Policy & Compliance

  • October 08, 2026

    High Court Urged To Keep Prison Trans Care Ban Blocked

    The U.S. Supreme Court should decline the Trump administration's request to disturb a district court order barring the Federal Bureau of Prisons from enforcing a gender dysphoria care ban, a group of transgender individuals incarcerated in BOP facilities argued Thursday.

  • October 08, 2026

    New Fraud Division Flexes Might In Latest Enforcement Policy

    The National Fraud Enforcement Division's new corporate enforcement policy emphasizes the quick pursuit of certain types of fraud through data analysis and staff resources, expands the target list beyond traditional healthcare providers and highlights the division's growing dominance within the U.S. Department of Justice, experts say.

  • October 07, 2026

    Blue Cross Must Justify Carve-Up Unit By Unit In Calif.

    Counsel for hospital plaintiffs touted a "landmark" win in California state court litigation that will require the Blue Cross Blue Shield network to justify unit by unit how it has carved up markets.

  • October 07, 2026

    Eldercare Co.'s Wage Class Fight Bound For Wash. High Court

    Washington's highest court agreed Tuesday to take up whether an appellate panel rightly revived two workers' proposed wage-and-hour class action against an eldercare provider despite the plaintiffs' membership in a separate class action against the company that was previously settled.

  • October 07, 2026

    PhRMA Sues To Block Medicare Foreign Drug Price Rule

    The pharmaceutical industry's top lobbying group asked a D.C. federal judge Wednesday to block a new Medicare rule tying Part B drug payments to prices abroad, claiming that the U.S. Department of Health and Human Services is imposing a "most-favored-nation" price control that Congress has repeatedly declined to enact.

  • October 07, 2026

    BCBS Unit Owes Awards Under No Surprises Act, Court Told

    A Blue Cross Blue Shield unit failed to pay thousands of dollars in awards that an air ambulance company won through the No Surprises Act's arbitration process for out-of-network services rendered to the insurer's beneficiaries, the company alleges in a suit in West Virginia federal court.

  • October 07, 2026

    Mich. Judge Questions Push To Revive Abortion Restrictions

    A Michigan judge Wednesday called a state law requiring medical providers to give parenting information and a picture of a fetus to patients seeking an abortion a "hindrance" that is out of step with a voter-approved right to reproductive freedom.

  • October 06, 2026

    AstraZeneca Takes Drug-Pricing Law Challenge To 4th Circ.

    AstraZeneca on Monday asked the Fourth Circuit to resurrect its suit challenging how the Centers for Medicare & Medicaid Services determines which drugs are subject to the landmark drug-pricing program, arguing that CMS is dodging limits on how many drugs can be selected by grouping some together.

  • October 06, 2026

    CVS Can't Get Second Shot At Tossing Investors' AI Use Suit

    A New York federal judge on Tuesday declined to give CVS another opportunity to dismiss a lawsuit accusing it of inflating its revenues through the use of artificial intelligence. 

  • October 06, 2026

    Courts On Health Insurer Antitrust Row, Opioid MDL And More

    Law360 Healthcare Authority looks at the U.S. Supreme Court's request for the federal government to weigh in on an allergy company's antitrust case, a Sixth Circuit decision overturning a ruling that allowed hundreds of opioid claims against two large pharmacy benefit managers, and other legal news from the past week.

  • October 06, 2026

    1st Circ. Sees Gaps In Order Halting RFK's Vaccine Advisers

    A First Circuit panel on Tuesday puzzled over aspects of a lower court's order staying Health and Human Services Secretary Robert F. Kennedy Jr.'s appointments to a vaccine policy committee, with one judge saying he can't tell what authority the order was based on.

  • October 06, 2026

    Anthem BCBS Accused Of Failing To Reimburse 7 Hospitals

    Anthem Blue Cross and Blue Shield is facing claims in Georgia federal court filed by acute care hospitals in six states alleging the insurer failed to cover claims at agreed-upon rates and denied claims for reasons not allowed by their contracts.

