Policy & Compliance

  • July 15, 2026

    Acorda Can't Add $66M To Award In Ampyra Royalty Fight

    The Second Circuit on Wednesday refused to alter an arbitral award issued to Acorda Therapeutics to include nearly $66 million beyond the $16.6 million it won in a multiple sclerosis drug dispute, saying the company "slept on its rights" and couldn't change the result now.

  • July 15, 2026

    2nd Circ. Revives NY Provider's BCBS Underpayment Suit

    The Second Circuit on Wednesday revived a New York healthcare provider's suit accusing out-of-state Blue Cross Blue Shield licensees of underpaying insurance claims, saying the carriers' long-standing business relationship with a New York licensee to obtain preferential prices in the state supports jurisdiction there.

  • July 15, 2026

    Local Gov'ts Seek To Bar HHS Teen Health Program Changes

    A group of local governments and health nonprofits urged a D.C. federal court Wednesday to block recent federal mandates requiring Teen Pregnancy Prevention Program grant recipients to incorporate abstinence education and other changes to their reproductive health programming, arguing the changes are arbitrary and capricious.

  • July 15, 2026

    NC Panel Nixes Nurse Noncompetes For Being 'Too Broad'

    A medical clinic provider couldn't convince a North Carolina state appeals court to overturn a ruling that noncompete agreements for two former nurses were unenforceable, after a split panel ruled Wednesday that the terms were overly broad and voidable under public policy.

  • July 15, 2026

    United Owes $630K In Fight Over Teen's Mental Health Care

    United Healthcare must pay $630,000 to a mother who challenged the insurance company's decision to deny coverage for her son's residential mental health treatment, a Utah federal judge ordered, after rejecting the company's bid to slim her requests for interest and attorney fees.

  • July 15, 2026

    Mass. Says UnitedHealth FCA Case Belongs In State Court

    Massachusetts asked a federal judge to send its $100 million state False Claims Act lawsuit alleging overbilling by UnitedHealthcare back to state court, accusing the insurer of forum shopping with a theoretical defense touching on federal law.

  • July 15, 2026

    DC Circ. Affirms Ratings For Alignment Medicare Plans

    The D.C. Circuit sided with the Centers for Medicare & Medicaid Services regarding its decision not to discard certain unfavorable surveys for Alignment Healthcare's Medicare Advantage plans, saying there is no indication of an administrative error.

  • July 14, 2026

    Albertsons Probed On Pharmacy Compliance Staffing At Trial

    Two former Albertsons pharmacy compliance executives testified in video depositions played Tuesday before a Washington judge considering whether Albertsons failed to prevent the diversion of opioids in the state, acknowledging the nationwide compliance team consisted of just six staffers between 2015 and 2020 despite heightened scrutiny amid the opioid epidemic.

  • July 14, 2026

    3rd Circ. Revives Providers' Underpayment Suit Against Cigna

    The Third Circuit partially revived several New Jersey-based healthcare practices' Employee Retirement Income Security Act suit alleging Cigna improperly underreimbursed them for covered healthcare services provided to Cigna's subscribers, ruling Monday the plaintiffs sufficiently alleged they were underpaid for some out-of-network services when compared to their normal charges for similar services.

  • July 14, 2026

    Patent Eligibility Bill Divides Senators Over Health Costs

    Several U.S. senators expressed strong support at a hearing Tuesday for a bill aimed at expanding which inventions are eligible for patents, while others appeared to have reservations about the potential effect of the proposed changes on healthcare costs.

  • July 14, 2026

    Medical Device Co. Settles FCA Claims

    A company that sells compression devices to reduce swelling in patients with certain medical conditions will pay $551,000 to settle allegations that it obtained Medicare reimbursement with falsified medical records, the U.S. attorney's office in Massachusetts announced Tuesday.

  • July 14, 2026

    FDA Resumes Drug Denial Letters Amid Secrecy Clash

    Drugmakers are examining a new batch of drug application rejection letters released by the U.S. Food and Drug Administration this month — the first disclosure since regulators paused the releases amid industry outcry.

  • July 14, 2026

    CVS Caremark Settles Out Of FTC Suit Over Insulin Pricing

    The Federal Trade Commission reached a settlement on Tuesday with CVS Caremark that includes a number of changes to its business practices, the second deal in a case accusing the country's largest pharmacy benefit managers of inflating insulin prices through unfair rebate schemes.

