Policy & Compliance

  • May 20, 2026

    Pa. AG Aims To Revive Ban On Medicaid-Paid Abortions

    Pennsylvania Attorney General Dave Sunday plans to fight an appellate panel's ruling that Medicaid-funded abortions are a fundamental right to reproductive autonomy in the state.

  • May 20, 2026

    Bass Berry Adds Crowell & Moring Healthcare Atty In DC

    Bass Berry & Sims PLC has hired a former Crowell & Moring LLP partner, who in her last role represented a healthcare insurer against whistleblower claims that it participated in a kickback scheme involving Medicare Advantage customers.

  • May 19, 2026

    New Suits Target Fed. Loan Rule, CVS 340B Rates And More

    Law360 Healthcare Authority looks at new lawsuits targeting a U.S. Department of Education rule limiting loans available to students in nursing and other healthcare programs, CVS reimbursement practices for safety net providers under the federal 340B drug discount program and more.

  • May 19, 2026

    Cigna Can't Knock Out 401(k) Forfeiture, Fund Suit

    Cigna can't escape a proposed class action alleging that underperforming investment offerings and misallocated forfeitures in its employee 401(k) plan cost workers millions, after a Pennsylvania federal judge ruled Tuesday that alleged violations of federal benefits law were sufficiently backed up to reach discovery.

  • May 19, 2026

    Justice Alito Calls Out Slow Pace Of FDA Mifepristone Study

    The Trump administration’s slow-paced review of the abortion medication mifepristone has the attention of a U.S. Supreme Court justice, not just anti-abortion activists.

  • May 19, 2026

    9th Circ. Reopens Ex-Transit Manager's Vaccine Bias Suit

    The Ninth Circuit breathed new life into a Washington transit system manager's lawsuit alleging she was fired for requesting a religious exemption from a county's COVID-19 vaccine requirement, ruling Tuesday that she should be given a chance to revise her complaint.

  • May 19, 2026

    3 Things To Know As Distributors Test Conn. Drug Price Law

    The Second Circuit will hear arguments in a suit filed by a wholesale drug distributor group seeking to take down —​​​​​​​ or at least hold up —​​​​​​​ a Connecticut law tying price increases for generics to inflation.

  • May 19, 2026

    States Sue Over Student Loan Limits On Professional Degrees

    A coalition of 24 attorneys general and two governors are challenging a rule recently promulgated by the U.S. Department of Education, alleging in a complaint in Maryland federal court Tuesday that it unlawfully limits access to federal student loans for those pursuing professional degree programs.

  • May 19, 2026

    Mich. Hospitals Say CVS Diverted $66M In 340B Drug Savings

    CVS Health Corp. and several affiliates implemented a pricing scheme to divert to themselves savings from the federal 340B Drug Pricing Program, two University of Michigan hospital operators told a federal court, saying the scheme has resulted in more than $66 million in lost revenue over six years.

  • May 19, 2026

    Anthem Inks $3.6M Settlement In Proton Beam Therapy Suit

    Anthem and its affiliates have agreed to fork over approximately $3.6 million to end a proposed class action from employee health plan participants who challenged coverage denials for proton beam therapy to treat cancer, according to Tuesday filings in Tennessee federal court.

  • May 18, 2026

    PBMs Tell Mich. Court They're Not To Blame For Opioid Abuse

    Pharmacy benefit managers told a Michigan federal court on Monday they are not responsible for opioid abuse because they do not control prescription drugs once they are sold to patients, as Evernorth Health, Express Scripts and other companies seek an exit from the state attorney general's public nuisance suit.

  • May 18, 2026

    Aetna Denied A Freeze On Trans Facial Surgery Order

    A Connecticut federal judge ordered Aetna to comply with a preliminary injunction requiring it to reconsider coverage denials affecting two transgender health plan participants who sought gender-affirming facial surgery, refusing to stay the insurer's compliance obligations during its pending appeal in the proposed class action.  

  • May 18, 2026

    Morgan & Morgan Atty Barred From Harvard Suit Over AI Error

    A Massachusetts judge on Monday said a Morgan & Morgan PA attorney may not appear before him in a suit against Harvard University over the theft of body parts donated to its medical school, saying the lawyer did not learn his lesson after signing off on briefs in another case with fake case law generated by artificial intelligence.

