Policy & Compliance
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May 16, 2025
Feds Want Ex-McKinsey Exec To Serve Time For Obstruction
Prosecutors urged a Virginia federal judge Thursday to sentence a disbarred, former senior McKinsey & Co. partner to one year in prison for obstructing an investigation into the consulting giant's work with opioid-manufacturer Purdue Pharma, while defense counsel pushed for probation so that he can return to his home in Thailand.
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May 16, 2025
23 States Win Order Halting Billions In HHS Public Health Cuts
A Rhode Island federal judge on Friday barred the Trump administration from cutting off billions of dollars in funding to state public health programs, determining the abrupt grant terminations likely violated congressional authority over spending.
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May 16, 2025
Trucking Co. Worker Says Tobacco Surcharge Violates ERISA
An employee of Marten Transport Ltd. is suing the trucking company in Wisconsin federal court, alleging that a tobacco surcharge in its health plan violates federal antidiscrimination law.
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May 16, 2025
Surgical Center Operator Inks $15M Deal Over Data Breach
Shields Health Group Inc., which runs dozens of MRI and surgical centers around New England, has agreed to pay around $15 million to resolve claims in a proposed class action stemming from a data breach that compromised the personal information of over 2 million people.
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May 16, 2025
Trump Admin Settles Vaccine Contract Info Suit For $10K
The Trump administration has reached a $10,000 settlement with a consumer advocacy group over allegedly withholding information about the government's billion-dollar contracts with companies that developed and manufactured the COVID-19 vaccine, including Pfizer and Moderna.
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May 15, 2025
Ex-CEO Cops To Conspiracy Charge In $212M Fraud Case
A New Jersey-based former CEO of a medical billing company has pled guilty to conspiring to commit securities fraud in connection with government claims he was part of a $212.5 million scheme to inflate the value of his company to defraud potential investors in a go-private transaction.
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May 15, 2025
Feds Freeze Parity Enforcement As Agencies Rethink Regs
Federal agencies said Thursday they will hold off on enforcing a rule requiring employer group health plans to analyze how they restrict coverage for mental health and substance use disorder treatments, citing ongoing litigation aimed at blocking the policy and broader plans to reevaluate enforcement priorities.
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May 14, 2025
Mont. Court Blocks 'Ideological' Transgender Youth Care Ban
A Montana judge on Tuesday struck down a state statute that banned gender-affirming care for minors, holding that the state's interest is "ideological rather than medical" and violates the constitutional rights of transgender youth seeking gender-affirming care and of healthcare professionals who provide it.
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May 14, 2025
9th Circ. Doubts Wash. Anti-Vaxxers' Stance In Med Board Suit
A Ninth Circuit judge expressed skepticism on Wednesday that the federal appellate court could revive Robert F. Kennedy Jr.'s suit against the Washington Medical Commission for initiating disciplinary proceedings against physicians who publicly aired anti-vaccination views, pointing out that federal courts generally "don't interfere" with ongoing state litigation.
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May 14, 2025
Sage Therapeutics Brass Sued Over Drug Candidate Claims
The top brass of Sage Therapeutics Inc. have been hit with a shareholder derivative suit in New York federal court alleging they misled investors about the safety, efficacy, durability and commercial prospects of three of the company's drug candidates and overstated their likelihood to be approved by the U.S. Food and Drug Administration.
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May 14, 2025
Houston Midwife Says AG Has No Evidence To Close Clinics
A Houston-area midwife who was arrested earlier this year on a charge of providing an illegal abortion is arguing to a state appellate court that Texas Attorney General Ken Paxton "came nowhere close to meeting the state's burden" in his bid to shut down her clinics.
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May 14, 2025
RFK Jr. Defends HHS Cuts, Pledges To 'Spend Smarter'
In his first appearance on Capitol Hill since his confirmation, U.S. Department of Health and Human Services Secretary Robert F. Kennedy Jr. on Wednesday characterized a massive reorganization and reductions in workforce as practical moves to optimize the sprawling agency.
