Policy & Compliance

  • September 29, 2026

    Cancer Patients Can't Get Class Status In Proton Beam Suit

    A Tennessee federal judge shot down a BlueCross BlueShield health plan member's bid for class certification in his suit claiming the insurer wrongfully denied coverage for a proton beam cancer treatment it deemed investigatory, stating the case would require too much individual math to assess each patient's potential damages.

  • September 29, 2026

    DOJ Puts FCA Target On Health Data Security Lapses

    Government contractors that fail to protect personal health information are on the radar of U.S. Department of Justice officials looking to leverage the False Claims Act, attorneys told attendees at a health law conference in Washington, D.C.

  • September 29, 2026

    FCA Bar Debates Impact Of Updated Justice Manual

    The False Claims Act bar is divided on the practical impact of recent updates to a U.S. Department of Justice policy manual. Whatever happens, the healthcare industry is particularly exposed.

  • September 28, 2026

    Calif. Expands Reproductive Care, Abortion Access

    A series of new laws in California aim to expand access to medication abortion on community college campuses, bolster veterans' access to reproductive care including abortions, and make it easier for nursing parents to access lactation support, according to an announcement made Sunday.

  • September 28, 2026

    Illinois BCBS Can't Escape $6.6M Claim Repayment Fight

    Blue Cross Blue Shield of Illinois must face a specialty pharmacy's contract suit claiming the insurer illegally failed to pay out more than $6.6 million in prescription claim reimbursements for medicines the pharmacy provided to three insureds in 2021, an Illinois federal judge ruled Monday.

  • September 28, 2026

    Newsom Signs Slate Of Bills Bolstering LGBTQ+ Protections

    California Gov. Gavin Newsom signed a slate of bills defending against what he called the Trump administration's "all-out assault on the LGBTQ community," strengthening privacy protections, providing support to discharged service members and enhancing access to medical care.

  • September 28, 2026

    Split 7th Circ. Backs Ill. County's Win In COVID Vax Bias Suit

    The Seventh Circuit in a split decision Monday affirmed a summary judgment win for Cook County, Illinois, in a former hospital pharmacist's suit alleging she was unlawfully fired after she refused a COVID-19 vaccine, with the majority holding the county proved a religious exemption would've posed undue hardship and one dissenting judge saying the case should go to a jury.

  • September 28, 2026

    Trump Asks Justices To Restore Fed. Prison Trans Care Ban

    The Trump administration urged the U.S. Supreme Court on Monday to halt a district court order barring the Bureau of Prisons from enforcing a ban on gender dysphoria care for transgender people incarcerated in BOP facilities, arguing the lower court stepped beyond its proper role. 

  • September 28, 2026

    Faith-Based Rehab Program Can't Exit Wage Suit, Court Rules

    A Texas federal court allowed a man who was ordered into a faith-based addiction recovery program to pursue wage claims against the program's operators, finding he plausibly alleged participants were treated as employees who performed substantial commercial labor without lawful pay.

  • September 25, 2026

    SEC Says Mich. Atty Tipped Family About Pharma Co. Merger

    The U.S. Securities and Exchange Commission on Friday accused a Michigan tax lawyer of insider trading, alleging he told his brother and cousin about a planned but not-yet-announced merger between Y-mAbs Therapeutics Inc. and SERB Pharmaceuticals.

  • September 25, 2026

    SEC Says Md. Woman Illegally Traded On FDA Approval Info

    The SEC accused a Maryland resident of trading on nonpublic information she received from an insider ahead of the FDA's 2023 denial of a new drug application for a depression treatment submitted by Sage Therapeutics Inc. that caused the company's shares to lose over half of their value.

  • September 25, 2026

    Mayo Clinic Strikes $50K Deal To End EEOC Vax Bias Suit

    The Mayo Clinic will pay $50,000 to resolve a U.S. Equal Employment Opportunity Commission suit claiming it threatened to fire a Pentecostal Christian security guard if he didn't get vaccinated against COVID-19 despite his religious objections.

  • September 25, 2026

    Split 6th Circ. Keeps Block On Tenn. 'Abortion Trafficking' Ban

    A split Sixth Circuit panel upheld a permanent injunction on what Tennessee calls an abortion trafficking ban, finding the law is facially overbroad and violates the First Amendment by restricting speech on access to abortions in states where that care is legal.

