Policy & Compliance
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April 24, 2025
Ex-Pain Clinic Owner Gets 3½ Years For Drug Test Scheme
The former owner of a Pennsylvania pain management practice has been sentenced to three-and-a-half years in prison for conspiring with others to defraud Medicare by submitting unnecessary urine drug tests for chronic opioid patients at his medical clinics.
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April 24, 2025
'Egregious' Delays Wipe Out Ga. Health Fraud Case
A Georgia federal judge on Thursday dismissed an eight-year-old case over alleged Medicaid fraud, calling the government's delays in bringing three healthcare executives to trial "egregious" and noting that the alleged criminal conduct took place between 12 and 25 years ago.
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April 24, 2025
No Greece Trip For Ex-Conn. Official Facing Corruption Cases
A Connecticut federal judge on Thursday denied a former state official's request to take a trip to Greece amid two indictments, an order that came the day after the government opposed the plan.
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April 24, 2025
Polsinelli Gains 2 Healthcare Shareholders In Denver
Polsinelli PC announced this week that it has brought two Denver-based attorneys from Husch Blackwell LLP and the U.S. Food and Drug Administration to its healthcare practice, which the firm says gained six new shareholders in the past 12 months, not including these most recent additions.
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April 24, 2025
Harvard Seeks To Move 'Swiftly' In $2B Fund Freeze Suit
Harvard University is seeking to move as quickly as possible to get to the merits of its suit challenging the Trump administration's $2.2 billion funding freeze, asking a Massachusetts federal judge to expedite discovery and briefing.
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April 24, 2025
Workplace Screening Co. To Pay $8M For False Billing Claims
Vault Medical Services will pay $8 million to resolve allegations that it knowingly submitted false reimbursement claims for providing COVID-19 testing and other pandemic-related services to a federal program designated for uninsured patients.
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April 23, 2025
11th Circ. Considers Timeliness Of J&J Pelvic Mesh Claims
An Alabama couple urged the Eleventh Circuit on Wednesday to revive their lawsuit over injuries allegedly caused by pelvic mesh manufactured by Ethicon Inc. and its parent Johnson & Johnson, arguing that a district court wrongly found their claims were time-barred.
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April 23, 2025
Feds Oppose Ex-Conn. Official's 'Troubling' Greece Trip Plan
Federal prosecutors on Wednesday opposed a twice-indicted ex-Connecticut budget official's request to spend six weeks in Greece visiting family as he awaits twin corruption trials, citing a skipped deadline to relinquish guns and the risk that he might use Greek citizenship to evade justice.
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April 23, 2025
Genetic Testing Co., Marketer Settle FCA Case For $6M
A genetic testing company, marketing firm, and their top executives have agreed to pay $6 million to resolve the government's allegations that they billed Medicare for unnecessary medical tests, in violation of the False Claims Act.
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April 23, 2025
Eli Lilly Sues 4 Telehealth Cos. For Weight Loss Drug Copies
Eli Lilly filed a new round of lawsuits Wednesday over the compounding of its popular weight loss drugs Mounjaro and Zepbound, accusing four telehealth companies of making copies of the medications while alleging that two companies violated laws requiring doctors to make medical decisions, not corporations.
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April 22, 2025
Free Speech Experts Question DOJ Letter To Medical Journal
A federal prosecutor's letter to a medical journal skeptically asking about its commitment to nonpartisan debate is an unusual intrusion into editorial decision-making and may interfere with the publication's First Amendment rights, free speech experts say.
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April 22, 2025
'Fetal Personhood' Animates Neb. Aborted-Remains Debate
Nebraska lawmakers are sparring over a bill that would require healthcare facilities to bury or cremate fetal remains following an elective abortion. Supporters envision a "dignified" disposition. Opponents decry a requirement targeting providers while advancing the “fetal personhood” doctrine.
