Policy & Compliance

  • June 06, 2025

    Fla. Medical Billing Co. Accused Of Filing False Genetic Tests

    The U.S. government has filed a False Claims Act suit against a Florida medical billing and compliance services company for allegedly filing claims to Medicare for more than $15 million in medically unnecessary genetic laboratory tests.

  • June 05, 2025

    Red States Double Down On Bid To Stymie Trans Health Rule

    More than a dozen Republican attorneys general challenging a Biden-era rule that protected gender-affirming care under the Affordable Care Act said the U.S. Department of Health and Human Services can't keep the rule on the books just because the new administration is unlikely to enforce it.

  • June 05, 2025

    Sens. Float Automatic Biosimilar Interchangeable Label

    A bipartisan group of U.S. senators has reintroduced legislation that would reduce what the lawmakers called barriers to accessing lower-cost versions of biologic drugs, making an adjustment to how biosimilars are deemed interchangeable with their name-brand equivalents.

  • June 05, 2025

    $1.36B Home Healthcare Deal Dropped Amid FTC Scrutiny

    Healthcare solutions company Owens & Minor said Thursday that it's abandoning its $1.36 billion plan to buy home-based care business Rotech Healthcare Holdings after the Federal Trade Commission's scrutiny proved too much to bear.

  • June 05, 2025

    4 AGs Urge FDA To Lift Abortion Pill Restrictions

    Attorneys general from California, Massachusetts, New York and New Jersey on Thursday urged the U.S. Food and Drug Administration to lift restrictions on the abortion drug mifepristone, saying they aren't necessary under statutory requirements for an FDA drug safety program.

  • June 05, 2025

    Mich. AG Asks Judge To Block Abortion Coercion Screening

    Michigan's attorney general has asked a judge to strike down a state-law requirement that abortion patients be evaluated for coercion, after the judge upheld the screening while permanently blocking other abortion regulations last month.

  • June 05, 2025

    Ex-Bush Admin Atty To Lead HHS Civil Rights Office

    The U.S. Department of Health and Human Services has appointed an attorney to lead its civil rights office who brings more than 30 years of experience across the public sector and private practice, including as counsel for HHS during the George W. Bush administration.

  • June 04, 2025

    Calif. Won't Get Insulin Pricing Case Sent Back To State Court

    The New Jersey federal judge overseeing multidistrict litigation accusing Express Scripts, CVS Caremark and other pharmacy benefit managers of conspiring to fix the prices of insulin on Wednesday refused to ship a case brought by the state of California back to state court.

  • June 04, 2025

    States Take Aim At Healthcare REITs

    State lawmakers seeking to curb healthcare investment models they see as harmful to patients have sharpened their focus on real estate investment trusts, putting forth bills to restrict their ownership of healthcare real estate or increase oversight of such transactions.

  • June 04, 2025

    DC Judge Weighs Harm In Teen Program Funding Fight

    A D.C. federal judge on Wednesday seemed unconvinced by Planned Parenthood's assertion that new federal grant requirements for a public health initiative aimed at preventing teen pregnancy are harmful enough to warrant a preliminary injunction.

  • June 04, 2025

    Apple Can Shield Info In NJ TikTok Addiction Suit

    A New Jersey state court will allow Apple Inc. to inject itself into the state attorney general's high-profile lawsuit accusing TikTok of designing features that harm and cause addiction in children, allowing the manufacturer of the iPhone to argue, away from public view, that certain content in the lawsuit should be redacted.

  • June 04, 2025

    Ohio Nonprofit, Nursing Homes To Pay $3.6M To End FCA Suit

    An Ohio-based nursing home operator has agreed to pay $3.61 million to settle False Claims Act allegations brought against it by the government over purportedly substandard and in some cases nonexistent care, according to a new announcement from the U.S. Department of Justice.

  • June 03, 2025

    Trump Admin. Nixes Guidance Protecting ER Abortion Care

    The Trump administration said Tuesday that it is rescinding post-Dobbs guidance from 2022 that emphasized medical providers' abortion care obligations under federal law and that assured federal law protected providers' clinical judgment, regardless of conflicting state laws or mandates.

