Policy & Compliance
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April 07, 2026
Pa. Hospitals Accuse Aetna Of Underpaying Medicare Claims
Two Pennsylvania hospital operators have sued Aetna Health Inc. in federal court, alleging the insurer has been improperly denying Medicare Advantage claims for inpatient services, or underpaying, under a new policy.
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April 07, 2026
Insurer Premera Accuses Clinic Of Misusing No Surprises Act
Premera Blue Cross sued a weight loss clinic on Monday in Washington federal court saying it abused a federal law aimed at safeguarding patients from unexpected medical bills in order to shake down the insurer for exorbitant amounts of money — as much as 10 times what Premera pays in-network providers.
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April 07, 2026
Acadia Still On Hook For $9M Rehab Death Negligence Verdict
A California state appeals court on Tuesday affirmed a more than $9 million jury verdict against Acadia Healthcare Co. Inc. in a suit stemming from the death of a patient at one of its addiction treatment centers, saying there was substantial evidence that the Marin County facility was negligently understaffed.
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April 07, 2026
HHS Must Face States' Suit Over RFK's 'Dramatic Overhaul'
A Rhode Island federal judge rejected Tuesday the government's bid to toss a group of states' lawsuit challenging Robert F. Kennedy Jr.'s "dramatic overhaul" of the U.S. Department of Health and Human Services, criticizing the government for rehashing jurisdictional arguments the court already rejected and finding the states' claims are plausible.
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April 07, 2026
Minn. Can't Unfreeze $243M In Medicaid Funds, Judge Says
A Minnesota federal judge on Monday denied the state's preliminary injunction request to release $243 million in Medicaid funds deferred by the federal government during a fraud investigation, holding that the "unprecedented" size and scope of the deferral action doesn't mean the Centers for Medicare & Medicaid Services isn't legally cleared to pursue the action.
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April 07, 2026
3 Healthcare Decisions You May Have Missed This Week
A proposed class of HIV and AIDS patients is dropping their disability bias lawsuit, the Third Circuit on a COVID-era fraudster sentence, and Aetna escapes a testing payment lawsuit. Law360 Healthcare Authority looks at three decisions you may have missed.
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April 07, 2026
Judge Questions FTC's Motive In Gender-Care Probe
A federal judge in Washington said Tuesday he would have to balance any legitimate concerns about parents and children being misled on the issue of gender-affirming care with what appeared to be retaliatory motives behind Federal Trade Commission investigative demands to a pair of nonprofits.
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April 07, 2026
HHS Staff Changes Likely To Lead To Uncertain 2026
Healthcare experts are keeping a close eye on personnel changes at the U.S. Department of Health and Human Services. Law360 Healthcare Authority looks at how they could affect key agency policies.
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April 07, 2026
Mich. AG Says PBMs Can't Stall Discovery In Drug-Pricing Suit
Michigan's attorney general is urging a federal court to reject a renewed bid by pharmacy benefit managers to pause discovery in an antitrust case accusing them of price-fixing reimbursement rates, claiming the companies are relying on exaggerated burden claims and an ordinary motion to dismiss that is unlikely to succeed.
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April 07, 2026
DC Circ. Skeptical Ex-Steward CEO Could Skip Senate Hearing
A D.C. Circuit judge told the attorney for the embattled former CEO of Steward Health Care on Tuesday that she couldn't comprehend how his client could invoke his Fifth Amendment rights without showing up to his scheduled appearance before a Senate committee.
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April 07, 2026
Jury Awards $39.5M Over Discharged Psych Patient's Victims
A Philadelphia jury on Tuesday hit a healthcare management company and a Pennsylvania hospital with a $39.5 million verdict, finding them liable for the deaths of four people who were murdered by a family member who was discharged from a psychiatric unit that failed to submit paperwork that would have prevented him from purchasing the gun he used to kill them.
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April 06, 2026
RFK Jr. Tweaks HHS Vaccine Policy Panel Membership Criteria
U.S. Department of Health and Human Services Secretary Robert F. Kennedy Jr. is making changes to a key federal vaccine advisory panel's charter, according to a renewal notice the agency published Monday, after a Massachusetts federal judge last month declared Kennedy's committee picks "appear distinctly unqualified."
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April 06, 2026
Anthem Owes $2.1M For No Surprises Act Awards, Court Told
Two medical providers said Anthem Blue Cross and Blue Shield owes them a combined $2.1 million for medically necessary services rendered to its insured members, telling a Colorado state court that the carrier is wrongfully withholding payment despite losing multiple federal arbitration proceedings.
