Policy & Compliance
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July 22, 2025
Employers, Plans Force Freeze Of Iowa's PBM Law
A federal judge slapped a temporary hold on parts of an Iowa law that aims to limit pharmacy benefit managers' power to set drug prices, ruling that provisions barring discrimination against certain pharmacies and pushing cost-saving strategies are preempted by federal benefits law.
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July 22, 2025
4th Circ. Backs Medicaid Fraud Conviction, 17-Year Sentence
A North Carolina lab owner lost his bid Tuesday to overturn his healthcare fraud conviction after the Fourth Circuit found evidence against him to be sufficient and the terms of his sentence reasonable.
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July 22, 2025
NC Hospital Says Dropped Malpractice Claim Dooms 2004 Suit
A North Carolina hospital is asking state appellate judges to determine whether a hospital can face claims of negligently credentialing a doctor if the plaintiffs have dropped the underlying medical malpractice allegation against the physician.
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July 22, 2025
Medicaid Cuts To Raise Staffing Pressure On Nursing Homes
Massive changes coming to Medicaid are expected to push more seniors reliant on state-supported services into nursing homes, adding pressure to a system already struggling with staffing and quality of care issues.
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July 22, 2025
Lawmakers Consider Case Of Would-Be Donor's 'Signs Of Life'
The nation's organ transplant system is again under the microscope of federal lawmakers after a federal investigation found that a Kentucky organ procurement organization moved forward with the transplant process despite the patient showing "signs of life."
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July 22, 2025
FDA Talks Transparency. Drug Cos. Ask How Far It Will Go
The first batch of rejection letters published as part of the FDA’s new transparency effort didn’t shake up the pharmaceutical industry. But future releases could trigger litigation and influence drug-development strategies, depending on how far the agency is willing to go.
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July 22, 2025
Judge Blocks Some Planned Parenthood Cuts In Partial Ruling
A Massachusetts federal judge partially blocked a measure passed by Congress this month stripping Medicaid funding from Planned Parenthood-affiliated facilities, but only as it applies to those that do not provide abortions or that receive minimal federal support.
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July 22, 2025
A Billing Code 'Ambiguity' Retrial: 3 Things To Know
A Maryland doctor found guilty by a federal jury two years ago in a COVID-19 testing scheme, only to see his conviction thrown out, is once again facing a criminal trial. Law360 Healthcare Authority examines the restarted prosecution and talks to experts about what makes the case so unusual.
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July 21, 2025
Wash. Plastic Surgeon Can't Get $13M Jury Verdict Overturned
A Washington appeals court panel refused on Monday to undo a $13 million jury verdict against a plastic surgeon in a medical malpractice case, rejecting the doctor's argument that the lower court wrongly allowed evidence of state regulators' unrelated disciplinary proceedings against her.
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July 21, 2025
Pa. Hospital Can Shield Some Docs In Birth Injury Suit
A Pennsylvania state appeals panel won't force a hospital to turn over all of its internal reports in a suit by parents alleging that the hospital's negligence led to their son's injuries at birth, finding that the hospital sufficiently showed that two of the three contested files are privileged.
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July 21, 2025
States Say Noncitizen Benefit Restrictions Are Creating Chaos
A coalition of 20 Democratic-led states and the District of Columbia sued the Trump administration on Monday for "upending" noncitizens' access to publicly funded programs like Head Start and food banks.
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July 21, 2025
Trump Admin's Harvard Cuts Vex Judge: 'Staggering To Me'
A Massachusetts federal judge said Monday that the Trump administration has not presented evidence that Harvard has failed to address antisemitism on its campus and expressed bewilderment at the government's legal justifications for cutting $2.2 billion in funding.
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July 21, 2025
Hartford Unit Must Cover Drug Test Co. In False Results Suit
A Hartford unit must cover a drug testing company in a suit over false positive tests, a Virginia federal court ruled, finding that the suit was not related to a prior proposed class action filed during another insurer's coverage period.