  • June 03, 2025

    MAHA Report's Fake Citations A Red Flag For Experts

    Fake and misinterpreted citations in a recent federal report focused on chronic disease in the U.S. are raising alarm bells that federal health officials may be trading in scientific rigor for cherry-picked evidence.

  • June 03, 2025

    6th Circ. Denies PBMs' Privilege Claim In Opioid MDL

    A Sixth Circuit panel on Tuesday denied a petition from Cigna's Express Scripts and UnitedHealth's Optum seeking to reverse discovery orders allowing certain personnel files and internal communications into the multidistrict opioid litigation, finding that the two pharmacy benefit managers failed to show extraordinary abuses justifying relief.

  • June 03, 2025

    Plan Providers Must Face DOJ Overpayment Suit, Judge Says

    A Maine federal judge refused to let five military healthcare plan providers escape a False Claims Act suit alleging that they knowingly pocketed millions of dollars that were overpaid, holding that U.S. Department of Justice claims against them pass muster for now.

  • June 03, 2025

    DC Judge Blocks Trump's Ban On Transgender Prisoner Care

    A D.C. federal judge on Tuesday blocked the enforcement of a Trump administration executive order barring funding of gender-affirming care in federal prisons and granted class certification to a group of transgender inmates challenging the directive.

  • June 03, 2025

    HHS, DOGE Accused Of Using Flawed Data In Mass Layoffs

    Former federal workers laid off by the U.S. Department of Health and Human Services brought a putative class action Tuesday in D.C. federal court alleging their terminations were unlawful because they were based on "hopelessly error-ridden" personnel records, in violation of the Privacy Act.

  • June 03, 2025

    Health Policy Expert On The Changing Vaccine Landscape

    KFF's Jen Kates talks about the changing vaccine landscape, the trickle-down effects of the Trump administration's policies and what she's watching for from federal health officials in the future.

  • June 03, 2025

    2nd Circ. Says Social Worker Can't Challenge NY Abortion Law

    The Second Circuit on Tuesday rejected a social worker's constitutional challenge to a New York law decriminalizing abortion, finding that she lacked standing to sue because she couldn't identify any specific fetus facing harm.

  • June 03, 2025

    Health System, Staffing Co. Accused Of Shaving Work Time

    New York state's largest healthcare provider and a staffing firm unlawfully round down the amount of time employees spend working and deduct 30 minutes from their hours regardless of whether they took a break, according to a lawsuit filed in federal court.

  • June 03, 2025

    The Law360 400: A Look At The Top 100 Firms

    A rebound in client work sent the nation’s largest law firms into growth mode last year, driving a wave of hiring, mergers and strategic moves that reshaped the top tier of the Law360 400. Here's a preview of the 100 firms with the largest U.S. attorney headcounts.

  • June 02, 2025

    9th Circ. Sends Express Scripts Opioid Case To State Court

    The Ninth Circuit sent California's public nuisance lawsuit against Express Scripts and OptumRx over opioid dispensing back to state court Monday and denied the pharmacy benefit managers' bid to stay the remand pending appeal, saying the U.S. Supreme Court's 2009 Nken decision controls, not its later Coinbase ruling.

  • June 02, 2025

    Ore. Psilocybin Access Suit Can Continue, Judge Says

    An Oregon federal judge has ruled that the state's health regulator must face a suit brought under a federal antidiscrimination law that seeks to broaden access for homebound patients to the state's regulated psilocybin program.

  • June 02, 2025

    Nursing Exec Says DOJ Misapplied Justices' Fraud Ruling

    A Nevada nursing home executive convicted of wage-fixing and wire fraud has told a Nevada federal judge that a recent U.S. Supreme Court ruling in a fraud case doesn't preclude his motion for a new trial, contrary to what the U.S. Department of Justice has argued.

Expert Analysis

  • Spartan Arbitration Tactics Against Well-Funded Opponents

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    Like the ancient Spartans who held off a numerically superior Persian army at the Battle of Thermopylae, trial attorneys and clients faced with arbitration against an opponent with a bigger war chest can take a strategic approach to create a pass to victory, say Kostas Katsiris and Benjamin Argyle at Venable.