  • October 06, 2026

    What To Know About Challenge To Utah Constitutional Court

    A Utah abortion rights group says the state's attempt to transfer its abortion ban challenge to a newly created court tasked with hearing constitutional challenges is forbidden. 

  • October 06, 2026

    Hospitals Face New Reality Of Medicaid Coverage Cuts

    The first tranche of cuts to Medicaid took effect this month, booting certain categories of lawfully present immigrants. Hospitals are bracing for the bigger cuts to come.

  • October 06, 2026

    FDA Accuses 10 Retailers Of Selling Unapproved STI Meds

    Federal regulators have accused Amazon, Walmart and other online retailers of selling unapproved drugs to treat herpes and other sexually transmitted infections, according to warning letters disclosed to the public Tuesday.

  • October 06, 2026

    La. Abortion Pill Suit A Stretch For Nuisance Laws

    A lawsuit led by Louisiana officials targeting those sending abortion pills across state lines is a novel — and likely difficult — new approach to public nuisance law.

  • October 06, 2026

    7th Circ. Judge Hints Precedent Dooms Worker's Vax Fight

    A Seventh Circuit judge appeared disinclined Tuesday to restart a religious discrimination suit brought by a hospital pharmacy technician who was fired for refusing to get the COVID-19 vaccine, emphasizing that the same employer's recent win in a similar appeal is "binding authority."

  • October 05, 2026

    Air Ambulance Co. Says Pilot's 'Inattention' Wasn't Willful

    A pilot's actions in the cockpit during a patient transport flight that crashed in the mountains of North Carolina don't rise to the level of gross negligence or warrant punitive damages, an operator of air ambulance helicopters said in seeking to purge those claims from a personal injury suit.

  • October 05, 2026

    Boston Health Worker Says Firing Followed Fraud Concerns

    A former program director in Boston's health department says he was fired after refusing to enroll new clients until his concerns about fraud in a home visiting program were addressed, according to a lawsuit filed in Massachusetts state court.

  • October 05, 2026

    5th Circ. Hints CMS Medicare Advantage Rule May Violate APA

    A Fifth Circuit panel seemed hesitant to buy an argument that a rule from the Centers for Medicare & Medicaid Services dealing with Medicare Advantage plan overpayments went through proper rulemaking steps, asking Monday if the agency's argument that it can change its rationale "upends" rulemaking procedures.

  • October 05, 2026

    Securities Roundup: 7 Rulings You May Have Missed

    Federal judges from California to New York and several states in between issued a slew of decisions last week that determined the fates of shareholder lawsuits against a major health insurer, a New York bank that nearly failed in 2024 and a diagnostic company accused of hiding its challenges as COVID testing demand ebbed. 

  • October 05, 2026

    Catholic Org. Funding Cut Wasn't About Faith, Mich. Says

    A Catholic charity is improperly attempting to insert a prior religious liberty case over Michigan's foster care policies into current litigation challenging the charity's de-designation as a provider of treatment for substance use disorder, state officials have argued in a brief seeking dismissal.

  • October 05, 2026

    High Court Won't Review Medical Tape Antitrust Case

    The U.S. Supreme Court refused Monday to review a case accusing medical supplies group purchasing giant Vizient Inc. of locking in hospital customers, after the lower courts found a medical tape supplier failed to define a market that Vizient allegedly monopolized.

  • October 05, 2026

    1st Circ. Doubts Harvard Grant Fight Belongs In Claims Court

    The First Circuit Monday appeared skeptical that a lower court erred in backing Harvard University in a suit over the Trump administration's bid to freeze more than $2 billion in grant funding, suggesting that the case had been decided in the proper venue.

  • October 05, 2026

    Justices Won't Review Pregnancy Center Vandalism Case

    The U.S. Supreme Court on Monday said it will not review the conviction of a Florida woman for conspiring to violate a federal statute that prohibits intimidation and obstruction of people trying to access reproductive health facilities.

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.