Policy & Compliance
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September 19, 2025
Ga. Providers Seek Exit From 'Conspiratorial' BCBS Fraud Suit
Healthcare consulting firm HaloMD and several providers urged a federal judge Friday to toss a lawsuit from Blue Cross Blue Shield of Georgia accusing them of abusing a federal dispute resolution process for surprise medical bills, arguing the insurer's suit offers little more than "inflammatory, conspiratorial rhetoric."
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September 19, 2025
CDC Panel Urges Caution On COVID Vax, Punts On Hep B
A panel of advisers at the Centers for Disease Control and Prevention on Friday voted unanimously to recommend that people receiving the COVID-19 vaccine this season do so only after discussing it with their health providers.
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September 18, 2025
Brothers Blame Associate For $90M HIV Drug Fraud Scheme
Two Maryland brothers accused of selling $90 million worth of mislabeled HIV drugs told a Florida federal jury on Thursday that their charges stem from an associate hired for his pharmaceutical industry connections, but who instead lied about the medication's black market origins and told them it was purchased legitimately.
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September 18, 2025
Mich. Top Court To Weigh Medicare's Role In No-Fault Cases
Michigan's highest court will weigh whether an injured driver who opted out of personal injury protection due to his Medicare coverage must offset his damages by billing the insurance program for accident-related medical expenses in a no-fault dispute.
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September 18, 2025
HHS Shutters Miami Organ Donor Org. For 'Unsafe' Practices
Federal health officials have decertified a Miami-based organ procurement organization that arranges organ donations after an investigation found a pattern of "unsafe" practices, marking the first time the federal government has revoked the certification of such a group, according to an announcement Thursday from Health Secretary Robert F. Kennedy Jr.
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September 18, 2025
Elevance Won't Cover Zepbound To Treat Apnea, Patient Says
Elevance Health, formerly known as Anthem Inc., arbitrarily excludes coverage of FDA-approved Zepbound to treat moderate to severe obstructive sleep apnea and refuses to consider requests for exceptions by maintaining that the medication is for weight loss, alleges a proposed class action filed by an enrollee in Indiana federal court Tuesday.
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September 18, 2025
Senate Confirms Trump's Pick To Lead DOL Benefits Arm
The Senate confirmed fiduciary liability insurance expert Daniel Aronowitz on Thursday to lead the U.S. Department of Labor's employee benefits division, which oversees regulation and enforcement of employer-provided health and retirement plans.
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September 18, 2025
Couple Slam NC Defense Attys In Hospital Negligence Appeal
A couple pursuing negligence claims against a local hospital scoffed at the idea that they were lurking on the sidelines waiting to cash in on a favorable outcome in a similar case, telling the North Carolina appeals court to ignore an amicus brief by defense attorneys arguing as much.
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September 18, 2025
1st Circ. Won't Lift Block On HHS Job, Program Cuts
The First Circuit on Wednesday rejected a bid by the Trump administration to let it move ahead with cutting 10,000 jobs and end a number of programs at the U.S. Department of Health and Human Services while it appeals a Rhode Island federal judge's order temporarily barring the plan.
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September 18, 2025
Withheld Email Not Enough To Revive Doc's Retaliation Suit
A psychiatrist failed to convince the Second Circuit to reinstate his suit claiming a New York City-area hospital system forced him out because he raised patient safety concerns, with the appeals court saying he couldn't show the hospital's omission of an email during discovery was purposeful.
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September 17, 2025
J&J Whistleblowers Defend $1.6B False Claims Act Win
Whistleblowers filed a brief Wednesday in the Third Circuit in a closely watched False Claims Act appeal involving a $1.6 billion judgment against Johnson & Johnson unit Janssen as well as the constitutionality of the FCA's "qui tam" whistleblower provisions, arguing that the act's lawfulness has been settled by its "unbroken 162-year history."
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September 17, 2025
FDA Says Vape Manufacturer Lying About Marketing Approval
The U.S. Food and Drug Administration on Tuesday sued manufacturers of flavored vapes in New Jersey federal court to seek an end to their sales, saying that they are falsely representing that their products had received marketing approval.
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September 17, 2025
3rd Circ. Weighs Limits On NJ Medical Aid In Dying Act
The Third Circuit on Wednesday considered whether a Delaware woman with terminal cancer can challenge New Jersey's residency requirement for medical aid in dying, even though she has yet to be certified as having six months or less to live.