  • The Road Ahead For Florida's Drug Importation Program

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    Though the U.S. Food and Drug Administration approved Florida's drug importation program in January, a series of hurdles — including requisite buy-in from Canada — and potential legal challenges must be addressed before importation can begin, say attorneys at Ropes & Gray.

  • Assessing CDC's Revised Guideline On Opioid Prescriptions

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    Kenneth Weinstein, Nicholas Van Niel and Kate Uthe at Analysis Group look at newly available data to evaluate the impact that the Centers for Disease Control and Prevention's revised opioid monitoring guideline have had on prescription trends in recent years, highlighting both specific and overall decreases.

  • Valeant Ruling May Pave Way For Patent-Based FCA Suits

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    The Ninth Circuit’s recent ruling in Silbersher v. Valeant marks a significant development in False Claims Act jurisprudence, opens new avenues for litigation and potentially raises the stakes for patent applicants who intend to do business with the government, say Joshua Robbins and Rick Taché at Buchalter.

  • Suits Against Insulin Pricing Are Driven By Rebate Addiction

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    A growing wave of lawsuits filed by states, cities and counties against insulin manufacturers and pharmacy benefit managers improperly allocate the blame for rising insulin costs, when in actuality the plaintiffs are partially responsible, says Dan Leonard at Granite Capitol Consulting.

  • When Physician Retirement Arrangements May Be Legal

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    A recent advisory opinion from the Office of Inspector General regarding physician retirement arrangements sheds light on key considerations and mitigating factors that may be useful when attempting to balance healthcare operational needs with statutory conformity, says Magda Rodriguez at Day Pitney.

  • ESG Around The World: Gulf Cooperation Council

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    The Gulf Cooperation Council is in the early stages of ESG policy implementation, but recent commitments by both states and corporations — including increases in sustainable finance transactions, environmental commitments, female representation on boards and human rights enforcement — show continuing progress toward broader ESG goals, say attorneys at Cleary.

  • Navigating ACA Reporting Nuances As Deadlines Loom

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    Stephanie Lowe at Liebert Cassidy walks employers through need-to-know elements of Affordable Care Act reporting, including two quickly approaching deadlines, the updated affordability threshold, strategies for choosing an affordability safe harbor, and common coding pitfalls.

  • Lessons From Rare Post-Verdict Healthcare Fraud Acquittal

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    A Maryland federal court recently overturned a jury verdict that found a doctor guilty of healthcare fraud related to billing levels for COVID-19 tests, providing defense attorneys with potential strategies for obtaining acquittals in similar prosecutions, says attorney Andrew Feldman.

  • ChristianaCare Settlement Reveals FCA Pitfalls For Hospitals

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    ChristianaCare's False Claims Act settlement in December is the first one based on a hospital allegedly providing private physicians with free services in the form of hospital-employed clinicians and provides important compliance lessons as the government ramps up scrutiny of compensation arrangements, say attorneys at Sheppard Mullin.

  • Patent Waiver For COVID Meds Would Harm US Biopharma

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    If the Biden administration backs the World Trade Organization in waiving patent rights on COVID-19 treatments, it would negatively affect the U.S. biopharmaceutical industry and help foreign competitors, without necessarily expanding global access to COVID-19 care, says clinical pathologist Wolfgang Klietmann.

  • New CMS Rule Will Change Nursing Facility Disclosures

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    A new rule from the Centers for Medicare & Medicaid Services significantly expands disclosure requirements for nursing facilities backed by private equity companies or real estate investment trusts, likely foreshadowing increased oversight that could include more targeted audits, say Janice Davis and Christopher Ronne at Morgan Lewis.

  • Skirting Anti-Kickback Causation Standard Amid Circuit Split

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    Amid the federal circuit court split over the causation standard applicable to False Claims Act cases involving Anti-Kickback Statute violations, which the First Circuit will soon consider in U.S. v. Regeneron, litigators aiming to circumvent the heightened standard should contemplate certain strategies, say Matthew Modafferi and Terence Park at Frier Levitt.