  • July 14, 2026

    The Latest Medicare Star Lawsuits: What You Need To Know

    Following a win in a Georgia federal court for a health plan challenging a Medicare Advantage Star Ratings calculation, Law360 Healthcare Authority looks at a recent batch of insurer lawsuits seeking to capitalize on the ruling.

  • July 14, 2026

    1st Circ. Backs CDC Ban On Importing Dogs Under 6 Months

    The First Circuit has upheld a rule requiring all dogs imported into the U.S. to be at least six months of age, saying the federal Centers for Disease Control and Prevention had shown it was a reasonable measure to fight rabies.

  • July 14, 2026

    DOJ Asks 9th Circ. Undo Trans Health Ruling Against Premera

    The federal government has backed Premera Blue Cross in its bid at the Ninth Circuit to overturn a Washington federal court's judgment that held the insurance company's coverage policy for gender dysphoria surgery is discriminatory, arguing the decision is out of line with U.S. Supreme Court precedent.

  • July 14, 2026

    Clinics Want Medicaid Abortion Stay Lifted After Pa. Court Win

    Allegheny Reproductive Health Center and other healthcare providers on Tuesday asked a Commonwealth Court judge to unfreeze money for Medicaid-funded abortions in Pennsylvania following the court's landmark ruling that the state's coverage exclusions for such abortions were unconstitutional.

  • July 14, 2026

    Kroger Says Flimsy Claims Doom Tobacco Fee Suit

    Grocery giant Kroger urged an Ohio federal judge to toss a suit challenging the legality of an extra health plan fee it charged tobacco users, stating it complied with federal benefits law by giving workers a 90-day window each year to dodge the fee by enrolling in a wellness program.

  • July 14, 2026

    HHS Wields Checkbook To Pressure State Fraud Units

    Cutting off federal funding to Medicaid fraud units in New York and Hawaii could reshape the enforcement priorities of similar units across the country. The HHS watchdog has made clear the agency wants states to lean in on criminal Medicaid fraud cases.

  • July 14, 2026

    Amgen Colo. Win May Chill States' Push To Cap Drug Prices

    A Colorado injunction blocking a prescription drug pricing statute may have thrown a wrench into efforts in other states to limit drug costs for consumers through a new crop of state oversight boards.

  • July 13, 2026

    Albertsons, Safeway Face Trial Over Wash.'s Opioid Epidemic

    Albertsons and Safeway ignored signs of problematic opioid prescriptions in Washington for years, an attorney for the state told a Seattle judge Monday during opening statements in a bench trial over allegations that the pharmacy chains failed to prevent the diversion of opioids that fueled the state's long-running overdose crisis.

  • July 13, 2026

    2nd Circ. Says Tylenol Maker Must Face Autism, ADHD Suits

    The Second Circuit said Monday that a lower court had wrongly excluded plaintiffs experts from testifying about an alleged relationship between using Tylenol during pregnancy and autism spectrum disorder and attention-deficit/hyperactivity disorder, although the panel cautioned that the decision was not political or scientific.

  • July 13, 2026

    J&J Asks 3rd Circ. To Block Return Of Ex-Worker's Fee Claims

    Johnson & Johnson has asked the Third Circuit to keep dismissed excessive fee claims out of a proposed class action alleging the company charged employees too much for a prescription drug benefits program, arguing that the lower court correctly tossed that portion of the suit for lack of standing.

  • July 13, 2026

    Northwell Escapes Suit Over Pension Plan Conversion

    Northwell Health defeated a proposed class action alleging it hid cuts to workers' pension plans when converting to a cash-balance plan in the late 1990s, with a New York federal judge finding the hospital system adequately disclosed how the change could impact participants' benefits.

  • July 13, 2026

    Health Org. Can't Halt FTC Texas Suit Over Trans Youth Care

    A D.C. federal court declined to bar the Federal Trade Commission from pursuing a consumer protection suit in Texas against the World Professional Association for Transgender Health, finding WPATH failed to show those proceedings threatened the court's injunction of a related investigation by the FTC.

Expert Analysis

  • 3rd Circ. Decision Sheds Light On BIPA Bank Exemption

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    The Third Circuit's recent decision in McGoveran v. Amazon illuminates how courts are extending the Illinois Biometric Information Privacy Act's financial institution carveout beyond banks and insurers to technology vendors and other businesses handling biometric data, a defendant-friendly shift that still casts uncertainty around BIPA's enforcement, say attorneys at Dorsey & Whitney.

