Policy & Compliance
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August 21, 2025
11th Circ. Backs Health System In Black Worker's Bias Suit
The Eleventh Circuit ruled Thursday that a fired Black worker can't revive her race and disability bias suit against a Georgia health system, saying her failure to provide a proposed date to return from medical time off amounted to an unreasonable request for indefinite leave.
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August 21, 2025
Seton Hall Gets COVID-19 Death Suit Tossed For Good
A New Jersey federal judge wasn't swayed by new arguments brought by parents of a Seton Hall University sophomore who died during a COVID-19 isolation period, saying their contract-related claims failed to establish one existed at all.
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August 21, 2025
Employer Plans In Limbo As Courts Grapple With Trans Care
Despite appellate courts' apparent willingness to allow states to ban gender-affirming care for minors, employers are still waiting for clarity on whether federal anti-discrimination laws require health plans to cover transgender healthcare access, experts say.
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August 20, 2025
17 States, DC Urge FDA To Lift Mifepristone Restrictions
Seventeen states and the District of Columbia Wednesday joined four others in urging the U.S. Food and Drug Administration to lift restrictions on the abortion drug mifepristone, saying that data their health departments collected overwhelmingly back the drug's safety.
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August 20, 2025
Judge Grills Feds On Upending 30-Year Noncitizen Benefits
A Rhode Island federal judge seemed perplexed Wednesday by a government attorney's contention that for nearly 30 years, various administrations across the political spectrum have wrongly interpreted a law the Trump administration now says requires immigration status checks for additional federal benefits.
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August 20, 2025
Ohio Justices Free Bank From $77M Guaranty Disclosure Duty
The Ohio Supreme Court on Wednesday ruled that nothing in state law required Huntington Bank to inform a co-signer of a $77 million loan guaranty about the risks associated with signing the deal with two other partners, one of whom later pled guilty to a check-kiting scheme.
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August 20, 2025
Northwell Health Inks $2.75M Deal In 403(B) Suit
New York healthcare giant Northwell Health Inc. has agreed to pay $2.75 million to end a former employee's claims it breached its fiduciary duties to participants and beneficiaries in its retirement plan by allegedly saddling workers with excessive recordkeeping fees and offering an underperforming fund.
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August 20, 2025
TikTok Can't Dodge NC Claims Over Addictive App Design
Chinese internet behemoth ByteDance Inc. and its social media subsidiary TikTok Inc. can be sued in the Tar Heel State, North Carolina's business court ruled Tuesday, preserving a lawsuit that accuses the companies of exploiting minors through addictive app design.
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August 20, 2025
NC's Cap On Med Mal Damages Is Constitutional, Panel Rules
The North Carolina state appeals court ruled Wednesday that a state law capping compensatory damages in certain medical malpractice lawsuits at $500,000 is constitutional, handing a defeat to a woman seeking to recoup her full $7.5 million jury verdict stemming from the loss of her unborn baby.
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August 20, 2025
Texas AG Threatens Suit Over Orgs. Mailing Abortion Pills
Texas Attorney General Ken Paxton has sent cease-and-desist letters to three organizations he's accused of shipping abortion drugs to women in the state in violation of state and federal laws.
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August 20, 2025
State AGs Sidelined From Sandoz Price-Fixing Deal
A group of over 40 states and territories cannot intervene in a $275 million settlement resolving generic-drug price-fixing claims against Sandoz because they only have a nominal interest in the suit that fails to confer standing, a Pennsylvania federal judge said.
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August 20, 2025
$2.8B BCBS Antitrust Deal Approved With $759M For Attys
An Alabama federal judge has approved a $2.8 billion settlement between Blue Cross Blue Shield and a class of medical providers in a landmark antitrust case, with $759 million going to Whatley Kallas LLP and other law firms for attorney fees and costs.
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August 20, 2025
Insurers Say Gov't Misusing FCA To Get Medicare Cost Cap
Insurers accused of paying brokers to steer customers to their Medicare Advantage plans asked a Massachusetts federal judge to dismiss a False Claims Act lawsuit, saying the government is mischaracterizing legal payments for marketing as kickbacks in an attempt to impose caps it has thus far been unable to obtain.
