Policy & Compliance

  • April 01, 2024

    Cigna Can't Escape Patients' ERISA Fight Over Claim Rates

    A Connecticut federal judge agreed to trim a federal benefits lawsuit against Cigna alleging the company underpaid claims from providers who indirectly contracted with the insurer, finding allegations from participants in employer-sponsored health plans could proceed to discovery but that several medical associations lacked standing to sue.

  • April 01, 2024

    Fla. Justices Uphold Abortion Ban, Approve Pro-Choice Ballot Measure

    The Florida Supreme Court on Monday upheld a 15-week abortion ban in the state while also approving an initiative to preserve abortion access for placement on the ballot in November, leaving it to voters to decide the state's post-Dobbs future.

  • April 01, 2024

    Amazon's Disability Inclusion Efforts A Sham, Suit Says

    Amazon's stated commitments to disability inclusion are a sham, a California worker with cerebral palsy claimed in a proposed class action, saying the company gave him a warehouse gig despite his many warnings that he couldn't meet the job's physical demands.

  • March 29, 2024

    Calif. Justices Rule Living Wills Not A Path To Arbitration

    The California Supreme Court has unanimously ruled that an advance healthcare directive, or living will, does not permit a designated power of attorney to opt into arbitration on a patient's behalf, a decision that, while blessed by consumer groups, left some in the medical community "pretty disappointed."

  • March 29, 2024

    Hogan Lovells Vet's High Court Debut A Study In Contrasts

    Several weeks ago, when a Hogan Lovells lawyer finally delivered U.S. Supreme Court arguments after 20 years at the firm, she parsed arcane arbitration issues and her words weren't widely heard outside the courtroom. But weeks later and back at the high court podium, her words were heard nationwide when she pointedly spotlighted a judge's use of "anonymous blog posts" in a bombshell abortion ruling.

  • March 29, 2024

    Home Depot Asks High Court To Block $2.67B BCBS Deal

    Home Depot has asked the U.S. Supreme Court to take up its challenge of a $2.67 billion settlement in antitrust litigation targeting Blue Cross Blue Shield, saying the deal immunizes activity that hurts competition.

  • March 29, 2024

    Ohio Abortion Providers File Suit Over 24-Hour Wait Period

    A group of Ohio organizations filed a lawsuit Friday on behalf of abortion providers in the state, arguing certain longstanding abortion regulations violate amendments made to the state's constitution in November that protect access to abortion care.

  • March 29, 2024

    Retired Sidley Austin Atty Joins Pharma Group's Case

    A former Sidley Austin LLP attorney said Thursday that he is coming out of retirement to work for a pharmaceutical coalition in its push for protection from anti-kickback restrictions in a federal lawsuit.

  • March 28, 2024

    Medical Lab Inks $2.1M Deal To End NC's False Claims Probe

    A North Carolina lab will pay back $2.1 million to the state's Medicaid program after settling an investigation into how it charged the public health program for tests, the state attorney general's office announced Thursday.

  • March 28, 2024

    9th Circ. Won't Let Cigna Patients Appeal Class Cert. Denial

    The Ninth Circuit won't let a group of Cigna plan participants immediately appeal a trial court's rejection of class status in their lawsuit accusing the insurance giant of unlawfully colluding with its billing contractor to underpay out-of-network claims for mental health treatments.

  • March 28, 2024

    Implant Maker's Bribe Case Ripe For Trimming, Judge Says

    A money laundering charge levied against implant manufacturer SpineFrontier Inc. and its executives may be dropped from the broader bribery and kickback prosecution as a Boston federal judge Thursday struggled to square up how the company could have allegedly concealed the unlawful transfers to surgeons while also disclosing them publicly.

  • March 28, 2024

    Doctor Allowed To Withdraw NBA Fraud Plea, Gets June Trial

    A Manhattan federal judge will allow a Seattle-area doctor to pull back his guilty plea and go to trial in June, against prosecutors' objections, in a case alleging he assisted a cohort of retired NBA players to create fake invoices to submit to the league's healthcare plan.

