Policy & Compliance

  • 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.

  • May 30, 2025

    $5.2M Generic Drug Price-Fixing MDL Deal Gets Final OK

    Apotex Corp. will be paying $5.2 million to settle claims from a class of indirect purchasers alleging the drugmaker was working with other pharmaceutical companies to hike up the price of certain generic medications.

  • May 30, 2025

    5th Circ. To Rehear No Surprises Act Ruling En Banc

    The full Fifth Circuit agreed Friday to reconsider a dispute over provisions for calculating qualifying payments under the 2020 No Surprises Act.

  • May 30, 2025

    DLA Piper Adds Healthcare Regulatory Atty In DC Office

    DLA Piper strengthened its healthcare regulatory resources in Washington, D.C., with the recent addition of an attorney who previously served as acting general counsel for the U.S. Department of Health and Human Services.

  • May 29, 2025

    AstraZeneca Inks $51.4M Settlement In Pay-For-Delay Case

    AstraZeneca Pharmaceuticals LP and Handa Pharmaceuticals LLC have agreed to shell out a combined $51.4 million to put to rest allegations AstraZeneca paid off generic-drug makers, including Handa, to protect its brand antipsychotic drug Seroquel XR, according to a filing Thursday in Delaware federal court.

  • May 29, 2025

    CMS Seeks Hospital Responses On Gender Dysphoria Care

    The Centers for Medicare & Medicaid Services is asking hospitals to produce information on gender dysphoria care provided to children and adolescents, noting in an oversight letter that the U.S. government has "serious concerns" surrounding hormone therapy and other gender-affirming medical interventions.

  • May 29, 2025

    Ga. BCBS Says Providers Are Gaming Billing Dispute System

    Blue Cross Blue Shield of Georgia has accused a healthcare consulting firm and a handful of Peach State providers of systematic abuse of a federal dispute resolution process for surprise medical bills, accusing them of "flooding" the system with bogus dispute claims.

  • May 29, 2025

    Express Scripts Says Arkansas Can't Ban PBM Pharmacies

    Pharmacy benefits manager Express Scripts sued the state of Arkansas in federal court Thursday, alleging that the state's recently enacted law banning PBMs from owning pharmacies in the state violated the U.S. Constitution and ran afoul of federal law governing military employee benefits.

  • May 29, 2025

    Split 9th Circ. Says Spa's Rule On Certain Trans Women Biased

    A divided Ninth Circuit refused to reinstate a Korean spa's constitutional challenge against the Washington State Human Rights Commission and ordered it to rescind its policy denying admission to trans women without gender-affirming surgery, noting Thursday the policy violated state law prohibiting discrimination based on sexual orientation and gender identity.

  • May 28, 2025

    Elon Musk Is Leaving White House Role, Trump Admin Says

    Billionaire Elon Musk is ending his work with President Donald Trump and the federal Department of Government Efficiency, a White House official confirmed Wednesday evening.

  • May 28, 2025

    Justices Told Del. Expert Law Doesn't Apply In Federal Court

    A retired attorney who claims he was negligently injured by healthcare providers urged the U.S. Supreme Court on Tuesday to hold that a Delaware federal court need not apply a state statute requiring an expert affidavit for all medical malpractice suits.

  • May 28, 2025

    Judge Rejects Johns Hopkins Unit's Claim FCA Suit Is Untimely

    A Maine federal judge on Wednesday denied Johns Hopkins Medical Services Corp.'s bid to dismiss a False Claims Act suit as untimely, ruling it must face allegations it failed to report being overpaid for healthcare services for military personnel, retirees and their families.

  • May 28, 2025

    Feds Urge Supreme Court To Let 10th Circ. PBM Ruling Stand

    The federal government urged the U.S. Supreme Court not to take up the state of Oklahoma's challenge to a Tenth Circuit decision that found parts of a law regulating pharmacy benefit managers were preempted by federal benefits and healthcare laws, arguing the case doesn't warrant further review from the justices.

