, say attorneys at Venable.
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Top 10 Noncompete Developments Of 2024
Following an eventful year in noncompete law at both state and federal levels, employers can no longer rely on a court's willingness to blue-pencil overbroad agreements and are proceeding at their own peril if they do not thoughtfully review and carefully enforce such agreements, say attorneys at Faegre Drinker.
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What 2024 Tells Us About Calif. Health Transaction Reviews
Looking back at the California Office of Health Care Affordability's first year accepting notices for material healthcare transactions reveals critical lessons on what the OHCA's review process may mean for the future of covered transactions in the state, say attorneys at Ropes & Gray.
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Updated HIPAA Rule Is A Necessary Step For Data Protection
The U.S. Department of Health and Human Services' updated rules addressing cybersecurity threats in healthcare will necessitate significant investment in technology, training and compliance infrastructure, but are an essential evolution in safeguarding data in an increasingly digital world, say attorneys at Clark Hill.
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Courts Must Curb The Drug Price Negotiation Program
The Inflation Reduction Act's drug price negotiation program upends incentive structures that drive medical innovation, and courts must act appropriately to avoid devastating consequences for American healthcare and the pharmaceutical industry, says Jeff Stier at the Consumer Choice Center.
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The OIG Report: Preparing For Oversight In 2025
Across sectors, Office of Inspector General work plans and challenge reports for 2025 provide a trove of information on the issues and industries that will likely be the focus of government oversight in the year to come, says Diana Shaw at Wiley.
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5 Drug And Device Developments That Shaped 2024
The last year saw significant legal developments affecting drug and device manufacturers, with landmark decisions and regulatory changes that require vigilance and agility from the industry, say attorneys at Faegre Drinker.
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How New Fraud Enforcement Tool Affects Gov't Contractors
Government contractors will likely face greater scrutiny under the recently enacted Administrative False Claims Act, which broadens federal agencies' authority to pursue low-dollar fraud claims, but contractors may also find the act makes settlement of such claims easier to negotiate, say attorneys at Wiley.
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Consultants Should Be Aware Of DOJ's Potential New Reach
The U.S. Department of Justice's recent first-of-its-kind settlement with McKinsey & Co. indicates not only the DOJ's more aggressive stance toward businesses' potential criminal wrongdoings, but also the benefits of self-disclosure and cooperation when wrongdoing becomes apparent, says Dom Caamano at Kibler Fowler.
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Health Tech Regulatory Trends To Watch In 2025
With an upcoming change in administration and the release of some long-awaited rules, the healthcare industry should prepare for shifting trends, including a growing focus on health data and interest in technology-enabled delivery of healthcare, say attorneys at Orrick.