Policy & Compliance

  • 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.

  • July 13, 2026

    Utah Health System Beats 401(k) Suit Over Stable Value Fund

    A Utah federal judge tossed a suit by workers who claimed a western U.S. health system kept an underperforming stable value fund in a retirement plan and greenlighted excessive management fees, ruling their case lacks evidence that the plan could have secured better funds and fees.

  • July 10, 2026

    JPMorgan Workers Defend ERISA Suit Over High Drug Costs

    JPMorgan employees urged a New York federal judge on Friday not to end their Employee Retirement Income Security Act suit alleging they paid too much for prescription drugs, arguing JPMorgan still has not shown that its contract with its pharmacy benefit manager was reasonable.

  • July 10, 2026

    States' Stopgap Suit Aims To Shield K-12 Mental Health Grants

    Washington and 14 other states launched a preemptive lawsuit Friday to stop the Trump administration from ending federal grants for mental health programming in public schools, seeking to preserve the funding if the U.S. Department of Education succeeds in asserting new grounds for canceling the grants in a related case.

  • July 10, 2026

    DOJ Appeals Order Shielding Trans Youth Medical Records

    The U.S. Department of Justice asked the Ninth Circuit to review a California federal court's order blocking the government from trying to identify individuals who received gender-affirming care from a Stanford Medicine hospital as minors.

Expert Analysis

  • 5th Circ.'s Abortion Pill Order Is Shaky On Multiple Grounds

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    The Fifth Circuit's recent order in Louisiana v. U.S. Food and Drug Administration, reinstating an in-person dispensing requirement for the abortion medication mifepristone, seems to turn federalism upside-down, and is also questionable for several other reasons, says Gregory Curtner at Curtner Law.

  • 5 Takeaways From Justices' Subpoena Fight Ruling

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    The U.S. Supreme Court's recent decision in First Choice v. Davenport fortifies a line of First Amendment associational privacy cases stretching back nearly 70 years, and ensures that organizations subject to government demands for donor information have a meaningful federal forum in which to defend their constitutional rights, say attorneys at DLA Piper.

  • Accelerated Psychedelic Therapy Pathways Require Caution

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    President Donald Trump's new executive order aiming to accelerate the approval of psychedelic drugs for the treatment of mental health disorders will likely bolster investigational psychedelic therapies, but parties within the psychedelic product supply chain will still need to prepare for potentially burdensome compliance requirements, say attorneys at Morgan Lewis.

  • Health Cos. Must Act Quickly To Secure Digital Front Doors

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    A fast-approaching deadline will require health providers to implement digital accessibility standards to their websites, necessitating important compliance steps that will help to ensure equal access to online health services, say attorneys at Holland & Knight.

  • How Oregon Ruling Affects Federal Gender Care Crackdown

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    In a favorable development for healthcare providers, an Oregon federal court recently vacated certain U.S. Department of Health and Human Services restrictions on gender-affirming care for minors, but the government's broader campaign against this care, including proposed rulemaking and agency investigations, leaves significant uncertainty, say attorneys at Arnold & Porter.

  • NY Opioid Antagonist Mandate Leaves Employers Guessing

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    A recently enacted New York law will require employers that are federally mandated to maintain first-aid supplies to now include an opioid antagonist, but being that it is subject to a complicated Occupational Safety and Health Administration analysis, employers face several unanswered compliance questions, say attorneys at Conn Maciel.

  • Calif. Case Raises Questions For Medical Practice Investors

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    The California attorney general's amicus brief in Art Center v. WCE and the California Medical Association's response highlight how the California appeals court's ruling could significantly affect the structure and enforceability of succession arrangements in medical practice ownership, say attorneys at Ropes & Gray.

  • Previewing FDA Preapproval Access In Psychedelics EO

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    The second of two pathways for psychedelic drug access outlined in President Donald Trump's recent executive order constitutes an unprecedented expansion of the Right to Try Act, which could fundamentally alter the psychedelic access landscape while presenting significant regulatory, operational and legal challenges, say attorneys at Husch Blackwell.

  • Previewing FDA National Priority Vouchers In Psychedelics EO

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    President Donald Trump's recent executive order on psychedelic drug access represents a watershed moment in federal drug policy, but its significance lies in two distinct regulatory pathways, the first being the Commissioner's National Priority Vouchers, which offer a significant opportunity to compress U.S. Food and Drug Administration review, say Kimberly Chew at Husch Blackwell and Odette Hauke at Odette Alina.

  • AG Watch: Texas Charts A Course On Investigative Authority

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    The Texas Supreme Court's recent decision in Texas v. PFLAG affirmed, and arguably expanded, the Texas attorney general's civil investigative demand authority, providing a road map that other courts evaluating state attorney general CIDs may find instructive, amid a lack of precedent, say attorneys at Kelley Drye.

  • Initial Virginia AG Actions Signal Focus On Multistate Efforts

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    Now that Virginia Attorney General Jay Jones has reached the 100-day mark in office, his first set of actions reveals a clear preference for coalition with regional and national counterparts, which means the primary risk for businesses is no longer just the fact of enforcement, but the speed at which investigations can escalate, says Lauren Cooper at Hogan Lovells.

  • How CMS Fraud Priorities Complicate Provider Acquisitions

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    As the Centers for Medicare & Medicaid Services steps up usage of its affiliates authority and post-transaction audits, parties contemplating the acquisition or sale of home health and hospice providers should take steps to avoid the potential suspension of Medicare billing privileges, say attorneys at Alston & Bird.

  • Mapping Philly US Atty's White Collar Enforcement Push

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    Attorneys at Blank Rome discuss the U.S. Attorney for the Eastern District of Pennsylvania David Metcalf’s commitments and priorities, survey early results from his first year, and suggest practical action items for companies operating under the office's jurisdiction.