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April 06, 2026
Biz Groups Urge 4th Circ. To End Allergan Overcharge Suit
Major pharmaceutical and business associations urged the Fourth Circuit to reconsider a panel decision that revived a whistleblower lawsuit accusing an Allergan Sales LLC predecessor of overcharging Medicaid, warning it threatens to become a road map for False Claims Act abuses.
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April 06, 2026
Splenda Loses Bid To End Scientist's Libel Counterclaim
The maker of Splenda lost its bid for a pretrial win on a scientist's counterclaims for libel after a North Carolina federal judge on Monday ruled they weren't filed too late because the counterclaims are directly linked to the company's defamation suit challenging her statements linking Splenda to cancer-causing chemicals.
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April 06, 2026
1st Circ. Suggests It May Resurrect AdTech Wiretap Case
A panel of the First Circuit appeared receptive Monday to reinstating federal wiretap claims leveled against a Massachusetts healthcare system over its use of online tracking tools, despite arguments that such a ruling could cripple the industry amid an influx of similar cases nationwide.
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April 06, 2026
Cleary FCA Task Force Head On Enforcement Trends To Watch
Former U.S. Attorney for the Eastern District of New York Breon Peace, who now leads a False Claims Act task force at Cleary Gottlieb Steen & Hamilton LLP, is predicting a continued surge in enforcement as the Trump administration wields the law in new ways.
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April 06, 2026
Mass. Justices Hint Insurer Owes Defense In Doc's Discipline
An allegation that a Massachusetts doctor prescribed addictive medications to manipulate a patient into a sexual relationship could be enough to trigger a malpractice insurer's duty to defend him in a disciplinary proceeding launched years later over other alleged misconduct, justices on the state's highest court hinted Monday.
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April 06, 2026
WilmerHale Adds Regulatory Atty From Mayer Brown In DC
WilmerHale announced Monday it has hired a veteran U.S. Food and Drug Administration and life sciences regulatory attorney from Mayer Brown LLP.
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April 03, 2026
Case-By-Case Guide As Justices Eye Landmark Pharma Law
Drugmakers and prominent allies are inundating the U.S. Supreme Court with calls to scrutinize Medicare's new power to slash payments by tens of billions of dollars, and the justices look poised to take up or turn down a fistful of legal challenges in one fell swoop.
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April 03, 2026
Wash. DOC Inks Deal Over Trans Treatment In Facilities
The Washington State Department of Corrections will start improving conditions for transgender, intersex and nonbinary people in its facilities and submit to yearly monitoring, according to a settlement agreement between the agency and a nonprofit in the state.
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April 03, 2026
SEC Moves To Set Up $40M Investor Fund In Cassava Case
The U.S. Securities and Exchange Commission asked a Texas federal court on Friday to establish a $40 million fund to potentially compensate investors harmed by a Texas biopharmaceutical company and two former executives' alleged misstatements about an Alzheimer's drug, following the company's 2024 settlement with the regulator.
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April 03, 2026
Northwestern Can't Escape ERISA Fight Over Health Offerings
An Illinois federal court refused to toss a proposed class action against Northwestern University alleging excessive employee healthcare costs violated federal benefits law, concluding ex-workers had sufficiently backed up their allegations that an expensive plan option breached fiduciary duties.
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April 03, 2026
Law360 Announces The Members Of Its 2026 Editorial Boards
Law360 is pleased to announce the formation of its 2026 Editorial Advisory Boards.
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April 03, 2026
Ga. Urology Network To Pay $14M To Resolve FCA Case
An Atlanta urology network and its founder will pay $14 million to settle allegations that they billed Medicare and Medicaid for medically unnecessary procedures, ranging from ultrasounds to endoscopic exams, according to an announcement by federal and Georgia state prosecutors.
High Court Ruling Won't End 'Conversion Therapy' Battles
The U.S. Supreme Court's rejection of Colorado's ban on what is commonly known as gay conversion therapy may have rendered dozens of similar laws toothless, but don't expect it to be the end of legal challenges in this arena.
As FCA Meets 340B, Geyser Of Qui Tam Suits May Erupt
A Ninth Circuit ruling on the intersection of two of the most contentious laws in healthcare may be a combustible mix that triggers a new wave of fraud litigation.
Utah Hospitals To Track Violence As States Step Up Reporting
Under a new law, Utah hospitals will join a national effort to better understand the risks facing healthcare workers.