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July 18, 2025
Law360 Names 2025's Top Attorneys Under 40
Law360 is pleased to announce the Rising Stars of 2025, our list of more than 150 attorneys under 40 whose legal accomplishments belie their age.
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July 18, 2025
Kaiser's $11M Class Meal Break Deal Gets Final OK In Wash.
A Washington state judge gave the final green light on Friday to a nearly $11 million class deal to end claims that Kaiser Permanente shortchanged Evergreen State employees who worked through their meal breaks, while also awarding class counsel $3.6 million in legal fees from the settlement fund.
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July 18, 2025
Investor Sues Biotech Capricor After Product's FDA Denial
Biotechnology company Capricor Therapeutics Inc. faces a proposed investor class action alleging it misrepresented its lead product candidate's approval prospects before the U.S. Food and Drug Administration.
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July 18, 2025
Judge Advised Against State AG Intervention In Sandoz Deal
A special master on Friday advised a Pennsylvania federal court to deny a bid by California and other state attorneys general to intervene in a $275 million settlement resolving generic-drug price-fixing claims against Sandoz, finding they lacked standing to represent the interests of consumers.
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July 18, 2025
Judge Questions Basis For Planned Parenthood Funding Cuts
A Massachusetts federal judge on Friday pressed the government for any plausible rationale, besides retaliation, for a provision in Congress' budget reconciliation that will prevent Planned Parenthood and its affiliates from receiving Medicaid reimbursements if any one of them offers abortion services.
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July 18, 2025
Pillsbury Atty Fights Sanctions In Nurse Wage-Fixing Case
A partner with Pillsbury Winthrop Shaw Pittman LLP told a Nevada federal court he should not be sanctioned for using a poor choice of words when communicating with the government about the availability of an expert witness during a wage-fixing and wire fraud trial.
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July 17, 2025
21 States Fight ACA Rule They Say Guts Health Coverage
A 21-state coalition led by the attorneys general of California, Massachusetts and New Jersey sued the U.S. Department of Health and Human Services and the Centers for Medicare and Medicaid Services on Thursday, challenging a new Trump administration rule they say unlawfully undermines access to healthcare under the Affordable Care Act.
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July 17, 2025
Senators Float 'Patent Thicket' Bill To Limit Generic Litigation
A bill floated in the U.S. Senate would limit the use of so-called patent thickets that are asserted by major pharmaceutical companies in litigation to restrict generic competition.
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July 17, 2025
Insurer, Urology Practices Beat Puerto Rico Antitrust Suit
A Puerto Rico federal judge threw out an antitrust lawsuit accusing insurer Triple-S Salud and two urology firms of colluding to exclude rival practices from the commonwealth's government-run healthcare program, finding that the selection of a defendant practice through a competitive process means there was no anticompetitive harm.
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July 17, 2025
Ex-CEO Agrees To $27.5M Judgment In Medicare Fraud Case
A day before his trial was set to begin, the former CEO and owner of the now-defunct laboratory Premier Medical Inc. agreed to a $27.5 million consent judgment, acknowledging he was likely to be found liable in the suit brought against him by the federal government and three states.
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July 17, 2025
Fla. AG, Sandoz Clash With Other Enforcers Over 'Done' Deal
Sandoz and Florida's attorney general pressed a Connecticut federal judge Wednesday to let them settle out of sweeping price-fixing litigation against generic-drug makers, contending that federal civil procedure rules give no room for objections from other state enforcers worried the Sunshine State deal interferes with their own ability to negotiate settlements.
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July 17, 2025
4th Circ. Orders New Trial After Doc Acquitted In Fraud Case
A Fourth Circuit panel ordered a new trial for a doctor who received a judge's acquittal after a jury found him guilty of alleged healthcare fraud, finding that the jury had sufficient evidence to convict, but the case was "close," and the district court was correct in hedging and allowing another shot at the case.
Expert Analysis
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1st Gender Care Ban Provides Context For High Court Case
The history of Arkansas' ban on gender-affirming medical care — the first such legislation in the U.S. — provides important insight into the far-reaching ramifications that the U.S. Supreme Court's decision in U.S. v. Skrmetti next term will have on transgender healthcare, says Tyler Saenz at Baker Donelson.
