Policy & Compliance
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April 29, 2025
DC Judge Worries About 340B Rebate Program Without 'Teeth'
The D.C. federal judge tasked with deciding dueling summary judgments in litigation accusing the government of blocking drugmakers' efforts to reshape the way they do rebates seemed skeptical of endorsing a vision of the program that could have "potentially devastating consequences."
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April 29, 2025
HHS Inspector Nominee A Partisan Outlier For Watchdog Role
President Donald Trump's pick to lead the Office of Inspector General at the U.S. Department of Health and Human Services has a particularly partisan background for a role viewed as nonpolitical.
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April 29, 2025
GenBioPro Can Defend FDA Approval In Mifepristone Suit
A Texas federal judge has allowed drugmaker GenBioPro to join a legal fight over access to the abortion drug mifepristone, finding that the company has a distinct interest in defending federal approval of the generic version of the medication.
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April 29, 2025
Companies Are Increasing Security Coverage For GCs, Execs
UnitedHealth Group has disclosed it spent nearly $1.9 million on security for its executives and their families in 2024, including over $213,000 for chief legal officer Christopher Zaetta, and a new study shows more corporations are following suit.
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April 29, 2025
Opioid MDL Judge Won't Recuse Over Ex Parte Allegations
An Ohio federal judge will not step aside from multidistrict opioid litigation after the plaintiffs' attorney, who had alleged the judge "regularly communicates" with other lawyers involved in the litigation, testified that there was no such communication after all, the judge ruled Tuesday.
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April 29, 2025
BCBS Wants Hospital Sanctioned For 'Cat-And-Mouse' Tactics
Blue Cross Blue Shield of North Carolina asked a federal judge to sanction a hospital company and its related entities for their purported "evasion, obfuscation, misdirection and outright misrepresentation" during discovery in a $32 million billing dispute that has gone on for seven years.
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April 29, 2025
High Court Backs HHS In Hospital Pay Formula Dispute
The U.S. Supreme Court on Tuesday sided with federal health officials in a challenge over a formula used to calculate billions of dollars in annual payments to hospitals treating indigent patients, saying that those entitled to Supplemental Security Income should be collecting cash payments before they're counted in the formula.
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April 28, 2025
Gov't Reverses Position On Surgery For Trans Prisoners
The Trump administration is rejecting the federal government's previous stance that prison officials are constitutionally required to provide gender confirmation surgery to incarcerated people with gender dysphoria who request the treatment, noting the shift in recent statements to a Georgia federal court.
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April 28, 2025
NC Dentist Acquitted Of $3M Fraud, Tax Evasion Charges
A North Carolina dentist was acquitted of wire fraud and tax evasion charges on the fourth day of a federal jury trial in which prosecutors had alleged the dentist submitted false loan applications to the Small Business Administration and failed to pay income taxes.
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April 28, 2025
Mich. Nurses Quit Claims Of Pay Withheld For Breaks Untaken
Two registered nurses agreed to drop their claims of unpaid wages against the two locations of a Michigan healthcare system they had accused in federal court of requiring them to work through meal breaks without pay, ending the case Monday in federal court.
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April 28, 2025
2nd Circ. Upholds Clinic Manager's Repeat Charges For Fraud
A decision that allowed the federal government to reindict a health clinic manager for a Medicare and tax fraud scheme can stand, a Second Circuit panel found Monday, agreeing with the lower court that his offenses were serious enough to permit it.
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April 28, 2025
Red States Want ACA Trans Health Rule Permanently Off Books
A group of 15 red states that successfully got a Biden-era rule frozen that protected gender-affirming care under the Affordable Care Act have urged a Mississippi federal judge to rule the U.S. Department of Health and Human Services overstepped its authority and cannot require states to allow gender-affirming care for transgender people.
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April 25, 2025
HHS Sued Over Withholding Of $65.8M In Title X Funding
The U.S. Department of Health and Human Services unlawfully withheld $65.8 million in federal grants for critically needed family planning services, a nonprofit alleged in a suit filed Thursday in D.C. federal court, saying the withholding seemed to be based, in part, on grantees' support for diversity, equity and inclusion.
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April 25, 2025
Justices Want More Info On HHS Authority In Task Force Row
The U.S. Supreme Court on Friday ordered the federal government and a group of Texas businesses and individuals to compile more information as to whether the U.S. Department of Health and Human Services secretary has the authority to appoint members of a task force under the Affordable Care Act.