  • May 28, 2025

    Colorado, Feds Clash Over $6.7M From Collapsed Insurer

    A Colorado federal judge pressed the state Wednesday on how its bid to pay out $6.7 million from a defunct health insurer to a Denver Health plan doesn't conflict with the federal government's interests, noting the disbursement would result in less money to a federal risk program.

  • May 28, 2025

    DOJ Says Justices' Ruling Backs Nursing Exec's Conviction

    The U.S. Department of Justice is pointing to a recent U.S. Supreme Court ruling to bolster its fight against a new trial being sought by a convicted Nevada nursing home executive, saying that the new high court decision establishes that economic loss isn't needed to prove wire fraud.

  • May 28, 2025

    Cooley Adds Ex-FDA Attorney To DC Life Sciences Group

    Cooley LLP has hired a former U.S. Food and Drug Administration attorney, who for the majority of her public service career worked as an associate chief counsel, trying civil actions and criminal prosecutions against those accused of violating regulations for a range of products.

  • May 27, 2025

    Musk, DOGE Fail To Nix States' Suit Against 'Limitless' Power

    Fourteen states can proceed in their lawsuit challenging Elon Musk and the Department of Government Efficiency's influence in the federal government after a D.C. federal judge Tuesday refused to toss their suit, rejecting the government's contention that Musk wasn't subject to the U.S. Constitution's appointments clause.

  • May 27, 2025

    CMS Heightens Medicaid Oversight For Immigrant Care

    The Centers for Medicare & Medicaid Services on Tuesday said it is ramping up its financial oversight of states to detect misuse of federal Medicaid dollars, telling states it will seek to recoup federal funds spent on nonemergent care for "illegal aliens."

  • May 27, 2025

    Healthcare Hires: Wilson Sonsini, BCLP, Proskauer And More

    Wilson Sonsini Goodrich & Rosati PC has bolstered its regulatory practice with the addition of a U.S. Department of Health and Human Services attorney who most recently led Crowell & Moring LLP's digital health group.

  • May 27, 2025

    What The MAHA Report Tells Us About Its Future Agenda

    A long-awaited report from a commission tasked with addressing childhood chronic disease in the United States signals key parts of the healthcare system that may soon see policy changes as part of the larger Make America Healthy Again agenda.

  • May 27, 2025

    The Surgical Pay Gap: How Bias May Hurt Women's Health

    Medical and legal professionals warn that systemic sex discrimination in U.S. surgical valuations — in the form of lower pay for procedures on female anatomy — discourages specialization in women's health, leads to delayed care and increased suffering for female patients, and could expose insurers to legal liability.

  • May 27, 2025

    Feds No Longer Advise COVID Shot For Kids, Pregnant Adults

    The nation's public health agency on Tuesday pulled the COVID-19 vaccine from the list of recommended shots for healthy children and pregnant adults, a move that experts say could reduce demand for the vaccine and make it more expensive for some families.

  • May 27, 2025

    Fla. Judge Pauses Suit Over Baseball Player's Death

    A Florida state court judge on Tuesday ordered a temporary halt to a lawsuit alleging medical malpractive against a Minnesota Twins physician over the death of a minor league baseball player, pausing the case while an order denying immunity for the doctor is appealed.

  • May 27, 2025

    Wilson Sonsini Adds Ex-HHS, Crowell & Moring Leader In DC

    A former policy director at the U.S. Department of Health and Human Services who later helped Crowell & Moring LLP launch its healthcare consulting group has joined Wilson Sonsini Goodrich & Rosati PC's Washington, D.C., team, the firm announced Tuesday.

Expert Analysis

  • When Banks Unknowingly Become HIPAA Biz Associates

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    There appears to be significant confusion regarding the application of the Health Insurance Portability and Accountability Act to financial institutions when serving healthcare-related clients, so these institutions should consider undertaking several steps as a starting point in the effort to achieve compliance, say attorneys at Vorys.