  • May 18, 2026

    Justices Deny Eli Lilly's Qui Tam Constitutional Challenge

    The U.S. Supreme Court on Monday declined to review Eli Lilly's $183 million trial loss to a whistleblower who claimed the drugmaker knowingly defrauded the government by underpaying Medicaid drug rebates.

  • May 18, 2026

    Colo. Justices Tell Hospital To Resume Gender-Affirming Care

    The Colorado Supreme Court ordered Children's Hospital Colorado on Monday to resume its provision of gender-affirming care for transgender youth patients, finding the patients demonstrated actual harm from the denial of care.

  • May 18, 2026

    High Court Spurns Pharma Challenges To IRA Drug Price Talks

    The U.S. Supreme Court rejected six petitions Monday from pharmaceutical giants seeking to bring down the Medicare drug price negotiations established as part of the Inflation Reduction Act three years ago.

  • May 15, 2026

    Texas Hospital Creates 'De-Transition Clinic' After Settlement

    The Texas attorney general announced a settlement with Texas Children's Hospital that will see the creation of a detransition clinic, saying Friday that the hospital will pay $10 million for billing Texas Medicaid for "illegal 'gender-transition' interventions."

  • May 15, 2026

    Minn. Twins Doctor Can't Claim Immunity In Player Death Suit

    A doctor employed by the Minnesota Twins can't claim immunity in a lawsuit alleging he failed to diagnose a heart condition in a ballplayer that led to his death, a Florida appeals panel ruled on Friday.

  • May 15, 2026

    4th Circ. Hands Express Scripts Jury Trial In W.Va. Opioid Suit

    The Fourth Circuit on Friday issued a writ of mandamus backing Express Scripts Inc.'s right to a jury trial in litigation over the pharmacy benefit manager's alleged role in contributing to the opioid crisis in West Virginia.

  • May 15, 2026

    Texas Justices Revive Anti-SLAPP Bid In Abortion Fund Suit

    The Texas Supreme Court on Friday revived a woman's anti-SLAPP bid in an abortion fund's suit against her, holding that the suit was filed in response to the woman's earlier attempt to investigate the fund's deputy director for potential violations of state abortion law.

  • May 15, 2026

    NC Social Worker Wants Resentencing In Medicaid Fraud Suit

    A clinical social worker in North Carolina serving more than 11 years in prison on healthcare fraud charges is challenging her sentence in the Fourth Circuit, saying Thursday that a lower court used overly generalized findings to apply a vulnerable victim sentence enhancement.

  • May 14, 2026

    NJ Doctor Prescribed Medical Marijuana To Kids, AG Says

    A New Jersey doctor had his medical license temporarily suspended by a state board, which found there is good reason to believe he is "a grave danger" to his patients after prosecutors accused him of repeatedly prescribing marijuana to adults and children without complying with state law.

  • May 14, 2026

    NC Republicans Want Fetal Personhood Question On '26 Ballot

    Two Republicans in the North Carolina House who have a history of advancing so-called fetal personhood bills have made another attempt to put a constitutional amendment to voters in November to decide if life begins at fertilization.

  • May 14, 2026

    Pa. Psych Hospital Faces Multiple Abuse Lawsuits

    A Pittsburgh-area psychiatric hospital has been hit with five state court lawsuits alleging it allowed patients as young as 10 years old to be physically and sexually abused by staff members and other patients, despite multiple investigations and warnings.

  • May 14, 2026

    Moda Health Settles Wilderness Therapy Coverage Suit

    Health insurance provider Moda Health has agreed to settle a lawsuit alleging it unlawfully denied a family's claims for their daughter's stays at two wilderness therapy programs and left them with thousands of dollars in medical bills, according to a filing in Oregon federal court.

Expert Analysis

  • How The Healthline Privacy Settlement Redefines Ad Tech Use

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    The Healthline settlement is the first time California has drawn a clear line in the sand around how website tracking must function in practice, so if your site uses tracking technologies, especially around sensitive content like health or finance, regulators are inspecting your website's back end, not just its banner, say attorneys at Baker Donelson.