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May 13, 2025
Healthcare Hires: Ex-DOJ, Fresenius Attys On The Move
An ex-federal prosecutor who led healthcare fraud investigations in Texas has joined Hicks Thomas LLP, and an attorney with in-house experience at Fresenius Medical Care and GE Healthcare joined King & Spalding LLP in its government investigations practice. Here, Law360 Healthcare Authority looks at the week's most notable lateral hires in the healthcare industry.
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May 13, 2025
Health Co. Elevance Faces Suit Over Post-COVID Costs Claims
Health insurance provider Elevance Health Inc. and some of its executives face a proposed investor class action alleging the company hurt shareholders by mismanaging expectations about its Medicaid business's costs amid the post-pandemic eligibility redetermination process in certain markets it served.
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May 13, 2025
A Trump Do-Over On 'Most Favored Nation' Drug Prices
President Donald Trump's move this week to "equalize" U.S. drug prices with lower overseas prices hearkens back to a similar effort made in his first term that faced a swarm of legal challenges before being shelved.
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May 13, 2025
Planned Parenthood Wants Teen Program Fund Rule Blocked
Planned Parenthood on Monday urged a D.C. federal judge to vacate the U.S. government's "unlawful" requirements to "align" with President Donald Trump's executive orders lest risk losing Teen Pregnancy Prevention Program funding, arguing its facilities will suffer staff cuts and loss of medically accurate, age-appropriate education services absent an injunction.
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May 13, 2025
FDA Move On Industry Influence Only 'Cosmetic,' Experts Say
A Trump administration move to boot pharmaceutical employees off U.S. Food and Drug Administration advisory panels won’t do much to address conflicts of interest or change how regulators interact with the industry, experts say. But that doesn't mean other measures shouldn't be considered.
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May 13, 2025
NIH Letters Ending Grants Lack Factual Support, Judge Says
A Massachusetts federal judge said Tuesday that a "blast" of hundreds of virtually identical letters in March canceling National Institutes of Health-funded research projects appeared to offer no factual basis, only unsupported assertions that the projects were unscientific or discriminatory.
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May 13, 2025
Michigan Judge Strikes Down State's Abortion Restrictions
A Michigan judge struck down several of the state's abortion restrictions Tuesday, including a mandatory waiting period, required counseling materials and a rule that only doctors may perform abortions, finding the laws make it harder for people to access abortion and don't protect patients' health.
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May 13, 2025
PBMs Get Bipartisan Bashing At Hearing On Drug Costs
Senators across party lines slammed pharmacy benefit managers on Tuesday, sometimes in coarse language, as they wrestled with how to reduce drug prices for patients while also preventing the closure of rural pharmacies.
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May 13, 2025
DOJ Puts New Target On Medicare Advantage 'Steering'
U.S. Department of Justice officials' decision to back whistleblower claims that major health insurance companies paid millions in illegal kickbacks to brokers marks a dramatic escalation of an effort to crack down on Medicare Advantage "steering."
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May 13, 2025
Feldesman Grants Atty On 'Chaos' Of HHS Funding Cuts
Massive cuts in federal funding for healthcare programs are testing the avenues of recourse for safety-net hospitals and others that depend on grants to keep their doors open.
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May 13, 2025
Ind. Tells Nonprofit Hospitals To Curb Prices, Or Else
A new Indiana law gives charitable hospitals a stark choice: Lower prices or face the loss of their nonprofit status.
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May 13, 2025
Attys Push 11th Circ. To Weigh Judge Shopping Sanctions
The Eleventh Circuit can hear three attorneys' appeal of sanctions against them for judge shopping during their legal challenge to an Alabama law criminalizing gender-affirming care, because the underlying case was dismissed, making the jurisdictional question moot, two of those lawyers told the appellate court.
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May 13, 2025
Associate GC Of University Hospital In NJ Joins Frier Levitt
New Jersey-based national healthcare boutique Frier Levitt has hired a former in-house counsel at University Hospital in Newark this week as a partner in the firm's healthcare practice group.
Expert Analysis
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Motion To Transfer Venue Considerations For FCA Cases
Several recent decisions highlight the importance for practitioners of analyzing as early as possible whether a False Claims Act case warrants a change of venue, and understanding how courts weigh certain factors for defendants versus whistleblowers, say Ellen London at London & Stout, and Li Yu and Corey Lipton at DiCello Levitt.