  • March 28, 2024

    Grading Garland: Attys Give AG Mixed Reviews 3 Years In

    U.S. Attorney General Merrick Garland's name won't be on the ticket in November, but his performance three years into his tenure is a subplot in the 2024 presidential election.

  • March 28, 2024

    Feds Finalize Restraints On Short-Term Health Insurance

    President Joe Biden's administration finalized regulations Thursday that shrink the window for short-term, limited-duration health insurance from three years to no more than four months, but it backed off more sweeping changes from its July proposal that would have affected fixed indemnity insurance.

  • March 28, 2024

    Romney Tells DEA Pot Review Must Heed Treaty Obligations

    Sen. Mitt Romney, R-Utah, on Wednesday expressed skepticism about federal health regulators' recommendation to loosen marijuana restrictions and pressed the U.S. Drug Enforcement Administration to explain how it would consider the drug's status in light of U.S. treaties.

  • March 27, 2024

    Idaho AG Won't Defend Abortion Stance, Confusing 9th Circ.

    The Idaho solicitor general insisted at a hearing before the Ninth Circuit Wednesday that the state's attorney general isn't "trying to be cute" by refusing to defend his expansive interpretation of Idaho's abortion ban in front of a baffled appellate panel.

  • March 27, 2024

    Ill. Court Revives Med Mal Suit Over Gauze Left In Sinus

    An Illinois appeals court has revived a woman's suit against her doctor and SIU Physicians & Surgeons Inc. over gauze that she alleges was negligently left in her sinuses after a procedure, finding there's a factual dispute over when the woman found out about the gauze.

  • March 27, 2024

    BCBS Can't Escape Therapy Coverage Suit

    A North Carolina federal judge refused to throw out a proposed class action accusing Blue Cross Blue Shield of unlawfully refusing to cover proton beam therapy to treat prostate cancer, saying the case could remain in court if a state worker health plan is added as a defendant.

  • March 26, 2024

    Breaking Down The Supreme Court's Abortion Pill Arguments

    The same U.S. Supreme Court that undid the federal right to an abortion two years ago seems a lot less keen to limit access to the abortion medication mifepristone.

  • March 26, 2024

    EEOC Disability Bias Suit Over Welder's Meds Sent To Trial

    A U.S. Equal Employment Opportunity Commission disability bias suit needs a jury's review, a Texas federal judge found, saying too many fact issues prevented the court from determining whether an oilfield manufacturer unlawfully yanked a job offer from a welder over his opioid use disorder medication.

  • March 26, 2024

    New Feldesman Atty Talks 'Crucial' Drug Discount Program

    Feldesman Leifer LLP in Washington D.C., has welcomed healthcare attorney Stephen Kuperberg — an expert on the federal 340B drug discount program — to its healthcare and government investigations teams.

  • March 26, 2024

    Ohio Health Staffing Co. Settles Visa Fraud Probe For $9.25M

    An Ohio healthcare staffing company has agreed to pay a $9.25 million penalty to resolve criminal and civil investigations that the U.S. Department of Justice was conducting into its visa sponsorship program over what the firm's chief executive officer called "problematic conduct in our visa process."

  • March 26, 2024

    Opioid Public Nuisance Claims 'Unique,' Ohio High Court Told

    Counsel for two Ohio counties that won a $650 million verdict against Walmart, CVS and Walgreens told the Ohio Supreme Court on Tuesday that opioids are a "unique" problem during oral arguments about whether the counties' public nuisance claims are blocked by the state's product liability law.

  • March 26, 2024

    Geico Alleges $5.6M Billing Scam Targeted NY Insurance Cos.

    The insurance giant Geico has sued a New Jersey man and three medical imaging companies in New York federal court, accusing them of a $5.6 million scheme to submit fraudulent bills for unnecessary or otherwise useless tests on auto accident victims.

  • March 26, 2024

    In Abortion Case, Gorsuch Frets 'Rash' Of National Injunctions

    U.S. Supreme Court Justice Neil Gorsuch renewed his criticisms of nationwide injunctions Tuesday, saying a Texas judge's universal order limiting access to popular abortion medication mifepristone turned a potentially small legal challenge into a national debate.