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April 22, 2025
Hogan Lovells Adds Ex-HHS Atty To Health Practice
Hogan Lovells on Tuesday announced the arrival of a former U.S. Department of Health and Human Services attorney to the firm's global regulatory and intellectual property practice group.
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April 22, 2025
Trump's Healthcare Order A Mixed Bag For Big Pharma
While Trump's executive order last week is more of a general road map than a clear plan for cutting prices, experts say it signals key policy priorities for the administration — including on a point of serious contention between drug companies and federal regulators.
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April 22, 2025
Pharma Co. Owner Cops To Selling $60M Of Sham HIV Drugs
An owner of a pharmaceutical company has pled guilty in Florida to participating in a $60 million nationwide scheme to illegally distribute misbranded and adulterated HIV drugs to patients.
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April 22, 2025
MoFo Adds Perkins Coie FDA Regulatory Leader In DC
Morrison Foerster LLP has hired a former Perkins Coie LLP leader who focuses his practice on a range of regulatory matters involving the U.S. Food and Drug Administration as its new head of food and regulatory, the firm announced Tuesday.
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April 22, 2025
Trump Deregulation Order Puts Target On Nurse Survey Rule
The Trump administration's push for mass deregulation is raising the hopes of nursing facilities that have spent years pushing back on a controversial rule limiting when a registered nurse must be present during facility safety inspections.
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April 22, 2025
State Legislatures Pull Back On Certificate-Of-Need Laws
Lawmakers in a handful of states are considering a fresh round of repeals and rollbacks to certificate-of-need laws, an often divisive tool designed to control healthcare costs by limiting duplication of services. That means more changes to a legal landscape that has evolved significantly since the advent of the statutes in the 1970s.
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April 22, 2025
Save Mart Reaches $20.5M Deal On Nonunion Retiree Benefits
California-based Save Mart Supermarkets will pay about $20.5 million to escape a suit from workers who alleged the company unlawfully revoked a monthly health reimbursement that it promised to nonunion retirees and their spouses for life, according to a proposed deal filed in federal court.
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April 22, 2025
Nossaman Health Atty Talks Staffing, Evolving Calif. Law
A former Procopio Health attorney has made the jump to Nossaman LLP at a time when California law around peer and judicial review processes for medical staff is evolving.
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April 21, 2025
Premera's Teen Trans Policy 'Textbook' Sex Bias, Judge Says
Premera Blue Cross discriminated based on sex against transgender teens at the center of a lawsuit alleging the insurer and health plan administrator illegally denied coverage for gender-affirming chest surgery, according to a Washington federal judge who also denied class certification because the teens' claims are not typical of class members.
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April 21, 2025
Harvard Sues Trump Admin Over $2B Funding Freeze
Harvard University on Monday hit the Trump administration with a suit in Massachusetts federal court, escalating a high-profile battle after the government slashed more than $2 billion in funding amid allegations the elite school has failed to properly address antisemitism on its campus.
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April 21, 2025
NJ Panel Revives Ex-Group Home Worker's Whistleblower Suit
A New Jersey appeals court reinstated a group home worker's lawsuit alleging she was fired for raising concerns about staffing levels and training, reasoning Monday that she met the pleading standards for the state's whistleblower law.
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April 21, 2025
Unions Demand Halt To DOGE's Info Access At DOL, HHS
A D.C. federal judge must block Elon Musk's Department of Government Efficiency from accessing sensitive systems in the U.S. Department of Labor and Department of Health and Human Services, unions argued in a preliminary injunction bid, saying the government's search for "waste, fraud and abuse" doesn't warrant access.
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April 21, 2025
HCA, Workers Eye Mediation in Wage Suit
HCA Healthcare Inc. asked a North Carolina federal court to press pause on a respiratory therapist's class and collective action accusing the company of manipulating workers' time sheets to pay them less overtime wages, saying the parties are planning to attend mediation in July.
Expert Analysis
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Class Actions At The Circuit Courts: September Lessons
In this month's review of class action appeals, Mitchell Engel at Shook Hardy identifies practice tips from four recent class certification rulings involving denial of Medicare reimbursements, automobile insurance disputes, veterans' rights and automobile defects.