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6 Lessons From DOJ's 1st Controlled Drug Case In Telehealth
Following the U.S. Department of Justice’s first-ever criminal prosecution over telehealth-prescribed controlled substances in U.S. v. Ruthia He, healthcare providers should be mindful of the risks associated with restricting the physician-patient relationship when crafting new business models, says Jonathan Porter at Husch Blackwell.
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After Chevron: Scale Tips Favor Away From HHS Agencies
The loss of Chevron deference may indirectly aid parties in challenging the U.S. Department of Health and Human Services' interpretations of regulations and could immediately influence several pending cases challenging HHS on technical questions and agency authority, say attorneys at Ropes & Gray.
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After Chevron: FDA Regulations In The Crosshairs
The U.S. Supreme Court's overturning of the Chevron doctrine is likely to unleash an array of challenges against the U.S. Food and Drug Administration, focusing on areas of potential overreach such as the FDA's authority under the Federal Food, Drug and Cosmetic Act, say attorneys at Debevoise.
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USPTO Disclaimer Rule Would Complicate Patent Prosecution
The U.S. Patent and Trademark Office's proposed changes to terminal disclaimer practice could lead to a patent owner being unable to enforce a valid patent simply because it is indirectly tied to a patent in which a single claim is found anticipated or obvious in view of the prior art, say attorneys at Sterne Kessler.
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Navigating Scrutiny Of Friendly Professional Corps. In Calif.
In light of ongoing scrutiny and challenges to private equity participation in the California healthcare marketplace, particularly surrounding the use of the friendly professional corporation model, management services organizations should consider implementing four best practices, say attorneys at Holland & Knight.
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Takeaways From New HHS Substance Use Disorder Info Rules
A new U.S. Department of Health and Human Services rule continues the agency's efforts to harmonize complex rules surrounding confidentiality provisions for substance use disorder patient records, though healthcare providers will need to remain mindful of different potentially applicable requirements and changes that their compliance structures may require, say attorneys at Ropes & Gray.
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Calif. Banking Brief: All The Notable Legal Updates In Q2
The second quarter of 2024 in California, which saw efforts to expand consumer protection legislation and enforcement actions in areas of federal focus like medical debt and student loans, demonstrated that the state's role as a trendsetter in consumer financial protection will continue for the foreseeable future, say attorneys at Sheppard Mullin.
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How Cannabis Rescheduling May Affect Current Operators
The U.S. Drug Enforcement Agency's proposal to reschedule marijuana to Schedule III provides relief in the form of federal policy from the stigma and burdens of Schedule I, but commercial cannabis operations will remain unchanged until the federal-state cannabis policy gap is remedied by Congress, say Meital Manzuri and Alexis Lazzeri at Manzuri Law.
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Air Ambulance Ruling Severely Undermines No Surprises Act
A Texas federal court's recent decision in Guardian Flight v. Health Care Service — that the No Surprises Act lacks a judicial remedy when a health insurer refuses to pay the amount established through an independent review — likely throws a huge monkey wrench into the elaborate protections the NSA was enacted to provide, says Mark DeBofsky at DeBofsky Law.
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Class Actions At The Circuit Courts: June Lessons
In this month's review of class action appeals, Mitchell Engel at Shook Hardy considers two recent decisions from the Third and Tenth Circuits, and identifies practice tips around class action settlements and standing in securities litigation.
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How Congress Is Tackling The US Healthcare Shortage
With healthcare shortages continuing across the U.S. despite industry efforts to improve patient access to care, increased Medicare support for graduate medical education could be a crucial component of the solution, say Sarah Crossan and Miranda Franco at Holland & Knight.
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The Current State Of Healthcare Transaction Reviews In Calif.
As of April, certain healthcare transactions in California have been subject to additional notification compliance requirements, and complying with these new rules could significantly delay and discourage some deals, says Andrew Demetriou at Husch Blackwell.