Policy & Compliance

  • March 19, 2024

    FTC Sends Benefytt's Sham Health Plan Buyers $100M

    The Federal Trade Commission is sending refund checks to hundreds of thousands of customers from the $100 million Benefytt Technologies Inc. paid to settle allegations that it deceptively marketed sham health plans as qualified under the Affordable Care Act.

  • March 19, 2024

    NBA Fraudster Dodges Prison After Cooperation, Testimony

    A former NBA shooting guard avoided prison Tuesday for participating in a $5 million retiree healthcare fraud scheme after Manhattan federal prosecutors lauded his assistance and testimony at a trial this past fall.

  • March 19, 2024

    OptumRx Can't Get Motley Rice Disqualified From Opioid MDL

    An Ohio federal judge has denied a bid by pharmacy benefit manager OptumRx to disqualify Motley Rice LLC from representing plaintiffs in the national opioid litigation, saying the company hasn't shown that the firm's prior representation of states investigating opioids puts the company at a disadvantage in the multidistrict litigation.

  • March 18, 2024

    Patent Suit Over AstraZeneca's Tagrisso Heads To Jury

    A Delaware federal judge said Monday that there are too many "genuine factual disputes" to end a lawsuit from a Pfizer brand claiming it developed a cancer treatment that's being infringed by a drug that has racked up billions in sales for rival AstraZeneca.

  • March 18, 2024

    9th Circ. Frees Kaiser, Union From Fired Calif. Nurse's Suit

    Kaiser Permanente and the California Nurses Association defeated a fired nurse's lawsuit Monday, with the Ninth Circuit affirming that the nonprofit health care giant had valid reasons for firing her and that the union adequately represented her in her challenge to the termination.

  • March 18, 2024

    4th Circ. Sends Opioid 'Nuisance' Question To W.Va. Top Court

    The Fourth Circuit asked West Virginia's high court Monday to determine whether the state's public nuisance law can be used to target companies that shipped drugs to pharmacies in a community ravaged by addiction, a crucial question in litigation spawned by the opioid crisis.

  • March 18, 2024

    High Court Doubts Feds Coerced Social Media Cos.

    A majority of the U.S. Supreme Court appeared unconvinced Monday that the Biden administration violated the First Amendment by working with social media platforms to combat the spread of misinformation, often chiding Louisiana's solicitor general for presenting confusing and overly expansive arguments.

  • March 18, 2024

    Doctor Can't Yank NBA Fraud Plea, Feds Insist

    Prosecutors have told a Manhattan federal judge that a doctor accused of assisting a group of NBA players in creating false documents to defraud the league's healthcare plan shouldn't be allowed to yank his guilty plea, arguing evidence shows his guilt and that too much time has passed.

  • March 18, 2024

    High Court Declines To Review Appeal Of EMT Liability Suit

    The U.S. Supreme Court on Monday declined to take up an appeal of a Tenth Circuit decision finding a group of EMTs had qualified immunity in a suit alleging their failure to secure the neck of a man who'd been injured in a bar fight caused his death.

  • March 16, 2024

    Up Next At High Court: Gov't Jawboning & Retaliatory Arrests

    The U.S. Supreme Court has a packed oral arguments calendar this week that includes disputes over the Biden administration's work with social media companies to combat misinformation, the appropriate evidence standard for bringing retaliatory arrest claims and whether the federal government can object to a consent decree entered into by three states.

  • March 15, 2024

    'Cobra Venom' Painkiller Co. Inks Deal To Settle SEC Claims

    A penny stock company that previously held itself out as a maker of cobra venom-infused pain drugs has agreed to resolve U.S. Securities and Exchange Commission fraud claims, according to court filings that note the company's two principals have also reached a settlement.

  • March 15, 2024

    Ex-Fugitive Behind Fake Silver COVID Cure Pleads Guilty

    A former fugitive who was accused of peddling a phony, silver-based treatment for diseases such as COVID-19 pled guilty Thursday just before opening statements were set to begin at his fraud trial.

  • March 14, 2024

    Feds Say Healthcare Ruling Could Upset Tribal Relationships

    The federal government is urging the U.S. Supreme Court to overturn a lower court's ruling that ordered Indian Health Services to reimburse millions in administrative healthcare costs, saying if the two tribes prevail in the litigation, it would upend 35 years of practice between the agency and its contracting tribes.