  • How Sweeping Budget Bill Shakes Up Health Industry

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    With the recently passed One Big Beautiful Bill Act marking one of the most significant overhauls of federal health policy since the passage of the Affordable Care Act, providers, managed care organizations and life sciences companies must now shift focus from policy review to implementation planning, say advisers at Holland & Knight.

  • New DOJ Penalty Policy Could Spell Trouble For Cos.

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    In light of the U.S. Department of Justice’s recently published guidance making victim relief a core condition of coordinated resolution crediting, companies facing parallel investigations must carefully calibrate their negotiation strategies to minimize the risk of duplicative penalties, say attorneys at Debevoise.

  • A Look At Key 5th Circ. White Collar Rulings So Far This Year

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    In the first half of 2025, the Fifth Circuit has decided numerous cases of particular import to white collar practitioners, which collectively underscore the critical importance of meticulous recordbuilding, procedural compliance and strategic litigation choices at every stage of a case, says Joe Magliolo at Jackson Walker.

  • What US Medicine Onshoring Means For Indian Life Sciences

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    Despite the Trump administration's latest moves to onshore essential medicine manufacturing, India will likely remain an indispensable component of the U.S. drug supply chain, but Indian manufacturers should prepare for stricter compliance checks, says Jashaswi Ghosh at Holon Law Partners.

  • FCA Working Group Reboot Signals EHR Compliance Risk

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    The revival of the False Claims Act working group is an aggressive expansion of enforcement efforts by the Justice Department and the U.S. Department of Health and Human Services targeted toward technology-enabled fraud involving electronic health records and other data, say attorneys at ArentFox Schiff.

  • FDA's Hasty Policymaking Approach Faces APA Challenges

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    Though the U.S. Food and Drug Administration has abandoned its usual notice-and-comment process for implementing new regulatory initiatives, two recent district court decisions make clear that these programs are still susceptible to Administrative Procedure Act challenges, says Rachel Turow at Skadden.

  • The Metamorphosis Of The Major Questions Doctrine

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    The so-called major questions doctrine arose as a counterweight to Chevron deference over the past few decades, but invocations of the doctrine have persisted in the year since Chevron was overturned, suggesting it still has a role to play in reining in agency overreach, say attorneys at Crowell & Moring.

  • A Rapidly Evolving Landscape For Noncompetes In Healthcare

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    A wave of new state laws regulating noncompete agreements in the healthcare sector, varying in scope, approach and enforceability, are shaped by several factors unique to the industry and are likely to distort the market, say attorneys at Seyfarth.

  • Arguing The 8th Amendment For Reduction In FCA Penalties

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    While False Claims Act decisions lack consistency in how high the judgment-to-damages ratio in such cases can be before it becomes unconstitutional, defense counsel should cite the Eighth Amendment's excessive fines clause in pre-trial settlement negotiations, and seek penalty decreases in post-judgment motions and on appeal, says Scott Grubman at Chilivis Grubman.

  • $95M Caremark Verdict Should Put PBMs On Notice

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    A Pennsylvania federal judge’s recent ruling that pharmacy benefits manager CVS Caremark owes the government $95 million for overbilling Medicare Part D-sponsored drugs highlights the effectiveness of the False Claims Act, as scrutiny of PBMs’ outsized role in setting drug prices continues to increase, say attorneys at Duane Morris.

  • DOJ Actions Signal Rising Enforcement Risk For Health Cos.

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    The U.S. Department of Justice's announcement of a new False Claims Act working group, together with the largest healthcare fraud takedown in history, underscore the importance of sophisticated compliance programs that align with the DOJ's data-driven approach, say attorneys at Debevoise.

  • Spotlight On Medicare Marketing Practices Enforcement Trend

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    Recent U.S. Department of Justice actions, including its recent Medicare kickback allegations in Shea v. eHealth, demonstrate increasing enforcement scrutiny on Medicare Advantage marketing practices, say Ellen London at London & Naor, Li Yu at Bernstein Litowitz and Erica Hitchings at the Whistleblower Law Collaborative.