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August 20, 2025
CVS PBM Overbilling Judgment Trebled To $290M
A Pennsylvania federal judge has increased threefold a judgment against CVS Caremark from $95 million to $290 million for overbilling Medicare Part D-sponsored drugs.
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August 19, 2025
Tenn. Judge Trims Healthcare Contract TRAP Suit
A Tennessee federal judge dismissed Fair Labor Standards Act claims brought by operating room technicians claiming their ex-employer, SpecialtyCare, unlawfully required them to repay tens of thousands of dollars for specialty training, plus interest, if they quit within three years, but the judge greenlit their Truth in Lending Act claims.
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August 19, 2025
Losses Mount For Medicare Drug Negotiation Challengers
Big Pharma's losses in challenges to Medicare drug price negotiations are piling up. But don't think the industry is ready to wave the white flag.
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August 19, 2025
High Court Interest In Health Sharing Ministry Case
The U.S. Supreme Court is showing interest in a challenge to state regulatory authority over health care sharing ministries. The nonprofit groups, which offer a cheaper alternative to traditional insurance, are expected to see more demand under major changes coming to the insurance marketplace.
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August 19, 2025
Novo Nordisk Gets Forfeiture Claims Cut From 401(k) Suit
A New Jersey federal judge on Tuesday dismissed workers' allegations that Novo Nordisk unlawfully used forfeited funds in its $2.3 billion 401(k) plan for its own benefit and kept a shoddy fund on its investment roster, leaving an excessive fee claim in play.
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August 19, 2025
Panel Weighs Ga. High Court Ruling In Sham Donor Suit
Customers who accused a sperm bank of selling sperm without disclosing the true medical and criminal histories of donors urged the Georgia Court of Appeals to revive their lawsuits Tuesday, arguing the dismissals were based on a misreading of a 2020 decision from the state's high court.
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August 19, 2025
CMS Defeats 'Hair's Breadth' Star Rating Challenge
Insurance companies challenging the "star" system for rating Medicare Advantage organizations have lost another round in court, with a Texas federal judge saying Elevance Health failed to show federal officials violated the law when rounding down scores.
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August 19, 2025
Judge Backs Deal To Overhaul NY Kids' Mental Healthcare
A New York federal judge has given the green light to allow the state to revamp its Medicaid mental health services for children to expand greater in-home and crisis care to prevent the institutionalization of kids.
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August 19, 2025
Hawaii Abortion Drug Fight: 3 Things To Know
The drug mifepristone has emerged as a key flash point in legal battles over state abortion restrictions, drug prescribing rules and the legalities of sending abortion medications across state lines. This week, a federal court in Hawaii will hear arguments in a challenge to the FDA's changes to the drug safety review process.
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August 19, 2025
Trump's 'Abnormal' Use Of FCA Could Get Tricky In Court
The Trump administration is wielding the False Claims Act in unusually narrow ways to drive policies on social and cultural issues — including gender-affirming care and diversity, equity and inclusion programs — but the government's potential theories of liability under the federal law remain largely untested and might not hold up in court, experts say.
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August 18, 2025
Most Ozempic, Wegovy Claims Survive MDL Dismissal Bid
Eli Lilly & Co. and Novo Nordisk will have to face most of a multidistrict litigation accusing them of misleading consumers over the risks and benefits of popular weight loss drugs like Ozempic and Trulicity, after a Pennsylvania federal judge only trimmed a few of the dozen claims the drugmakers tried to have tossed.
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August 18, 2025
Judge Known For Nixing ACA To Lead Texas' Northern District
A conservative judge known for declaring Obamacare unconstitutional, among other high-profile rulings, took over as chief judge of the U.S. District Court for the Northern District of Texas on Monday, according to an announcement from the court.
