Policy & Compliance
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March 04, 2025
Calif. PBM Opioid Suit Belongs In Federal Court, 9th Circ. Told
Pharmacy benefit managers Express Scripts Inc. and OptumRx Inc. urged the Ninth Circuit on Tuesday to require California to litigate its public nuisance claims over their opioid dispensing practices in federal court, arguing that allowing the state to litigate in state court would create a circuit split.
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March 04, 2025
Special Master Recommends Win For UnitedHealth In FCA Suit
A massive False Claims Act case targeting Medicare Advantage plans operated by UnitedHealth relies on "speculation and assumptions," according to a special master's report that recommends ruling in the company's favor and ending the lawsuit.
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March 04, 2025
PBMs Ask 8th Circ. To Pause FTC's Insulin Pricing Case
Caremark Rx, Express Scripts and OptumRx have asked the Eighth Circuit to pause the Federal Trade Commission's in-house case accusing the pharmacy benefit managers of artificially inflating insulin prices as they push their constitutional claims against the agency.
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March 04, 2025
Virginia Gov. Again Mulls Drug Price Oversight Board
For the second time in two years, Virginia Gov. Glenn Youngkin has to decide whether the state should become the 12th one to create a prescription drug oversight board after the Legislature passed a measure in February.
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March 04, 2025
Meet The Attys Representing Mifepristone Maker GenBioPro
Attorneys from Arnold & Porter Kaye Scholer LLP and progressive legal nonprofit Democracy Forward Foundation have teamed up to represent drug manufacturer GenBioPro Inc. as it seeks to join litigation over the abortion medication mifepristone.
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March 04, 2025
Conn. Hospital Network Seeks Sanctions From Antitrust Class
Hartford HealthCare Corp. moved to sanction a proposed class of antitrust plaintiffs for asking a Connecticut judge to formally recognize a document exchange schedule privately agreed to by both sides, arguing that it should get attorney fees and costs for opposing the request.
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March 04, 2025
Congress' Plan To Cut Medicaid Budget: 3 Things To Know
As Congress grapples with potential Medicaid cuts after passage of the House budget last week, experts are concerned that lawmakers will slash the program by $880 billion, leading to fresh lawsuits and legal obstacles.
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March 04, 2025
Hospitals Risk Penalties As Trump Pushes Price Transparency
President Donald Trump's executive order to sharpen enforcement of healthcare price transparency regulations is a "warning bell" that hospitals and health plans may face stiffer fines and tighter deadlines as they evaluate how to disclose complex data.
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March 04, 2025
HHS Cuts Hit Attys Tackling Medicare Appeals Backlog
The Department of Health and Human Services is terminating more than a dozen attorneys charged with reducing a massive backlog of Medicare appeals at an internal administrative board. The cuts may slow an already cumbersome administrative process.
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March 04, 2025
Lead Testing Operations Chief To Admit Misbranding Charge
The former chief operating officer of Magellan Diagnostics will admit to defrauding the public by hiding flaws in the company's lead testing devices for years, according to a filing in Massachusetts federal court.
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March 03, 2025
Ultragenyx Loses Bid To Toss Suit Over Henrietta Lacks' Cells
A Maryland federal judge on Monday refused to toss a lawsuit lodged by the family of the late Henrietta Lacks against biotechnology company Ultragenyx for allegedly profiting off her stolen "immortal" cells, saying proof Ultragenyx engaged in intrastate business in Maryland would thwart its contention the lawsuit was filed too late.
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March 03, 2025
Sandoz Settles Florida's Generic Drug Price-Fixing Claims
Sandoz AG reached a settlement with Florida that ends federal antitrust claims the Sunshine State lodged against the drugmaker within wider litigation claiming numerous pharmaceutical companies and individuals participated in a conspiracy to fix generic drug prices, according to a Friday court filing.
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March 03, 2025
Teva Should Face Key Copaxone Antitrust Claims, Court Told
Mylan and pharmaceutical wholesalers should be allowed to proceed with some, but not all, parallel claims accusing Teva of using regulatory deception, false advertising, improper rebates and more to delay generic competition to its Copaxone multiple sclerosis treatment, a special master has recommended in New Jersey federal court.