  • March 14, 2024

    8th Circ. Weighs If No-Bill Agreements Break Minn. Law

    The Eighth Circuit carefully considered arguments Thursday between six Farmers units and a policyholder class as to whether the carriers' agreements with healthcare providers restricted the class's medical expense coverage in violation of Minnesota law, giving little indication of which way it leaned.

  • March 14, 2024

    Extended Workers' Comp Needs High Bar, NC Justices Told

    The North Carolina Department of Public Safety told the state's top court Wednesday that injured workers must clear a higher hurdle to keep collecting disability benefits after their initial workers' compensation runs out, saying an appellate court got it wrong by applying a more lax standard.

  • March 14, 2024

    8th Circ. Questions Patient Standing In ERISA Claims Dispute

    An Eighth Circuit panel appeared skeptical Thursday of reviving a suit from patients insured by UnitedHealth Group alleging a billing practice known as cross-plan offsetting violated federal benefits law, with judges questioning whether the patients sufficiently established injury.

  • March 14, 2024

    Feds Seek 20 Mos. For Aegerion Fraud 'Puppet Master'

    A pharmaceutical sales representative who gloated about being a "puppet master" for false insurance claims for Aegerion's cholesterol drug should serve 20 months in prison, the U.S. government has told a Boston federal judge.

  • March 14, 2024

    Trial Challenging NC Abortion Restrictions Pushed To July

    A July trial date has been set in a closely watched constitutional challenge seeking to dismantle a state law that restricts access to abortions in North Carolina after 12 weeks, marking a pushback from the court's earlier projected spring timetable for the trial.

  • March 13, 2024

    Planned Parenthood Foe Calls Immunity Claim 'Half-Baked'

    Attorneys for a pseudonymous relator who sued Planned Parenthood over allegations that it improperly billed Medicaid programs urged the Fifth Circuit on Wednesday to reject the group's position that it was shielded by attorney immunity, calling the entity's argument "half-baked."

  • March 13, 2024

    Wash. Hospital Workers Sue Kaiser Over Missed Breaks

    A nursing assistant at Seattle's Kaiser Permanente hospital said understaffing compels her and other healthcare employees to work through their meal breaks, but that the hospital system has not been paying them for that time, according to a proposed class action filed in Washington state court.

  • March 12, 2024

    NYC Hospital Signs $17.3M 'Kickback' Deal With Feds, State

    NewYork-Presbyterian/Brooklyn Methodist Hospital has agreed to pay $17.3 million to resolve allegations that it paid unlawful kickbacks to physicians at its chemotherapy infusion clinic, the U.S. Department of Justice announced Tuesday.

  • March 12, 2024

    NY Jury Rules Some Claims About Prevagen Are Misleading

    A New York federal jury said some statements made by Quincy Bioscience about its memory booster Prevagen were misleading to consumers but found that most statements about the supplement were made on solid grounds.

  • March 12, 2024

    2nd Circ. Revives Parts Of McKesson Whistleblower Suit

    The Second Circuit on Tuesday revived parts of a lawsuit brought by a McKesson Corp. whistleblower who accuses the pharmaceutical company of a kickback scheme, finding that the lower court should reconsider the claims that were brought under state anti-kickback laws.

  • March 12, 2024

    Walgreens, Kenvue Unit Sued Over Benzene In Acne Products

    Walgreens, Kenvue unit Johnson & Johnson Consumer Inc. and Genomma Lab face a trio of proposed consumer fraud class actions in California federal court by customers who alleged their acne treatment products contain unsafe levels of benzene, but that each of the companies failed to disclose its presence in their labeling.

  • March 12, 2024

    4th Circ. Revives Navy Surgery Wrongful Death Claims

    The Fourth Circuit on Tuesday reversed an order dismissing claims from the estate of a woman who died after an allegedly botched surgery at a Navy hospital, saying the trial court was wrong to conclude that Navy regulations for implementing Federal Tort Claims Act procedures created jurisdictional requirements beyond what the FTCA's text includes.