  • Data Reveals Pivot In Feds' Financial Fraud Priorities

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    Recent Justice Department data shows fraud prosecutions fell to their lowest rate in a decade in 2025, illustrating a move away from traditional financial cases and toward a targeted mix of healthcare, government program, consumer and sanctions matters, say Paul Hinton and Adrienna Huffman at The Brattle Group.

  • New Timeline For Benefits Cases May Increase FCA Litigation

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    Recent reforms designed to speed enforcers’ intervention decisions in False Claims Act suits involving state-administered benefits will likely encourage more qui tam relators to litigate cases without the government’s imprimatur, and increase defendants’ discovery burdens, defense costs and business disruptions, say attorneys at Morgan Lewis.

  • FTC's Clinical Trial Requirement Threatens Food Claim Rules

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    The Federal Trade Commission's general requirement for randomized controlled trials for most health-benefit claims, recently embraced by the National Advertising Review Board, lacks legal basis and endangers the existing statutory framework Congress created for marketing food and dietary supplements versus drugs, say attorneys at Keller & Heckman.

  • HHS Enforcement Restructuring Signals Compliance Risks

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    The U.S. Department of Health and Human Services' recent restructuring of its Office for Civil Rights suggests that, while Health Insurance Portability and Accountability Act enforcement remains central, its priorities have expanded to encompass civil rights, conscience and religious freedom, and data and cybersecurity issues, say attorneys at King & Spalding.

  • AG Watch: Oregon's Strategic Civil Enforcement Approach

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    Oregon Attorney General Dan Rayfield’s recent antitrust litigation activity and proposed staffing increase are the latest in a series of structural and policy changes that signal that the state Department of Justice is taking a more aggressive approach to civil enforcement, says Keturah Taylor at Cozen O'Connor.

  • A Decade Later, Escobar Is Still Shaping FCA Cases

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    The U.S. Supreme Court's decision 10 years ago in Universal Health Services v. U.S. ex rel. Escobar changed the way in which lower courts evaluate False Claims Act cases — and the ruling remains vital in nearly every FCA case filed today, say attorneys at Bradley Arant.

  • How FCA, FCPA Risks Are Shifting As Feds Pull Back

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    As the federal government continues its retreat from white collar enforcement, companies should expect False Claims Act risk to grow through private whistleblower suits and Foreign Corrupt Practices Act scrutiny to shift toward foreign prosecutors, requiring more adaptability as accountability becomes less centralized, says Temidayo Aganga-Williams at Selendy Gay.

  • Trump Admin's Agency Records Purge Tests Judicial Notice

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    While courts commonly take judicial notice of data in government websites and reports, the Trump administration's recent modification or wholesale deletion of these sources means that litigants must look elsewhere to support trial admission of this information, says Jon Gryskiewicz at Lewis Baach.

  • West Coast Health Cos. Must Brace For Federal Enforcement

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    In light of the U.S. Department of Justice's newly established West Coast strike force targeting healthcare fraud across Northern California, Arizona and Nevada, health organizations will need to prioritize knowledge, vigilance and operational discipline to reduce exposure from potentially parallel criminal and civil investigations, says Michael Beckwith at Dickinson Wright.

  • High Court's Hikma Decision Reshapes 'Skinny Label' Suits

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    The U.S. Supreme Court's decision in Hikma v. Amarin marks a significant victory for generic drug manufacturers, but rather than putting an end to so-called skinny label inducement claims, it narrows and refocuses them, say attorneys at Sterne Kessler.

  • Turning To The Courts When PBM Reform Falls Short

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    The effectiveness of state laws intended to regulate pharmacy benefit managers remains uncertain, but litigation — utilizing tried-and-true theories like breach of contract and fair dealing — offers another mechanism through which stakeholders may seek relief from PBMs, say attorneys at Reed Smith.

  • High Court's Abortion Pill Stay Reinforces Appellate Principles

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    The U.S. Supreme Court's recent order in Danco Laboratories v. Louisiana, staying a Fifth Circuit ruling that reinstated an in-person requirement for dispensing the abortion medicine mifepristone, should be seen not as a definitive ruling on reproductive rights, but as an affirmation of a more disciplined jurisdictional reality, says Daniel Nardo at Nardo & Associates.