Expert Analysis
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A Check-Up On HHS' Push To Implement AI Infrastructure
The U.S. Department of Health and Human Services has made some headway in its efforts to implement artificial intelligence across its agencies, but will have to overcome a number of near-term tests in order to be successful, says Theodore Thompson at Stinson.
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Mich. Banking Brief: All The Notable Legal Updates In Q1
Michigan's financial services sector saw several significant developments in 2026's first quarter, including the state Department of Insurance and Financial Services' issuance of a bulletin on the use of artificial intelligence and the Michigan House's introduction of a bill based on the Model Money Transmission Modernization Act, say attorneys at Dykema.
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The Road Ahead For Drug Development In The US
Against the backdrop of drug manufacturers potentially looking to move development efforts overseas, the U.S. Food and Drug Administration's latest guidance on new approach methodologies signals the FDA is likely to be receptive to industry innovation that makes U.S.-based drug development faster or less expensive, creating opportunities and compliance risks for tech companies, say attorneys at Morgan Lewis.
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FDA's Crackdown On Drug Ads Conflicts With Precedent
Recent U.S. Food and Drug Administration warning letters to drug manufacturers targeting direct-to-consumer advertising raise significant constitutional concerns, and directly clash with prior FDA stances, say attorneys at Sidley.
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Informal Announcements Are Reshaping FDA Regulations
The U.S. Food and Drug Administration's recent shift toward using press releases, podcasts and other informal channels to announce major policy changes reflects a valid desire to modernize and accelerate regulatory efforts, but it could lead to diminished transparency, increased industry burden and reduced policy durability, says Rachel Turow at Skadden.
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A Shift In Fed. Circ.'s Approach To Patent Summary Judgment
The Federal Circuit's recent decision in Range of Motion v. Armaid may come to be seen as a seminal opinion for potentially exposing and entrenching the Federal Circuit's movement away from its previous framework for identifying obvious noninfringement cases, says Nicholas Nowak at Nowak IP Group.
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DOJ Actions Suggest Expansion Of Healthcare Enforcement
Recent actions by the U.S. Department of Justice and U.S. Food and Drug Administration suggest that federal healthcare enforcement efforts are moving away from traditional program-based fraud and toward cases centered on product integrity, regulatory transparency and telehealth marketing, effectively widening the government's enforcement playbook, say attorneys at MoFo.
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New Orphan Drug Law Provides A Key Fix For Pharma Cos.
The Consolidated Appropriations Act enacted last month restores the U.S. Food and Drug Administration's long-standing interpretation of "same disease or condition," related to orphan drug exclusivity, resolving years of regulatory uncertainty and litigation that have discouraged rare disease research, say attorneys at Spencer Fane.
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FDA User Fee Talks Offer Clues On Upcoming Reforms
As the U.S. Food and Drug Administration undergoes the User Fee Act reauthorization process and renegotiates its user fee agreements over the next several months, the agency's consultation meetings with relevant industries can shed light on the FDA's priorities, and provides stakeholders an opportunity to participate in the reform process, say attorneys at Holland & Knight.
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Changes Coming To The SBIR And STTR Programs
Legislation recently approved by Congress to reauthorize the Small Business Innovation Research and Small Business Technology Transfer Programs includes changes focused on national security that would improve transparency but also increase applicants' administrative burdens, slow the awards process and likely increase litigation, say attorneys at Fluet & Associates.
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FDA Framework For Personalized Therapies Raises Questions
The U.S. Food and Drug Administration's new plausible mechanism framework for developing individualized therapies reflects the agency's focus on rare-disease drugs, but numerous significant, unresolved issues cast uncertainty on how effective the framework will be in practice, say attorneys at Ropes & Gray.
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Scrutiny Of Nursing Home Practices Marks Inflection Point
Recent congressional inquiries into UnitedHealth Group's Medicare Advantage-linked nursing home practices raise questions about whether financial metrics are allowed to influence decisions governed by the standard of care, and could implicate duties imposed by federal regulations, state negligence laws and elder abuse statutes, says Lindsey Gale at Rafferty Domnick.
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7 Steps For Gov't Contractors In Post-IEEPA Tariff Landscape
In response to U.S. Supreme Court's recent decision to strike down tariffs issued by the Trump administration under the International Emergency Economic Powers Act, there are several actions federal contractors should take to preserve their place in any refund waterfall, and to manage audit, overpayment and False Claims Act risk, say attorneys at Holland & Knight.