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Proposed Legislation May Crack Down On Online Drug Ads
A bill recently proposed in Congress could serve as a sea change in how the U.S. Food and Drug Administration regulates drug-related speech, with significant trickle-down effects on various corners of not only the drug industry but also on consumers and providers themselves, say Dominick DiSabatino and Arushi Pandya at Sheppard Mullin.
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What To Expect From Calif. Bill Regulating PE In Healthcare
A California bill currently awaiting Gov. Gavin Newsom's approval, intended to increase oversight over private equity and hedge fund investments in healthcare, is emblematic of recent increased scrutiny of investments in the space, and may affect transactions and operations in California in a number of ways, say attorneys at Ropes & Gray.
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Vertex Suit Highlights Issues For Pharma Fertility Support
Vertex Pharmaceuticals' recent lawsuit challenging the U.S. Department of Health and Human Services' interpretation of the Anti-Kickback Statute is influenced by a number of reproductive rights and health equity issues that the Office of Inspector General should address more concretely, including in vitro fertilization and fertility preservation programs, says Mary Kohler at Kohler Health Law.
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CMS' New 'Breakthrough' Device Policy Shows Little Promise
The Centers for Medicare & Medicaid Services’ recent procedural notice outlining a new Medicare coverage pathway for breakthrough medical devices will, at best, be a failed experiment and, at worst, result in Medicare beneficiaries denied access to innovative treatments, say attorneys at King & Spalding.
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A Preview Of AI Priorities Under The Next President
For the first time in a presidential election, both of the leading candidates and their parties have been vocal about artificial intelligence policy, offering clues on the future of regulation as AI continues to advance and congressional action continues to stall, say attorneys at Mintz.
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Managing Community Health Needs Assessments: A Checklist
Excerpt from Practical Guidance
To guide nonprofit hospitals and health systems through their required community health needs assessment every three years, this checklist outlines the steps for 12 phases of the process.
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Pa. Health Employers Must Prep For Noncompete Restrictions
Newly enacted legislation in Pennsylvania prohibits certain noncompete covenants for healthcare practitioners in the state beginning next year, creating compliance challenges that both employers and employees should be aware of, say attorneys at Buchanan Ingersoll.
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FTC Focus: What Access To Patent Settlements Would Mean
Settling parties should adopt a series of practice tips, including specifying rationales to support specific terms, as the Federal Trade Commission seeks to expand its access to settlements before the Patent Trial and Appeal Board, say Shannon McGowan and David Munkittrick at Proskauer.
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Agencies Should Reward Corporate Cyber Victim Cooperation
The increased regulatory scrutiny on corporate victims of cyberattacks — exemplified by the U.S. Securities and Exchange Commission's case against SolarWinds — should be replaced with a new model that provides adequate incentives for companies to come forward proactively and collaborate with law enforcement, say attorneys at McDermott.
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Strategies To Defend Against Healthcare Nuclear Verdicts
The healthcare industry is increasingly the target of megaclaims, particularly those alleging medical malpractice, but attorneys representing providers can use a few tools to push back on flimsy litigation and reduce the likelihood of a nuclear verdict, says LaMar Jost at Wheeler Trigg.
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What Drug Cos. Must Know About NY Price Transparency Law
Drug manufacturers must understand the contours of New York's recently implemented law requiring self-reporting of drug price increases, as well as best practices for compliance and challenges against similar laws in other states, say Elizabeth Bierut and Angie Garcia at Friedman Kaplan.
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Whistleblowers Must Note 5 Key Differences Of DOJ Program
The U.S. Department of Justice’s recently unveiled whistleblower awards program diverges in key ways from similar programs at other agencies, and individuals must weigh these differences and look first to programs with stronger, proven protections before blowing the whistle, say Stephen Kohn and Geoff Schweller at Kohn Kohn.