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A Primer On EU's Updated Human Substance Regulations
The European Union's updated standards regarding quality and safety of substances of human origin meant for human application carry significant implications for companies that work with cells and tissues, and U.S. companies active in the EU market should pay particular attention to the import and export rules, say Geneviève Michaux and Georgios Symeonidis at King & Spalding.
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CFPB's Medical Debt Proposal May Have Side Effects
The Consumer Financial Protection Bureau’s recent proposal to prevent medical debt information from appearing on consumer reports and creditors from basing lending decisions on such information may have initial benefits for some consumers, but there are potential negative consequences that should also be considered, say attorneys at Cooley.
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15 Areas That Would Change Under Health Data Rule Proposal
If finalized, the Office of the National Coordinator for Health Information Technology's proposed rule will significantly progress its efforts to advance interoperability, respond to stakeholder concerns and clarify compliance with the health IT certification program, say attorneys at Ropes & Gray.
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3 Healthcare FCA Deals Provide Self-Disclosure Takeaways
Several civil False Claims Act settlements of alleged healthcare fraud violations over the past year demonstrate that healthcare providers may benefit substantially from voluntarily disclosing potential misconduct to both the U.S. Department of Justice and the U.S. Department of Health and Human Services, say Brian Albritton and Raquel Ramirez Jefferson at Phelps Dunbar.
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Takeaways From High Court's Tribal Health Admin Cost Ruling
The U.S. Supreme Court's recent determination that the government must reimburse two Native American tribes for administrative healthcare costs will help tribes maintain equal footing with the Indian Health Service when administering programs, and continues a pattern of how the current court aligns on tribal concerns, say attorneys at Lewis Roca.
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FTC Focus: Private Equity Investments In Healthcare
As the Federal Trade Commission is tightening its scrutiny of private equity investment in healthcare, the agency is finding novel grounds to challenge key focus areas, including rollup acquisitions, the flip-and-strip approach and minority investments in rival providers, say attorneys at Proskauer.
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High Court's Expert Ruling May Help Health Fraud Defendants
The U.S. Supreme Court's decision in Diaz v. U.S. appears to give the government a powerful new tool in calling its own agents as expert witnesses, but it could also benefit defense counsel in criminal healthcare fraud and other white collar criminal cases that arise in complex legal or regulatory environments, say attorneys at Holland & Knight.
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Unpacking HHS' Opinion On Cell Therapy Refund Programs
A recent advisory opinion from the U.S. Department of Health and Human Services, determining that a biopharma company's refund program for its cell therapy will not be penalized, indicates an encouraging willingness to engage, but the regulator's assumptions about the program's limited term warrant a closer look, says Mary Kohler at Kohler Health.
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DOJ Innovasis Settlement Offers Lessons On Self-Disclosure
The recent $12 million settlement with Innovasis and two of its executives demonstrates the U.S. Department of Justice's continued prioritization of Anti-Kickback Statute enforcement amid the growing circuit split over causation, and illustrates important nuances surrounding self-disclosure, say Denise Barnes and Scott Gallisdorfer at Bass Berry.
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How Orange Book Antitrust Scrutiny Is Intensifying
Pharmaceutical patent holders should be reviewing Orange Book listing practices, as the Federal Trade Commission takes a more aggressive antitrust approach with actions such as the Teva listing probe, and the U.S. Food and Drug Administration calls attention to potentially improper listings, say attorneys at McDermott.
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After Chevron: Slowing Down AI In Medical Research
The U.S. Supreme Court's recent decision overturning the Chevron doctrine may inhibit agencies' regulatory efforts, potentially slowing down the approval and implementation of artificial intelligence-driven methodologies in medical research, as well as regulators' responses to public health emergencies, say Ragini Acharya and Matthew Deutsch at Husch Blackwell.
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FDA's Multifaceted Role On Display In MDMA Therapy Scrutiny
Ongoing deliberations at the U.S. Food and Drug Administration regarding MDMA-assisted therapy for post-traumatic stress disorder serves as a window into the intricate balance of scientific innovation and patient safety oversight, and offers crucial insights into regulatory nuances, say Kimberly Chew at Husch Blackwell and Kevin Lanzo at Pharmaka Clinical Consulting.