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March 03, 2025
Trump Admin Defends Right To Send DOGE Into Agencies
A group of unions is trying to limit the president's right to oversee the executive branch by claiming that Elon Musk's Department of Government Efficiency can't access agencies' computer systems, the Trump administration told a D.C. federal judge, asking him to nix the unions' injunction bid.
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March 03, 2025
Sutter Settles Years-Old Antitrust Suit On Courthouse Steps
Attorneys for a class of millions of health insurance premium payors announced an eleventh hour deal staving off a new antitrust trial Monday in California federal court over claims that hospital chain Sutter Health drives up costs by pushing all-or-nothing network deals on insurers.
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March 03, 2025
2nd Circ. Denies Amish Schools' Vaccine Rule Challenge
The Second Circuit on Monday denied a religious challenge to New York's immunization law from three Amish schools and two Amish parents, saying both the appellate court and the U.S. Supreme Court have a history of upholding school immunization requirements implemented by states.
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February 28, 2025
Group Blasts Judge's Call For Women In Contraception MDL
A judicial organization dedicated to fighting "leftist lawfare" filed a complaint Thursday against the Florida federal judge overseeing multidistrict litigation over the hormonal contraceptive drug Depo-Provera, claiming that her comments about women needing to be represented in the MDL leadership show an impermissible bias.
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February 28, 2025
Wash. Judge Picks Apart Parents' Hospital Data Privacy Suit
A Washington appellate judge on Friday grilled parents seeking to revive their proposed privacy class action against a Seattle hospital, expressing frustration with their argument that state wiretapping law could apply to an individual's queries to a public-facing website.
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February 28, 2025
Ex-Conn. Official Hit With New Corruption Charges
A federal grand jury has indicted former Connecticut budget official Konstantinos Diamantis and Christopher Ziogas, a suspended attorney and former lawmaker, for allegedly accepting bribes to end a state audit targeting Ziogas' fiancée, an optometrist who separately admitted to healthcare fraud, prosecutors said Friday.
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February 28, 2025
SuperValu Complains About Falsity Question In FCA Case
Whistleblowers claiming SuperValu overcharged the government by $123 million for prescriptions can ask witnesses a single question alluding to a bitterly contested legal finding in the False Claims Act case in Illinois federal court, the grocer revealed in a motion objecting to the judge allowing that question.
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February 28, 2025
Aetna, Optum To Pay $8.3M To End ERISA Fee Suit
Aetna Inc. and OptumHealth Care Solutions LLC will pay $8.3 million to settle 88,000 patients' claims that they were overcharged in a scheme to hide administrative fees as medical expenses, nearly three months after OptumHealth said it was pulling out of the deal.
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February 27, 2025
FTC Asks To Delay In-House PBM Insulin Case
Arguing that pharmacy benefit managers accused of artificially inflating insulin prices have already "unreasonably delayed" discovery, the Federal Trade Commission is asking an in-house judge to push back an evidentiary trial in the case, saying it would allow the administrative court more time to accommodate up to 17 expert witnesses.
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February 27, 2025
Unions Can Depose DOGE In Agency Access Suit, Judge Says
The Department of Government Efficiency must tell a group of unions whom it's sent into the Department of Labor, the Department of Health & Human Services and the Consumer Financial Protection Bureau and what computer systems they've accessed, a D.C. federal judge ruled Thursday.
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February 27, 2025
CooperSurgical Says Unique IVF Claims Require Separate Trials
Fertility company CooperSurgical Inc. is pushing back against the suggestion that four lawsuits accusing the company of negligently destroying embryos with its recalled culture media could be consolidated into one trial, saying the couples' varied location and unique IVF situations preclude joining them.
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February 27, 2025
CVS Freed From Hospital's Suit Over Drug Pricing Program
A Pennsylvania hospital's antitrust lawsuit claiming CVS forced healthcare providers participating in a federal discount drug program to go through the pharmacy chain's administrator has been tossed, with a federal judge ruling the hospital fell short in its allegations of anticompetitive behavior.
Expert Analysis
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FDA Warning Indicates Scrutiny Of Regenerative Health Cos.
The U.S. Food and Drug Administration's recent warning letter to Akan Biosciences is a quintessential example of the agency's enforcement priorities for certain products involving human cells and tissues, and highlights ongoing scrutiny placed on manufacturers, say Dominick DiSabatino and Cortney Inman at Sheppard Mullin.
