Policy & Compliance
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August 27, 2025
DOJ Throws Lifeline To J&J At 3rd Circ. After $1.6B FCA Loss
A district judge made multiple errors in an opinion and jury instructions underpinning a staggering False Claims Act verdict tied to Johnson & Johnson's drug marketing practices, and a fresh look is needed "under a correct view of the law," the U.S. Department of Justice told the Third Circuit on Wednesday.
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August 27, 2025
7th Circ. Denies Alcoa's Bid To Stay Health Benefits Injunction
An aluminum manufacturer must comply with an injunction ordering it to reinstate union-represented retirees' healthcare benefits while it argues in court that it was allowed to transition them to health reimbursement accounts in 2021, the Seventh Circuit held, rejecting the company's request for the court to pause the injunction.
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August 27, 2025
CVS To Pay $12M To Settle Mass. Medicaid Overbilling Claims
CVS Pharmacy Inc. will pay more than $12 million to settle allegations that it charged Massachusetts' Medicaid program higher prices than it offered to the public for the same drugs, the state attorney general announced Wednesday.
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August 27, 2025
6th Circ. Says Hospital Waived Arbitration In Pronoun Dispute
The Sixth Circuit reversed an order Wednesday allowing a University of Michigan hospital to arbitrate an ex-worker's suit claiming she was fired out of religious bias for refusing to use preferred pronouns for certain LGBTQ patients, ruling the institution waited too long to invoke an arbitration pact.
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August 27, 2025
Scholars Tell High Court To Back Conversion Therapy Ban
A group of health law experts told the U.S. Supreme Court that Colorado's conversion therapy ban doesn't violate healthcare providers' First Amendment rights, arguing that the law is consistent with states' and the federal government's ability to regulate healthcare.
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August 27, 2025
Boehringer Wins Another Zantac Cancer Trial In Ill.
An Illinois state court jury sided with Boehringer Ingelheim on Wednesday in a man's lawsuit claiming over-the-counter Zantac use contributed to his colorectal cancer development, adding another tally on the German drugmaker's list of victories over similar accusations.
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August 26, 2025
Split 9th Circ. Upholds Oregon Pharmaceutical Reporting Law
A split Ninth Circuit panel on Tuesday vacated a lower court's order blocking an Oregon law requiring drug manufacturers to report information related to certain prescription drugs to the state, ruling that the law is indeed constitutional under both the First and Fifth amendments.
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August 26, 2025
DC Circ. Backs HHS In Low-Income Patient Payment Dispute
The D.C. Circuit has delivered a blow to a group of hospitals in a recent decision finding they had challenged a key component of their Medicare reimbursements too early, despite hospital associations' warnings that such a ruling could slow healthcare providers' ability to seek review and "ultimately harm" patients.
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August 26, 2025
Mich. AG Lambasts UMich For Halting Trans Youth Care
Michigan's attorney general publicly warned the University of Michigan Tuesday that her office was "considering all of our options" after the university's hospital system said it would cease providing gender-affirming care to minors under pressure from the Trump administration.
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August 26, 2025
Maine Medicaid Cuts, Medicare Radiation Ruling And More
A Maine federal court turned down a family planning organization's request to temporarily block a congressional mandate withdrawing Medicaid funds to abortion providers. In South Carolina, Planned Parenthood filed a new complaint challenging a state policy kicking the provider out of the state's Medicaid program for providing abortions.
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August 26, 2025
Doctors Press 5th Circ. To Reverse Surprise Billing Ruling
Three physician trade associations urged the full Fifth Circuit to reverse a panel's ruling on how qualifying payments are calculated under the No Surprises Act, writing that the current decision harms underserved communities by narrowing provider networks.
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August 26, 2025
Cigna Strikes ERISA Ghost Network Suit Settlement Deal
Cigna Health and Life Insurance Co. has agreed to settle a proposed class action alleging the health plan administrator violated federal benefits law by advertising providers as in-network who were out-of-network to participants in employer-sponsored health benefit plans that Cigna administered, according to filings in Illinois federal court.
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August 26, 2025
Frier Levitt Adds FDA Regulation Specialist Duo
New Jersey-based national healthcare law boutique Frier Levitt added a partner and senior counsel pair from a life science law boutique this week to expand its expertise in Food and Drug Administration regulation and compliance and the cannabis and hemp industries.