  • September 25, 2026

    Conn. AG Beats Dentist's Appeal In Press Release Fight

    The Connecticut attorney general and a former social services commissioner did not violate a dentist's constitutional due process or privacy rights when they issued a press release announcing the $300,000 settlement of a False Claims Act case based on Medicaid billing claims, a state appellate panel ruled Friday.

  • September 25, 2026

    COVID Testing Co.'s Ex-COO Pleads Guilty In $500M Fraud

    The former chief operating officer of a COVID-19 testing company pled guilty in Michigan federal court to a healthcare fraud conspiracy allegedly involving more than $500 million in fraudulent insurance claims for services that were not performed as billed.

  • September 25, 2026

    United, TeamHealth Settle $100M ER Billing Fraud Suit

    UnitedHealthcare and TeamHealth have agreed to resolve a $100 million alleged fraud dispute over emergency room staffing and billing, according to a filing in Tennessee federal court.

  • September 25, 2026

    Cleveland Clinic Workers Win Notice In Time-Rounding Suit

    An Ohio federal judge approved notice to a proposed collective of Cleveland Clinic workers alleging the health system's time-rounding practices resulted in overtime violations, finding the workers showed a strong likelihood that they were similarly situated.

  • September 24, 2026

    Medical School Application Fee Antitrust Claim Moves Ahead

    A D.C. federal court issued an order on Thursday trimming several claims from a class action accusing the Association of American Medical Colleges of inflating medical school application fees, but allowed one of the antitrust claims to move ahead.

  • September 24, 2026

    FDA Nom Says Vaccines Safe, Won't Call IUDs Birth Control

    President Donald Trump's nominee to lead the U.S. Food and Drug Administration faced a Senate committee Thursday morning, where she affirmed the safety of vaccines when pressed but refused to directly contradict the president's false claim that the measles vaccine could be "quite lethal," and declined to affirm that IUDs are birth control and not abortifacients.

  • September 24, 2026

    Autism Therapy Provider Fights $1M MassHealth Demand

    Massachusetts' Medicaid program conducted a flawed audit of autism therapy providers last year and then demanded recoupment of paid claims without a meaningful way to challenge the audit's findings, a national therapy provider said in a lawsuit. 

  • September 24, 2026

    Full 5th Circ. Tough On Aetna's Bid To Arbitrate Aramark Suit

    The Fifth Circuit seemed skeptical Thursday of Aetna's bid to force a health plan benefits dispute from food services giant Aramark into arbitration, with judges picking the insurer's arguments apart during an en banc rehearing.

  • September 24, 2026

    UnitedHealth Blocked From Early Appeal In NM Nurse OT Suit

    A New Mexico federal court has refused to let UnitedHealthcare seek an early appeal of a ruling allowing a nurse case manager's proposed class action to proceed despite an expired statute of limitations, finding the company mischaracterized the ruling and failed to show a genuine circuit split.

  • September 23, 2026

    Blue Shield Still Facing Therapy 'Ghost Network' Suit

    A California federal judge ruled Wednesday that Blue Shield of California must face the majority of claims brought in subscribers' proposed class action alleging the insurer maintained a "ghost network" of mental-health providers that didn't exist or accept new patients, saying the suit adequately claims contract terms were not met.

  • September 23, 2026

    Colo. Judge Declines To Sanction Hospital In Gender Care Suit

    Children's Hospital Colorado properly complied with an injunction prohibiting it from refusing to provide medically necessary gender-affirming care to transgender youth patients, a state judge ruled, rejecting a request by a class of patients to hold the hospital in contempt.

  • September 23, 2026

    Vein Tech Maker Escapes Suit Over DOJ Kickback Probe

    A New York federal judge has tossed, for now, a proposed investor class action alleging that vein disease device maker Inari Medical Inc.'s share price fell after it disclosed an investigation into its compliance with federal anti-kickback laws, finding the suit does not plausibly show Inari was paying healthcare providers unlawful kickbacks, among other things.

Expert Analysis

  • How 6th Circ. Tightened NLRB Injunction Standard

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    The Sixth Circuit's recent ruling in Kerwin v. Trinity Health Grand Haven Hospital, dissolving a Section 10(j) injunction obtained by the National Labor Relations Board against an employer that refused to bargain, will make it harder for the NLRB to obtain injunctions while prosecuting unfair labor practice proceedings, say attorneys at Bass Berry.