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2 Regulatory Approaches To Psychedelic Clinical Trials
Comparing the U.S. and Canada's regulatory frameworks for clinical trials of psychedelic drugs can be useful for designing trial protocols that meet both countries' requirements, which can in turn help diversify patient populations, bolster data robustness and expedite market access, say Kimberly Chew at Husch Blackwell and Sabrina Ramkellawan at AxialBridge.
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'Food As Health' Serves Up Fresh Legal Considerations
The growth of food as medicine presents a significant opportunity for healthcare organizations and nontraditional healthcare players to improve patient outcomes and reduce costs, though these innovative programs also bring compliance considerations that must be carefully navigated, say attorneys at McDermott.
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DC Circ. Ruling Heightens HHS Contract Pharmacy Challenges
The D.C. Circuit's recent ruling that the Section 340B program does not bar manufacturers from restricting deliveries of discounted drugs to contract pharmacies represents a second strike against the U.S. Department of Health and Human Services' current contract pharmacy policy and raises the stakes surrounding an upcoming Seventh Circuit ruling on the same issue, say attorneys at Foley Hoag.
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FTC Focus: Exploring The Meaning Of Orange Book Letters
The Federal Trade Commission recently announced an expansion of its campaign to promote competition by targeting pharmaceutical manufacturers' improper Orange Book patent listings, but there is a question of whether and how this helps generic entrants, say Colin Kass and David Munkittrick at Proskauer.
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3rd Circ.'s Geico Ruling May Encourage Healthcare Arbitration
The Third Circuit's recent decision in Geico v. Mount Prospect, finding that claims under New Jersey's Insurance Fraud Prevention Act can be arbitrated, strengthens arbitration as a viable alternative to litigation, even though it is not necessarily always a more favorable forum, say Khaled Klele and Jessica Osterlof at McCarter & English.
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Proposed Cannabis Reschedule Sidesteps State Law Effects
The U.S. Department of Justice's recent proposal to move cannabis to Schedule III of the Controlled Substances Act provides certain benefits, but its failure to address how the rescheduling would interact with existing state cannabis laws disappointed industry participants hoping for clarity on this crucial question, says Ian Stewart at Wilson Elser.
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A Changing Regulatory Landscape For Weight Loss Drugs
As drugs originally approved to treat diabetes become increasingly popular for weight loss purposes, federal and state regulators and payors are increasing their focus on how these drugs are prescribed, and industry participants should pay close attention to rapidly evolving compliance requirements, say attorneys at Goodwin.
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Opioid Suits Offer Case Study In Abatement Expert Testimony
Settlements in the opioid multidistrict litigation provide useful insight into leveraging expert discovery on abatement in public nuisance cases, and would not have been successful without testimony on the costs necessary to lessen the harms of the opioid crisis, says David Burnett at DiCello Levitt.
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How HHS Discrimination Rule Affects Gender-Affirming Care
The U.S. Department of Health and Human Services' new final rule, which reinterprets the Affordable Care Act's anti-discrimination provision, greatly clarifies protections for gender-affirming care and will require compliance considerations from sponsors and administrators of most group health plans, say attorneys at McDermott.
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FTC Noncompete Rule's Impact On Healthcare Nonprofits
Healthcare entities that are nonprofit or tax-exempt and thus outside of the pending Federal Trade Commission noncompete rule's reach should evaluate a number of potential risk factors and impacts, starting by assessing their own status, say Ben Shook and Tania Archer at Moore & Van Allen.
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Key Takeaways From FDA Final Rule On Lab-Developed Tests
Michele Buenafe and Dennis Gucciardo at Morgan Lewis discuss potential consequences of the U.S. Food and Drug Administration's recently finalized rule regulating lab-developed tests as medical devices, and explain the rule's phaseout policy for enforcement discretion.
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Assessing HHS' Stance On Rare Disease Patient Assistance
The U.S. Department of Health and Human Services' recent advisory opinion, temporarily blessing manufacturer-supported copay funds for rare disease patients, carves a narrow path for single-donor funds, but charities and their donors may require additional assistance to navigate programs for such patients, says Mary Kohler at Kohler Health Law.