Expert Analysis

  • 4 Employer Action Steps For New Mental Health Parity Rules

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    A recently released guidance under the Mental Health Parity and Addiction Equity Act reiterated that employers contracting with outside service providers to administer their health plans are not relieved of their compliance obligations — so all employers sponsoring a group health plan should consider four action items for success, say attorneys at Ice Miller.

  • Recalling USWNT's Legal PR Playbook Amid World Cup Bid

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    As the U.S. Women's National Soccer Team strives to take home another World Cup trophy, their 2022 pay equity settlement with the U.S. Soccer Federation serves as a good reminder that winning in the court of public opinion can be more powerful than a victory inside the courtroom, says Hector Valle at Vianovo.

  • Parsing Through The FTC's Proposed Health Privacy Updates

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    The Federal Trade Commission's recently proposed updates to its Health Breach Notification Rule contain subtle but significant changes to key terms that help modernize the agency's health app regulation and provide stakeholders an important opportunity to help shape the future of virtual health care, say attorneys at Arnold & Porter.

  • Indivior Ruling May Affect Rebate Wall Litigation

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    A New Jersey federal court's recent decision in Indivior v. Alvogen, in which a claim that an alleged rebate wall anti-competitively blocked generic competition survived summary judgment, may provide a blueprint for successfully challenging other drug rebating practices, say Peter Herrick and Monsura Sirajee at O'Melveny.

  • Compliance Takeaways From HHS Information Blocking Rule

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    A recently finalized rule from the U.S. Department of Health and Human Services' Office of Inspector General demonstrates a renewed focus on investigating practices that may interfere with patients' access to their electronic health information, and should encourage renewed compliance efforts across a range of processes, say attorneys at Ropes & Gray.

  • Immigration Program Pitfalls Exacerbate Physician Shortages

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    Eliminating shortcomings from U.S. immigration regulations and policies could help mitigate the national shortage of physicians by encouraging foreign physicians to work in medically underserved areas, but progress has been halted by partisan gridlock, say Alison Hitz and Dana Schwarz at Clark Hill.

  • Mallory Gives Plaintiffs A Better Shot At Justice

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    Critics of the U.S. Supreme Court's recent decision in Mallory v. Norfolk Southern claim it opens the door to litigation tourism, but the ruling simply gives plaintiffs more options — enabling them to seek justice against major corporations in the best possible court, say Rayna Kessler and Ethan Seidenberg at Robins Kaplan.

  • Why Justices' SuperValu Ruling Wasn't Quite A 'Seismic Shift'

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    Notwithstanding an early victory lap by the relators' bar, the U.S. Supreme Court’s decision in U.S. v. SuperValu Inc. was a win for both whistleblowers and sophisticated companies, but unfortunately left “subjective belief” to be interpreted by lower courts and future litigants, say attorneys at Baker Donelson.

  • A Glimpse Into HHS' Digital App Enforcement Priorities

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    A recent opinion from the U.S. Department of Health and Human Services' Office of Inspector General sheds helpful light on the evolving intersection between health care regulation and digital apps, revealing some of the agency's key priorities and concerns in overseeing how federal program patients choose providers, says Mary Kohler at Kohler Health Law.

  • Courts Can Overturn Deficient State Regulations, Too

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    While suits challenging federal regulations have become commonplace, such cases against state agencies are virtually nonexistent, but many states have provisions that allow litigants to bring suit for regulations with inadequate cost-benefit analyses, says Reeve Bull at the Virginia Office of Regulatory Management.

  • Tales From The Trenches Of Remote Depositions

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    As practitioners continue to conduct depositions remotely in the post-pandemic world, these virtual environments are rife with opportunities for improper behavior such as witness coaching, scripted testimony and a general lack of civility — but there are methods to prevent and combat these behaviors, say Jennifer Gibbs and Bennett Moss at Zelle.

  • The Double-Edged Sword Of Using ChatGPT In Health Care

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    While ChatGPT has shown promising potential in health care, one of the key challenges for players in this space is balancing patient privacy and data protection with the benefits of utilizing this technology, say attorneys at Sheppard Mullin.

  • Level Up Lawyers' Business Development With Gamification

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    With employee engagement at a 10-year low in the U.S., there are several gamification techniques marketing and business development teams at law firms can use to make generating new clients and matters more appealing to lawyers, says Heather McCullough at Society 54.