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September 17, 2025
Hospital Agrees To End Retirement Plan Fee, Investment Suit
A New York hospital system told a federal court Wednesday it will end a proposed class action alleging it failed to remove underperforming investment options from its retirement plan and keep an eye on administrative costs, losing millions of dollars of employees' savings.
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September 17, 2025
Ex-CDC Head Says RFK Jr. Urged Vax Schedule Rubber Stamp
Susan Monarez, the former head of the Centers for Disease Control and Prevention, told federal lawmakers on Wednesday she was abruptly fired just weeks into her tenure for "holding the line on scientific integrity."
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September 16, 2025
Dr.'s COVID Falsehoods Are Free Speech, Wash. Panel Says
A Washington state appeals court unanimously ruled Tuesday that the Washington Medical Commission overstepped its authority by punishing a doctor for COVID-19 falsehoods he published to his blog, but affirmed the commission's decision to discipline him for prescribing ivermectin to COVID-19 patients.
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September 16, 2025
Harborview Nurses In Ga. Score Collective Status In OT Suit
A pair of nurses who worked at Harborview Health Systems' facility in Rome, Georgia, brought enough evidence to show they and other similarly situated nurses were subjected to pay practices that shorted them on overtime wages to proceed as a collective action, a New York magistrate judge said Tuesday.
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September 16, 2025
Merck Says Vaccine Case 'Poor Vehicle' For Antitrust Review
Merck & Co. told the U.S. Supreme Court to reject a bid from physicians looking to revive antitrust claims over submissions the pharmaceutical giant made to federal regulators concerning its mumps vaccine, arguing that the case is "an exceptionally poor vehicle" for review.
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September 16, 2025
FTC Ends Director Overlap In Healthcare Space
The Federal Trade Commission said three members of Sevita Health's board of directors resigned after enforcers flagged an overlap with the board of a competing provider of specialty healthcare for people with intellectual and developmental disabilities.
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September 16, 2025
Oregon Joins Expansion Of '5NP' Acupuncture Practice
Oregon has joined a number of states that have enacted laws that make it easier for people to get a "five needle" therapy with a raft of mental health benefits, including reduced substance withdrawal symptoms.
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September 16, 2025
Pharma Tests Drug Price Policies In Court: 3 Cases To Know
Two circuit courts issued notable rulings over the past week upholding laws aimed at lowering prescription drug prices. Elsewhere, insulin makers are seeking a panel rehearing in a proposed class action targeting discount programs. Here, Law360 Healthcare Authority looks at three key drug pricing cases you may have missed.
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September 16, 2025
Wash. Justices Scrutinize Minimum Wage 'Live In' Exclusion
Washington Supreme Court justices on Tuesday pushed counsel for an adult family home on the stance that its "live in" workers are adequately protected by existing laws and regulations, pointing to testimony its employees are always on call and sometimes at risk of physical assault by residents.
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September 16, 2025
Ill. Hospital Nonprofit Must Face Tobacco Fee Suit
An Illinois federal judge refused to toss the bulk of a proposed class action from an Illinois hospital worker who claimed a fee on the employee health plans of tobacco users was discriminatory and breached fiduciary duties under benefits law, finding most allegations sufficiently backed up to survive dismissal.
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September 16, 2025
DC Circ. Asked To Look At ADA Injunction In Segregation Case
Washington, D.C., wants the D.C. Circuit to narrow an injunction commanding the district to help people in Medicaid-funded nursing homes move out of those facilities and into less restrictive forms of care, as the litigation approaches its 15th birthday.
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September 16, 2025
$50B Rural Health Fund: A Primer
The U.S. Centers for Medicare & Medicaid Services will use a newly created $50 billion rural health fund to entice states to take unhealthy foods out of their food-stamp programs, expand telehealth and embrace other Trump administration priorities.

The Limits On Blue States' Push For Vaccine Policy Control
Democratic-run states are changing vaccine policies as HHS Secretary Robert F. Kennedy Jr. and other Trump health officials move to restrict vaccine access, creating a new policy patchwork. Those state efforts can only go so far, healthcare experts say.

MAHA Report Calls For Increased Scrutiny Of Drug Advertising
The Trump administration on Tuesday pledged to ramp up federal oversight of drug advertising, update dietary guidelines and slash unnecessary regulations as part of its strategy to boost the health of America's children and curb the rise in childhood chronic disease.

Pharmacists, Attys Navigate Murky COVID Vaccine Waters
In recent years, the changing of the season has sent millions of Americans to their local pharmacists for a COVID-19 vaccine with few worries about availability. This year, things aren't so simple. Without a complete federal roadmap, pharmacists are facing new legal uncertainties.