  • Md. Ruling Reflects Classic Administrative Law Principle

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    A Maryland federal court's recent decision in Columbus v. Kennedy significantly limits how far the Centers for Medicare & Medicaid Services can go in reshaping the Affordable Care Act through regulation, highlighting a principle that will likely be applied in similar Administrative Procedure Act challenges, says Michael King at Brownstein Hyatt.

  • Healthcare Orgs Should Prep For Greater Grant Oversight

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    The U.S. Department of Health and Human Services' new Audit Enforcement and Risk Oversight initiative, and a proposed overhaul of the governmentwide framework for grants management, signal an aggressive and data-driven approach to federal grant enforcement, and could significantly expand the pathways leading to enforcement actions and private litigation, say attorneys at Norton Rose.

  • 3rd Circ. Decision Sheds Light On BIPA Bank Exemption

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    The Third Circuit's recent decision in McGoveran v. Amazon illuminates how courts are extending the Illinois Biometric Information Privacy Act's financial institution carveout beyond banks and insurers to technology vendors and other businesses handling biometric data, a defendant-friendly shift that still casts uncertainty around BIPA's enforcement, say attorneys at Dorsey & Whitney.

  • Data Reveals Pivot In Feds' Financial Fraud Priorities

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    Recent Justice Department data shows fraud prosecutions fell to their lowest rate in a decade in 2025, illustrating a move away from traditional financial cases and toward a targeted mix of healthcare, government program, consumer and sanctions matters, say Paul Hinton and Adrienna Huffman at The Brattle Group.

  • New Timeline For Benefits Cases May Increase FCA Litigation

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    Recent reforms designed to speed enforcers’ intervention decisions in False Claims Act suits involving state-administered benefits will likely encourage more qui tam relators to litigate cases without the government’s imprimatur, and increase defendants’ discovery burdens, defense costs and business disruptions, say attorneys at Morgan Lewis.

  • FTC's Clinical Trial Requirement Threatens Food Claim Rules

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    The Federal Trade Commission's general requirement for randomized controlled trials for most health-benefit claims, recently embraced by the National Advertising Review Board, lacks legal basis and endangers the existing statutory framework Congress created for marketing food and dietary supplements versus drugs, say attorneys at Keller & Heckman.

  • HHS Enforcement Restructuring Signals Compliance Risks

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    The U.S. Department of Health and Human Services' recent restructuring of its Office for Civil Rights suggests that, while Health Insurance Portability and Accountability Act enforcement remains central, its priorities have expanded to encompass civil rights, conscience and religious freedom, and data and cybersecurity issues, say attorneys at King & Spalding.

  • AG Watch: Oregon's Strategic Civil Enforcement Approach

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    Oregon Attorney General Dan Rayfield’s recent antitrust litigation activity and proposed staffing increase are the latest in a series of structural and policy changes that signal that the state Department of Justice is taking a more aggressive approach to civil enforcement, says Keturah Taylor at Cozen O'Connor.

  • A Decade Later, Escobar Is Still Shaping FCA Cases

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    The U.S. Supreme Court's decision 10 years ago in Universal Health Services v. U.S. ex rel. Escobar changed the way in which lower courts evaluate False Claims Act cases — and the ruling remains vital in nearly every FCA case filed today, say attorneys at Bradley Arant.

  • How FCA, FCPA Risks Are Shifting As Feds Pull Back

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    As the federal government continues its retreat from white collar enforcement, companies should expect False Claims Act risk to grow through private whistleblower suits and Foreign Corrupt Practices Act scrutiny to shift toward foreign prosecutors, requiring more adaptability as accountability becomes less centralized, says Temidayo Aganga-Williams at Selendy Gay.

  • Trump Admin's Agency Records Purge Tests Judicial Notice

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    While courts commonly take judicial notice of data in government websites and reports, the Trump administration's recent modification or wholesale deletion of these sources means that litigants must look elsewhere to support trial admission of this information, says Jon Gryskiewicz at Lewis Baach.

  • West Coast Health Cos. Must Brace For Federal Enforcement

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    In light of the U.S. Department of Justice's newly established West Coast strike force targeting healthcare fraud across Northern California, Arizona and Nevada, health organizations will need to prioritize knowledge, vigilance and operational discipline to reduce exposure from potentially parallel criminal and civil investigations, says Michael Beckwith at Dickinson Wright.