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August 26, 2025
TikTok Takes State's Addictive App Case To NC Top Court
TikTok and its Chinese parent company are taking the state of North Carolina's lawsuit accusing it of intentionally designing the app to addict young users to the state's highest court after a Business Court judge rejected their early exit bid.
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August 26, 2025
Foley Hoag Adds Healthcare Co-Leader From Manatt
Foley Hoag LLP has hired the former president and CEO of the National Hospice and Palliative Care Organization as the new co-chair of its healthcare department.
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August 25, 2025
DOJ Wants $10.5M From Convicted Nursing Exec For Fraud
U.S. Department of Justice prosecutors asked a Nevada federal judge Friday for a $10.5 million preliminary forfeiture order against a nurse staffing executive convicted of wage-fixing, an amount that matches what he was paid for his staffing company after deceiving the buyer into thinking there was no criminal antitrust investigation.
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August 25, 2025
Greenberg Traurig Adds Healthcare Atty From Baker Donelson
Greenberg Traurig LLP has brought on a shareholder from Baker Donelson Bearman Caldwell & Berkowitz PC at its Tallahassee office, adding an experienced attorney to its healthcare and U.S. Food and Drug Administration practice, the firm announced Monday.
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August 25, 2025
Generic-Drugs Group Asks 9th Circ. To Nix Pay-For-Delay Law
A trade group for generic drugmakers urged the Ninth Circuit to fully scrap a California law banning brand pharmaceutical companies from paying to delay generics competition, in a brief targeting both the law's in-state features upheld by a district court and the extraterritorial reach the state wants revived.
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August 22, 2025
Texas, Fla. Want In On Abortion Medication Challenge
Texas and Florida have asked a Lone Star State federal court to allow them to intervene in litigation challenging federal approvals for the abortion medication mifepristone, arguing that their interests may "no longer be adequately represented" by Missouri, Kansas and Idaho, which are currently leading the suit.
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August 22, 2025
Chicago Feds Create New Healthcare Fraud Section
The U.S. attorney's office in Chicago announced Friday it has created a section within its Criminal Division dedicated solely to prosecuting healthcare fraud, which the U.S. Department of Justice has identified as a fraud enforcement priority.
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August 22, 2025
Judge Blocks Most ACA Rule Changes, Lets Others Proceed
A Maryland federal judge Friday largely froze the Trump administration's changes to Affordable Care Act regulations, handing a win to three cities, a coalition of doctors and a small business advocacy group that contend the changes would cause at least 1.8 million people to lose their healthcare coverage.
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August 21, 2025
CVS, Drugmakers Illegally Inflated Insulin Prices, City Claims
Drugmakers Eli Lilly and Co., Novo Nordisk Inc. and Sanofi-Aventis US LLC, pharmacy benefit managers CVS Caremark, Express Scripts and Optum Rx, and others have been hit with civil racketeering and state unfair trade practices law claims by the city of Torrington, Connecticut, over an alleged scheme to inflate insulin prices.
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August 21, 2025
DOJ Gets Backing In Fight Over Public Benefits
A group that fights to restrict immigration into the U.S. is urging a Rhode Island federal court to let the Trump administration narrow noncitizens' access to programs like Head Start, homeless shelters and food banks, arguing Thursday that a coalition of 20 states is trying to obstruct immigration enforcement and give benefits to "illegal aliens."
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August 21, 2025
High Court Allows Trump Admin To Cancel $783M In NIH Grants
The U.S. Supreme Court on Thursday allowed the Trump administration to resume the mass termination of scientific grants, overturning rulings by lower courts that had kept the funds flowing to universities and other recipients.
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August 21, 2025
Feds Claim Fla. Billing Co. Aided $15M Medicare Fraud
The U.S. government urged a Florida federal judge to deny an outsourcing company's motion to toss a $15 million False Claims Act lawsuit, saying the business aided a Miami-based laboratory to fraudulently bill Medicare for genetic tests that weren't used to treat patients.