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April 25, 2025
Sutter Health To Pay $228M In Years-Old Antitrust Suit
A class of millions of health insurance premium payors asked a California federal judge Friday to greenlight an eleventh-hour $228.5 million settlement resolving their long-running claims that hospital chain Sutter Health drives up costs by pushing all-or-nothing network deals on insurers.
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April 25, 2025
Refusing Mental Healthcare Means Liability, Pa. Justices Rule
Physicians in Pennsylvania can be held liable for turning away a mental health patient who goes on to harm someone if that patient came to the hospital asking for help, the state Supreme Court ruled Friday.
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April 25, 2025
HHS Says Cuts Target Excess After Judge Seeks More Info
The U.S. Department of Health and Human Services told a Rhode Island federal judge that a group of states has no basis to challenge the cancellation of billions in grants supporting public health programs because they already received the funds appropriated to them by Congress.
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April 25, 2025
Trans Prisoners Fight For Care Over New White House Hurdles
After staff at a New Jersey federal prison told Alishea Sophia Kingdom that, due to an executive order by President Donald Trump, she would no longer be receiving hormone therapy to treat gender dysphoria, Kingdom lodged the latest in a series of suits against the Federal Bureau of Prisons that contend following the executive order violates the Eighth Amendment's prohibition of cruel and unusual punishment.
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April 25, 2025
Organ Donor Network Wants Veteran's Waitlist Bias Suit Axed
The United Network for Organ Sharing asked a Georgia federal court to toss a lawsuit filed against it and several university medical schools over allegations that they delayed a Black military veteran's ability to receive a kidney transplant by artificially inflating his kidney function scores.
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April 25, 2025
DOD To Assess Tricare Program Competition In Ga. And Fla.
The U.S. Department of Defense has awarded contracts to CareSource Military and Veterans to compete with managed care support contractors in delivering health, medical and administrative support services to eligible Tricare beneficiaries in the Atlanta and Tampa markets.
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April 25, 2025
2nd Circ. Says Withdrawn Application Dooms Age Bias Suit
The Second Circuit refused Friday to reopen a sleep doctor's lawsuit claiming a hospital refused to consider him for a job because he was 66 years old, saying his decision to turn down an interview after receiving a misaddressed email doomed his case.
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April 25, 2025
5 Issues Benefits Attys Want The Gov't To Shed Light On
The first three months of President Donald Trump's administration have left lawyers who represent employers and benefit plans hungry for clarity on issues like cryptocurrency as a 401(k) investment and coverage for gender-affirming care. Here, Law360 looks at five areas where attorneys are hoping for guidance or regulations.
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April 24, 2025
Ex-Pain Clinic Owner Gets 3½ Years For Drug Test Scheme
The former owner of a Pennsylvania pain management practice has been sentenced to three-and-a-half years in prison for conspiring with others to defraud Medicare by submitting unnecessary urine drug tests for chronic opioid patients at his medical clinics.
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April 24, 2025
'Egregious' Delays Wipe Out Ga. Health Fraud Case
A Georgia federal judge on Thursday dismissed an eight-year-old case over alleged Medicaid fraud, calling the government's delays in bringing three healthcare executives to trial "egregious" and noting that the alleged criminal conduct took place between 12 and 25 years ago.
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April 24, 2025
No Greece Trip For Ex-Conn. Official Facing Corruption Cases
A Connecticut federal judge on Thursday denied a former state official's request to take a trip to Greece amid two indictments, an order that came the day after the government opposed the plan.

HHS Legal Staff Cuts Will Impair Abuse, Neglect Enforcement
A massive overhaul underway at the U.S. Department of Health and Human Services will wipe out the roles filled by more than 100 attorneys and other staff at offices in six states. Among the enforcement areas being hit are federal efforts led by regional HHS legal teams combating elder abuse and neglect at nursing homes.

'Fetal Personhood' Animates Neb. Aborted-Remains Debate
Nebraska lawmakers are sparring over a bill that would require healthcare facilities to bury or cremate fetal remains following an elective abortion. Supporters envision a "dignified" disposition. Opponents decry a requirement targeting providers while advancing the “fetal personhood” doctrine.

