Policy & Compliance

  • 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.

  • March 12, 2024

    Pharmacy Calls $11M False Claims Case A 'House Of Cards'

    A compounding pharmacy and its president trashed the Connecticut attorney general's $11 million false claims and kickback allegations against them as a "house of cards" that awarded "a sweetheart cooperation deal" to an alleged co-conspirator and improperly benefited private attorneys, calling instead for a judgment against the state.

  • March 11, 2024

    FDA Seeks $7.2B For Fiscal Year 2025

    The U.S. Food and Drug Administration on Monday said that it is requesting $7.2 billion as part of the Biden administration's proposed budget, an increase of nearly $500 million from fiscal year 2023's funding, with $15 million aimed at protecting food safety and nutrition.

  • March 11, 2024

    NY Man's COVID Loan 'Greed' Merits 10 Years, Feds Say

    Federal prosecutors have asked a New York judge to sentence a Long Island man to 10 years in prison for his role in a scheme to steal more than $10 million from the Paycheck Protection Program and other pandemic-era disaster relief programs.

  • March 11, 2024

    Biden Proposes More Mental Health Expansion In 2025 Budget

    The Biden administration's $7.3 trillion fiscal year 2025 spending blueprint unveiled Monday maintains a pledge to transform the nation's mental health system, but contains the least ambitious discretionary budget ask for the U.S. Department of Labor in four years.

  • March 11, 2024

    Pfizer Slams Ex-Compliance Officer's Whistleblower Claims

    Pfizer has asked a California federal court to again dismiss the bulk of a discrimination and retaliation lawsuit filed by a former compliance officer for the pharmaceutical giant, arguing his latest suit is "largely a regurgitation of his original complaint."

  • March 11, 2024

    Urologist Seeks Coverage For Defective Penile Implants Suit

    A urologist's medical device company told a California federal court that two insurers must cover it, the doctor and his practice in an underlying class action alleging that a silicone implant invented for penile enlargement, and the procedure that went with it, left patients with permanent damage.

  • March 08, 2024

    Trump 'An Existential Threat' To Rule Of Law, Attys Warn

    Former President Donald Trump represents an "existential threat" to democracy and the rule of law, legal experts said Friday at a conference on white collar crime in San Francisco.

  • March 08, 2024

    Judge Keeps Novel Insider Trading Indictment Alive

    A California federal judge has refused to throw out a novel insider trading indictment against a former healthcare CEO, saying that the federal prosecutors provided sufficient information to sustain their allegations that the executive acted criminally by shedding millions of dollars worth of stock at the same time an important client relationship was nearing its end. 

  • March 08, 2024

    FDA Pumps Brakes On Eli Lilly Alzheimer's Drug Approval

    The U.S. Food and Drug Administration is delaying an approval decision on Eli Lilly and Co.'s Alzheimer's drug donanemab, the company said Friday, throwing a wrench in what was expected to be a smooth approval process for the experimental neurodegenerative treatment.

  • March 08, 2024

    7th Circ. Wants 'Roadmap' For Ill. Workplace Disease Law

    The Seventh Circuit has asked the Illinois Supreme Court to weigh in on the state's Workers' Occupational Diseases Act, saying it needs a "roadmap" to handle claims for asbestos and other diseases that manifest belatedly as it considers a widow's suit alleging her husband's exposure to a toxic chemical while working for Goodrich Corp. led to his death.

  • March 07, 2024

    Abortion, Drug Costs Top Health Issues in State Of The Union

    President Joe Biden laid out a forceful healthcare agenda in his State of the Union address on Thursday, promising to ramp up efforts to control drug prices and pledging to reinstate the federal right to an abortion if voters elect a pro-abortion Congress.

  • March 07, 2024

    Judge Doubts Medicare Drug Pricing Amounts To 'Taking'

    A New Jersey federal judge on Thursday bristled at the position by pharmaceutical companies that Medicare's drug price negotiation program is an unconstitutional "taking" that undercuts their bottom line, suggesting that the drug powerhouses needed more numbers to back their argument.

  • March 07, 2024

    Wash. Justices Won't Hear Unions' Wage Clawback Case

    Washington's highest court has rejected three unions' request for justices to decide how private employers may respond when they erroneously overpay employees, clearing the way for a jury to hear the case contesting a healthcare system's wage clawback after its payroll system was hit by a cyberattack.

Expert Analysis

  • 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.

  • Addressing Legal Issues Raised By AI Use In Health Care

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    With the usage of artificial intelligence and machine learning in health care likely to be governed by a patchwork of state laws for the near future, industry actors should build flexibility into products to meet evolving regulatory concerns, including monetization of patient data and professional licensing questions, say Sara Shanti and Phil Kim at Sheppard Mullin.

  • Mallory Ruling Leaves Personal Jurisdiction Deeply Unsettled

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    In Mallory v. Norfolk Southern Railway, a closely divided U.S. Supreme Court recently rolled back key aspects of its 2017 opinion in Daimler AG v. Bauman that limited personal jurisdiction, leaving as many questions for businesses as it answers, say John Cerreta and James Rotondo at Day Pitney.

  • Recent Provider Relief Fund Audits Are Just The Beginning

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    Though the Health Resources and Services Administration's initial audits of the Provider Relief Fund program appear to be limited in scope, fund recipients should prepare for additional oversight, scrutiny and disallowances as the HRSA ramps up its efforts, say Brian Lee and Christopher Frisina at Alston & Bird.

  • 5 Ways Firms Can Rethink Office Design In A Hybrid World

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    As workplaces across the country adapt to flexible work, law firms must prioritize individuality, amenities and technology in office design, says Kristin Cerutti at Nelson Worldwide.

  • A Midyear Look At How AI Is Affecting Lawyers

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    The past six months have been a notable period for advancements in artificial intelligence and generative AI, and as we head into the second half of the year, we must review the implications that AI has for the legal industry, including how lawyers will be advising clients on use of AI technology, says Natasha Allen at Foley & Lardner.

  • Bar Score Is Best Hiring Metric Post-Affirmative Action

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    After the U.S. Supreme Court's ruling striking down affirmative action admissions policies, law firms looking to foster diversity in hiring should view an applicant's Multistate Bar Examination score as the best metric of legal ability — over law school name or GPA, says attorney Alice Griffin.

  • Preparing For The Future Of Virtual Direct Supervision

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    The Centers for Medicare & Medicaid Services are expected to make an announcement soon about the future of virtual direct supervision, which has the potential to either add permanent flexibility to Medicare payment policy or cause some satellite centers to become unviable virtually overnight, say attorneys at Bass Berry.

  • Ghosting In BigLaw: How To Come Back From Lack Of Feedback

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    Junior associates can feel powerless when senior colleagues cut off contact instead of providing useful feedback, but young attorneys can get back on track by focusing on practical professional development and reexamining their career priorities, says Rachel Patterson at Orrick.

  • How Spending Clause Ruling May Affect Medicaid Litigation

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    The U.S. Supreme Court's decision in Health and Hospital Corp. v. Talevski preserves an important avenue for health providers and beneficiaries to use the Civil Rights Act to sue state Medicaid agencies in a landscape that has steadily narrowed potential paths for challenging state violations of spending clause legislation, say attorneys at Hooper Lundy.