Expert Analysis
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When AI Denies, Insurance Bad Faith Claims May Follow
Two recent rulings from Minnesota and Kentucky federal courts signal that past statements about claims-handling practices may leave insurers using artificial intelligence programs in claims administration vulnerable to suits alleging bad faith and unfair trade practices, say attorneys at Cozen O'Connor.
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Health Insurance Kickback Cases Signal Greater Gov't Focus
A series of recent indictments by federal prosecutors in California suggests that the Eliminating Kickbacks in Recovery Act is gaining momentum as an enforcement tool against illegal inducement of patient referrals in the realm of commercial health insurance, say attorneys at BakerHostetler.
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FDA Transparency Plans Raise Investor Disclosure Red Flags
The U.S. Food and Drug Administration’s recently announced intent to publish complete response letters for unapproved drugs and devices implicates certain investor disclosure requirements under securities laws, making it necessary for life sciences and biotech companies to adopt robust controls going forward, say attorneys at Arnold & Porter.
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With Obligor Ruling, Ohio Justices Calm Lending Waters
A recent decision by the Ohio Supreme Court, affirming a fundamental principle that lenders have no duty to disclose material risks to obligors, provides clarity for commercial lending practices in Ohio and beyond, and offers a reminder of the risks presented by guarantee arrangements, says Carrie Brosius at Vorys.
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Federal AI Action Plan Marks A Shift For Health And Bio Fields
The Trump administration's recent artificial intelligence action plan significantly expands federal commitments across biomedical agencies, defining a pivotal moment for attorneys and others involved in research collaborations, managing regulatory compliance and AI-related intellectual property, says Mehrin Masud-Elias at Arnold & Porter.
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Preparing For DEA Rescheduling Of 2 Research Chemicals
A recent decision to allow the U.S. Drug Enforcement Administration to reclassify two research psychedelics in Schedule I under the Controlled Substances Act may pose significant barriers to scientific study, including stringent registration requirements, heightened security protocols and burdensome reporting obligations, say Kimberly Chew at Husch Blackwell and Jackie von Salm at Psilera.
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9th Circ.'s Kickback Ruling Strengthens A Prosecutorial Tool
The Ninth Circuit's decision last month in U.S. v. Schena, interpreting the Eliminating Kickbacks in Recovery Act to prohibit kickback conduct between the principal and individuals who do not directly interact with patients, serves as a wake-up call to the booming clinical laboratory testing industry, say attorneys at Kendall Brill.
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Fla. Misses Opportunity To Rectify Wrongful Death Damages
Florida Gov. Ron DeSantis' recent veto of a bill that would have removed certain arbitrary and unfair prohibitions on noneconomic wrongful death damages in medical negligence cases highlights the urgent need for reforms to current state law, say attorneys at Farah & Farah.
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A Shifting Trend In FDA Form 483 Disclosure Obligations
A New York federal court's Checkpoint Therapeutics decision extends a recent streak of dismissals of securities class actions alleging that pharmaceutical companies failed to disclose U.S. Food and Drug Administration Form 483 inspection reports, providing critical guidance for companies during the FDA approval process, say attorneys at Alston & Bird.
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The Future Of Lab-Test Regs After FDA Rescinds Rule
The U.S. Food and Drug Administration recently rescinded its laboratory-developed tests rule in response to a Texas federal court decision this spring, reinforcing a separation of authority between the FDA and the Centers for Medicare & Medicaid Services, and calling into question the FDA's role in overseeing such tests without congressional action, say attorneys at Venable.
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Unpacking Ore. Law's Limits On PE Healthcare Investment
A recent Oregon law imposes significant restrictions on nonphysicians owning or controlling medical practices, but newly enacted amendments provide some additional flexibility in certain ownership arrangements without scuttling the law's intent of addressing concerns about the rise of private equity investment in healthcare, say attorneys at Debevoise.
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Criminal Healthcare Fraud Takeaways From 4th Circ. Reversal
After the Fourth Circuit reversed a doctor’s postconviction acquittal in U.S. v. Elfenbein last month, defense attorneys should consider three strategies when handling complex criminal healthcare matters, says Jonathan Porter at Husch Blackwell.
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AG Watch: Texas Embraces The MAHA Movement
Attorneys at Kelley Drye examine Texas Attorney General Ken Paxton's actions related to the federal Make America Healthy Again movement, and how these actions hinge on representations or omissions by the target companies as opposed to specific analyses of the potential health risks.