Expert Analysis

  • Issues Ahead As Psychedelic Medicine Faces Pivotal Moment

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    Recent regulatory changes and decriminalization efforts have opened doors for research and development in psychedelic medicine, but challenges like stigma, access and funding persist, meaning companies will need to address these issues to support the industry’s credibility, say consultants at FTI Consulting.

  • An Overview Of 6 PBM Bills Moving Through Congress

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    As legislators turn to pharmacy benefit manager reform as a potential next step in addressing the cost of prescription drugs, six congressional committees have recently advanced PBM-related legislation with generally high bipartisan support, suggesting that a final package is likely to advance through Congress, say Rachel Stauffer and Katie Waldo at McDermott+Consulting.

  • 10th Circ. ERISA Ruling Is Promising For Self-Funded Plans

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    Though some recent appellate decisions have seemingly narrowed application of Employee Retirement Income Security Act preemption, which generally helps protect self-funded health plans from state regulation, the Tenth Circuit's decision in PCMA v. Mulready takes a big step toward reaffirming preemption, say attorneys at Bass Berry.

  • What Large Language Models Mean For Document Review

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    Courts often subject parties using technology assisted review to greater scrutiny than parties conducting linear, manual document review, so parties using large language models for document review should expect even more attention, along with a corresponding need for quality control and validation, say attorneys at Sidley.

  • Checking In On How SuperValu Has Altered FCA Litigation

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    Four months after the U.S. Supreme Court's ruling in U.S. ex rel. Chutte v. SuperValu, the decision's reach may be more limited than initially anticipated, with the expansion of the scienter standard counterbalanced by some potential defense tools for defendants, say Elena Quattrone and Olivia Plinio at Epstein Becker.

  • Participating In Living History Makes Me A Better Lawyer

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    My role as a baron in a living history group, and my work as volunteer corporate counsel for a book series fan association, has provided me several opportunities to practice in unexpected areas of law — opening doors to experiences that have nurtured invaluable personal and professional skills, says Matthew Parker at the Nebraska Department of Health and Human Services.

  • Private Equity Owners Can Remedy Law Firms' Agency Issues

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    Nonlawyer, private-equity ownership of law firms can benefit shareholders and others vulnerable to governance issues such as disparate interests, and can in turn help resolve agency problems, says Michael Di Gennaro at The Law Practice Exchange.

  • Cos. Must Overhaul Data Privacy Approach To Avoid Lawsuits

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    With the proliferation of third-party trackers and the increasing complexity of privacy laws, companies need to significantly change their approach to online privacy to avoid litigation by focusing on responsible data collection practices and ongoing monitoring of ad tech tools, says Ian Cohen at LOKKER.

  • Biden Admin's Mental Health Proposal May Not Be Enough

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    The Biden administration's recent proposed updates to federal mental health care rules acknowledge the difficulty that Americans face in finding and affording care, but may have limited impact due to enforcement challenges, a lack of providers and other issues, say Khaled Klele and Jessica Osterlof at Riker Danzig.

  • How To Protect Atty-Client Privilege While Using Generative AI

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    When using generative artificial intelligence tools, attorneys should consider several safeguards to avoid breaches or complications in attorney-client privilege, say Antonious Sadek and Christopher Campbell at DLA Piper.

  • How New Lawyers Can Leverage Feedback For Growth

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    Embracing constructive criticism as a tool for success can help new lawyers accelerate their professional growth and law firms build a culture of continuous improvement, says Katie Aldrich at Fringe Professional Development.

  • ESG Around The World: Australia

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    Clive Cachia and Cathy Ma at K&L Gates detail ESG-reporting policies in Australia and explain how the country is starting to introduce mandatory requirements as ESG performance is increasingly seen as a key investment and corporate differentiator in the fight for global capital.

  • Info Exchanges Must Stay Inside Now-Invisible Antitrust Lines

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    While the antitrust agencies recently withdrew long-standing enforcement policy statements for being "overly permissive" on information exchanges, we should not assume that all information exchanges are inherently suspect — they are still permissible if carefully constructed and vigorously managed, say attorneys at Nelson Mullins.