Medicare Advantage 'Upcoding' In Federal Crosshairs
Dr. Mehmet Oz and others have called for a crackdown on fraud and waste in privately run Medicare plans. But addressing "upcoding" won't be easy, and healthcare attorneys are watching to see whether the increased attention translates into actual enforcement.
Expert Analysis
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How Trump Orders Affect Health Orgs' Care For Trans Minors
Two recent executive orders issued by President Donald Trump regarding gender-affirming care for minors have put healthcare organizations in a precarious situation, and these institutions should prepare for various implications and potential scenarios, say attorneys at ArentFox.
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Reproductive Health Under Trump So Far, And What's Next
Based on priorities stated so far, the Trump administration will likely continue to weaken Biden-era policies that protect reproductive health, with abortion, in vitro fertilization and contraception all being issues to watch closely amid a post-Dobbs shift, say attorneys at McDermott.
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What's Next For Lab Test Regulation Without FDA Authority
A recent Texas federal court decision vacating the U.S. Food and Drug Administration's final rule that would apply FDA regulations to laboratory-developed tests signals potential positive impacts in the diagnostic space, and could inspire more healthcare entities to litigate against the government, say attorneys at Hooper Lundy.
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6 Criteria Can Help Assess Executive Branch Actions
With new executive policy changes announced seemingly every day, several questions can help courts, policymakers and businesses determine whether such actions are proper, effective and in keeping with our democratic norms, say Marc Levin and Khalil Cumberbatch at the Council on Criminal Justice.
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Learning From COVID-19 Enforcement Against Nursing Homes
Five years after the COVID-19 outbreak caused a high number of deaths in nursing homes, an examination of enforcement actions against nursing homes in New York and elsewhere in the country highlights obstacles that may arise when bringing cases of this type, and ways to overcome them, says Kenneth Levine at Stone & Magnanini.
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How Plan Sponsors Can Mitigate Risk In PBM Contracts
A recent lawsuit in New York federal court alleges that JPMorgan caused exorbitant prescription costs by mishandling the pharmacy benefit manager arrangement, adding to a growing body of Employee Retirement Income Security Act fiduciary breach litigation and affirming that fiduciaries must proactively manage their healthcare plan vendors, say attorneys at Hall Benefits Law.
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4th Circ. Health Data Ruling Opens Door To State Law Claims
In Real Time Medical v. PointClickCare, the Fourth Circuit recently clarified that state law claims can rest in part on violations of a federal law that prohibits electronic health information blocking, expanding legal risks for health IT companies and potentially creating exposure to a range of competitive implications, say attorneys at BCLP.
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Unpacking Trump Admin Plans For Value-Based Care
Recent developments from the Center for Medicare and Medicaid Innovation suggest the Trump administration intends to put its own stamp on value-based care, emphasizing cost savings assessment in particular, with its recent cancellation of several payment models that had supported primary care, says Miranda Franco at Holland & Knight.
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What To Expect For Stem Cell Regulation Under Trump Admin
The new administration's push for deregulation, plus the post-Chevron legal landscape, and momentum from key political and industry players to facilitate stem cell innovation may create an opportune backdrop for a significant reduction in the U.S. Food and Drug Administration's regulatory framework for stem cells, say attorneys at Sheppard Mullin.
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How Importers Can Minimize FCA Risks Of Tariff Mitigation
False Claims Act risks are inherent in many tariff mitigation strategies, making it important for importers to implement best practices to identify and report potential violations of import regulations before they escalate, says Samuel Finkelstein at LMD Trade Law.
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10 Practical Takeaways From FDA's Biopharma AI Guidance
Recent guidance from the U.S. Food and Drug Administration provides much-needed insight on the usage of artificial intelligence in producing information to support regulatory decision-making regarding drug safety, with implications ranging from life cycle maintenance to AI tool acquisition, say attorneys at Covington.
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Lawmakers Shouldn't Overlook Rare Disease Therapies' Value
As the ORPHAN Cures Act is pending in Congress, policymakers assessing the value of certain drugs for price regulation should consider data beyond what is collected in clinical trials, say Alice Chen at the University of Southern California, and Molly Frean and Yao Lu at Analysis Group.
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What Trump's Order Means For The Legal Status Of IVF
An executive order signed by President Donald Trump last month signals the administration's potential intention to increase protections for in vitro fertilization services, though more concrete actions would be needed to resolve the current uncertainty around IVF access or bring about a binding legal change, says Jeanne Vance at Weintraub Tobin.