  • The Regulatory Headwinds Facing Lab-Developed Tests

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    Though the U.S. Food and Drug Administration's final rule regarding regulation of laboratory-developed tests outlines a four-year plan for ending enforcement discretion, and though this rule is currently being challenged in courts, manufacturers should heed compliance opportunities immediately as enforcement actions are already on the horizon, say attorneys at Kirkland & Ellis.

  • 3 High Court Rulings May Shape Health Org. Litigation Tactics

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    Three separate decisions from the U.S. Supreme Court's most recent term — Loper Bright, Corner Post and Jarkesy — will likely strengthen healthcare organizations' ability to affirmatively sue executive agencies to challenge regulations governing operations and enforcement actions, say attorneys at McDermott.

  • A New Way Forward For COVID Vaccine Lawsuit Immunity

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    As Public Readiness and Emergency Preparedness Act protections for COVID-19 vaccines wane, adding those vaccines to coverage by the National Vaccine Injury Compensation Program would bolster defenses for administrators and manufacturers while also providing stronger remedies for those injured by vaccines, says Altom Maglio at MCT Law.

  • Why DOJ's Whistleblower Program May Have Limited Impact

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    The U.S. Department of Justice’s new whistleblower pilot program aims to incentivize individuals to report corporate misconduct, but the program's effectiveness may be undercut by its differences from other federal agencies’ whistleblower programs and its interplay with other DOJ policies, say attorneys at Milbank.

  • How Cos. With Chinese Suppliers Should Prep For Biotech Bill

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    A proposed bill to prohibit government-affiliated life sciences companies from contracting with Chinese biotech companies of concern may necessitate switching to other sources for research and supplies, meaning they should begin evaluating supply chains now due to the long lead times of drug development, say John O'Loughlin and Christina Carone at Weil Gotshal.

  • FTC's Drug Middlemen Probe Highlights Ongoing Scrutiny

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    The Federal Trade Commission's interim staff report on its inquiry into pharmacy benefit managers suggests that the industry will remain under an enforcement microscope for the foreseeable future due to concerns about how PBMs affect drug costs and accessibility, say attorneys at Arnold & Porter.

  • What Cos. Should Note In DOJ's New Whistleblower Pilot

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    After the U.S. Department of Justice unveiled a new whistleblower pilot program last week — continuing its efforts to incentivize individual reporting of misconduct — companies should review the eligibility criteria, update their compliance programs and consider the risks and benefits of making their own self-disclosures, say attorneys at Skadden.

  • Motion To Transfer Venue Considerations For FCA Cases

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    Several recent decisions highlight the importance for practitioners of analyzing as early as possible whether a False Claims Act case warrants a change of venue, and understanding how courts weigh certain factors for defendants versus whistleblowers, say Ellen London at London & Stout, and Li Yu and Corey Lipton at DiCello Levitt.

  • A Primer On EU's Updated Human Substance Regulations

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    The European Union's updated standards regarding quality and safety of substances of human origin meant for human application carry significant implications for companies that work with cells and tissues, and U.S. companies active in the EU market should pay particular attention to the import and export rules, say Geneviève Michaux and Georgios Symeonidis at King & Spalding.

  • CFPB's Medical Debt Proposal May Have Side Effects

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    The Consumer Financial Protection Bureau’s recent proposal to prevent medical debt information from appearing on consumer reports and creditors from basing lending decisions on such information may have initial benefits for some consumers, but there are potential negative consequences that should also be considered, say attorneys at Cooley.

  • 15 Areas That Would Change Under Health Data Rule Proposal

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    If finalized, the Office of the National Coordinator for Health Information Technology's proposed rule will significantly progress its efforts to advance interoperability, respond to stakeholder concerns and clarify compliance with the health IT certification program, say attorneys at Ropes & Gray.

  • 3 Healthcare FCA Deals Provide Self-Disclosure Takeaways

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    Several civil False Claims Act settlements of alleged healthcare fraud violations over the past year demonstrate that healthcare providers may benefit substantially from voluntarily disclosing potential misconduct to both the U.S. Department of Justice and the U.S. Department of Health and Human Services, say Brian Albritton and Raquel Ramirez Jefferson at Phelps Dunbar.