Expert Analysis
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Learning From COVID-19 Enforcement Against Nursing Homes
Five years after the COVID-19 outbreak caused a high number of deaths in nursing homes, an examination of enforcement actions against nursing homes in New York and elsewhere in the country highlights obstacles that may arise when bringing cases of this type, and ways to overcome them, says Kenneth Levine at Stone & Magnanini.
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How Plan Sponsors Can Mitigate Risk In PBM Contracts
A recent lawsuit in New York federal court alleges that JPMorgan caused exorbitant prescription costs by mishandling the pharmacy benefit manager arrangement, adding to a growing body of Employee Retirement Income Security Act fiduciary breach litigation and affirming that fiduciaries must proactively manage their healthcare plan vendors, say attorneys at Hall Benefits Law.
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4th Circ. Health Data Ruling Opens Door To State Law Claims
In Real Time Medical v. PointClickCare, the Fourth Circuit recently clarified that state law claims can rest in part on violations of a federal law that prohibits electronic health information blocking, expanding legal risks for health IT companies and potentially creating exposure to a range of competitive implications, say attorneys at BCLP.
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Unpacking Trump Admin Plans For Value-Based Care
Recent developments from the Center for Medicare and Medicaid Innovation suggest the Trump administration intends to put its own stamp on value-based care, emphasizing cost savings assessment in particular, with its recent cancellation of several payment models that had supported primary care, says Miranda Franco at Holland & Knight.
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What To Expect For Stem Cell Regulation Under Trump Admin
The new administration's push for deregulation, plus the post-Chevron legal landscape, and momentum from key political and industry players to facilitate stem cell innovation may create an opportune backdrop for a significant reduction in the U.S. Food and Drug Administration's regulatory framework for stem cells, say attorneys at Sheppard Mullin.
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How Importers Can Minimize FCA Risks Of Tariff Mitigation
False Claims Act risks are inherent in many tariff mitigation strategies, making it important for importers to implement best practices to identify and report potential violations of import regulations before they escalate, says Samuel Finkelstein at LMD Trade Law.
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10 Practical Takeaways From FDA's Biopharma AI Guidance
Recent guidance from the U.S. Food and Drug Administration provides much-needed insight on the usage of artificial intelligence in producing information to support regulatory decision-making regarding drug safety, with implications ranging from life cycle maintenance to AI tool acquisition, say attorneys at Covington.
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Lawmakers Shouldn't Overlook Rare Disease Therapies' Value
As the ORPHAN Cures Act is pending in Congress, policymakers assessing the value of certain drugs for price regulation should consider data beyond what is collected in clinical trials, say Alice Chen at the University of Southern California, and Molly Frean and Yao Lu at Analysis Group.
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What Trump's Order Means For The Legal Status Of IVF
An executive order signed by President Donald Trump last month signals the administration's potential intention to increase protections for in vitro fertilization services, though more concrete actions would be needed to resolve the current uncertainty around IVF access or bring about a binding legal change, says Jeanne Vance at Weintraub Tobin.
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Mitigating Tariff Risks For Healthcare In US And Canada
Healthcare stakeholders should take steps to evaluate the impact of cross-border tariffs, as the historically strong ties between Canada and the U.S. demonstrate the potential for real disruption and harm to the healthcare industry in both countries, say attorneys at Norton Rose.
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What's At Stake In High Court Transgender Care Suit
The outcome of U.S. v. Skrmetti will have critical implications for the rights of transgender youth and their access to gender-affirming care, and will likely affect other areas of law and policy involving transgender individuals, including education, employment, healthcare and civil rights, say attorneys at ArentFox Schiff.
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6 Laws Transforming Calif.'s Health Regulatory Framework
Attorneys at Hooper Lundy discuss a number of new California laws that raise pressing issues for independent physicians and small practice groups, ranging from the use of artificial intelligence to wage standards for healthcare employees.
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Anticipating Calif. Oversight Of PE Participation In Healthcare
A new bill recently introduced in the California Senate revives last year's attempt to increase oversight of healthcare transactions involving private equity groups and hedge funds, meaning that attorneys may soon need to assess the compliance status of existing management relationships and consider modifying contract terms, says Andrew Demetriou at Husch Blackwell.