Expert Analysis
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Takeaways From DOJ's 1st Wage-Fixing Jury Conviction
U.S. v. Lopez marked the U.S. Department of Justice's first labor market conviction at trial as a Nevada federal jury found a home healthcare staffing executive guilty of wage-fixing and wire fraud, signaling that improper agreements risk facing successful criminal prosecution, say attorneys at McGuireWoods.
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Deregulation Memo Presents Risks, Opportunities For Cos.
A recent Trump administration memo providing direction to agencies tasked with rescinding regulations under an earlier executive order — without undergoing the typical notice-and-review process — will likely create much uncertainty for businesses, though they may be able to engage with agencies to shape the regulatory agenda, say attorneys at Blank Rome.
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The IRS Shouldn't Go To War Over Harvard's Tax Exemption
If the Internal Revenue Service revokes Harvard's tax-exempt status for violating established public policy — a position unsupported by currently available information — the precedent set by surviving the inevitable court challenge could undercut the autonomy and distinctiveness of the charitable sector, says Johnny Rex Buckles at Houston Law Center.
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New Hospice Regulations Should Enforce Core Principles
As the U.S. Department of Health and Human Services' Office of Inspector General prepares to research and expand on oversight of Medicare hospice care, the OIG should keep in mind certain core principles, such as an emphasis on preventing the entry of hospices that raise red flags, says Bill Dombi at Arnall Golden.
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7 Considerations For Conducting Drug Clinical Trials Abroad
With continuing cuts to U.S. Food and Drug Administration staffing motivating some pharmaceutical companies to consider developing drugs abroad, it's important to understand the additional risks and compliance requirements associated with conducting clinical studies in other countries, say attorneys at Morgan Lewis.
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Compliance Lessons From Warby Parker's HIPAA Fine
The U.S. Department of Health and Human Services' civil money penalty against Warby Parker highlights the emerging challenges that consumer-facing brands encounter when expanding into healthcare-adjacent sectors, with Health Insurance Portability and Accountability Act compliance being a potential focus of regulatory attention, say attorneys at Saul Ewing.
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5th Circ. Ruling Is Latest Signal Of Shaky Qui Tam Landscape
In his recent concurring opinion in U.S. v. Peripheral Vascular Associates, a Fifth Circuit judge joined a growing list of jurists suggesting that the False Claims Act's whistleblower provisions are unconstitutional, underscoring that acceptance of qui tam relators can no longer be taken for granted, say attorneys at Miller & Chevalier.
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Medicare Advantage Enforcement Strong Amid Agency Cuts
The second Trump administration's actions thus far suggest that Medicare Advantage enforcement remains a bipartisan focus despite challenges presented by evolving trends in federal agency staffing and resources, say attorneys at Ropes & Gray.
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A New Tool For Assessing Kickback Risks In Health Marketing
The Seventh Circuit's recent decision in U.S. v. Sorensen, reversing a conviction after trial of a durable medical equipment distributor, highlights two principle considerations for determining whether payments to marketers in healthcare are unlawful under the Anti-Kickback Statute, says Elisha Kobre at Sheppard Mullin.
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How Trump Orders Affect Health Orgs.' Care For Trans Minors
Two recent executive orders issued by President Donald Trump regarding gender-affirming care for minors have put healthcare organizations in a precarious situation, and these institutions should prepare for various implications and potential scenarios, say attorneys at ArentFox.
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Reproductive Health Under Trump So Far, And What's Next
Based on priorities stated so far, the Trump administration will likely continue to weaken Biden-era policies that protect reproductive health, with abortion, in vitro fertilization and contraception all being issues to watch closely amid a post-Dobbs shift, say attorneys at McDermott.
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What's Next For Lab Test Regulation Without FDA Authority
A recent Texas federal court decision vacating the U.S. Food and Drug Administration's final rule that would apply FDA regulations to laboratory-developed tests signals potential positive impacts in the diagnostic space, and could inspire more healthcare entities to litigate against the government, say attorneys at Hooper Lundy.
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6 Criteria Can Help Assess Executive Branch Actions
With new executive policy changes announced seemingly every day, several questions can help courts, policymakers and businesses determine whether such actions are proper, effective and in keeping with our democratic norms, say Marc Levin and Khalil Cumberbatch at the Council on Criminal Justice.