Policy & Compliance

  • August 20, 2025

    Judge Grills Feds On Upending 30-Year Noncitizen Benefits

    A Rhode Island federal judge seemed perplexed Wednesday by a government attorney's contention that for nearly 30 years, various administrations across the political spectrum have wrongly interpreted a law the Trump administration now says requires immigration status checks for additional federal benefits.

  • August 20, 2025

    Ohio Justices Free Bank From $77M Guaranty Disclosure Duty

    The Ohio Supreme Court on Wednesday ruled that nothing in state law required Huntington Bank to inform a co-signer of a $77 million loan guaranty about the risks associated with signing the deal with two other partners, one of whom later pled guilty to a check-kiting scheme.

  • August 20, 2025

    Northwell Health Inks $2.75M Deal In 403(B) Suit

    New York healthcare giant Northwell Health Inc. has agreed to pay $2.75 million to end a former employee's claims it breached its fiduciary duties to participants and beneficiaries in its retirement plan by allegedly saddling workers with excessive recordkeeping fees and offering an underperforming fund.

  • August 20, 2025

    TikTok Can't Dodge NC Claims Over Addictive App Design

    Chinese internet behemoth ByteDance Inc. and its social media subsidiary TikTok Inc. can be sued in the Tar Heel State, North Carolina's business court ruled Tuesday, preserving a lawsuit that accuses the companies of exploiting minors through addictive app design.

  • August 20, 2025

    NC's Cap On Med Mal Damages Is Constitutional, Panel Rules

    The North Carolina state appeals court ruled Wednesday that a state law capping compensatory damages in certain medical malpractice lawsuits at $500,000 is constitutional, handing a defeat to a woman seeking to recoup her full $7.5 million jury verdict stemming from the loss of her unborn baby.

  • August 20, 2025

    Texas AG Threatens Suit Over Orgs. Mailing Abortion Pills

    Texas Attorney General Ken Paxton has sent cease-and-desist letters to three organizations he's accused of shipping abortion drugs to women in the state in violation of state and federal laws.

  • August 20, 2025

    State AGs Sidelined From Sandoz Price-Fixing Deal

    A group of over 40 states and territories cannot intervene in a $275 million settlement resolving generic-drug price-fixing claims against Sandoz because they only have a nominal interest in the suit that fails to confer standing, a Pennsylvania federal judge said.

  • August 20, 2025

    $2.8B BCBS Antitrust Deal Approved With $759M For Attys

    An Alabama federal judge has approved a $2.8 billion settlement between Blue Cross Blue Shield and a class of medical providers in a landmark antitrust case, with $759 million going to Whatley Kallas LLP and other law firms for attorney fees and costs.

  • August 20, 2025

    Insurers Say Gov't Misusing FCA To Get Medicare Cost Cap

    Insurers accused of paying brokers to steer customers to their Medicare Advantage plans asked a Massachusetts federal judge to dismiss a False Claims Act lawsuit, saying the government is mischaracterizing legal payments for marketing as kickbacks in an attempt to impose caps it has thus far been unable to obtain.

  • August 20, 2025

    CVS PBM Overbilling Judgment Trebled To $290M

    A Pennsylvania federal judge has increased threefold a judgment against CVS Caremark from $95 million to $290 million for overbilling Medicare Part D-sponsored drugs.

  • August 19, 2025

    Tenn. Judge Trims Healthcare Contract TRAP Suit

    A Tennessee federal judge dismissed Fair Labor Standards Act claims brought by operating room technicians claiming their ex-employer, SpecialtyCare, unlawfully required them to repay tens of thousands of dollars for specialty training, plus interest, if they quit within three years, but the judge greenlit their Truth in Lending Act claims.

  • August 19, 2025

    Losses Mount For Medicare Drug Negotiation Challengers

    Big Pharma's losses in challenges to Medicare drug price negotiations are piling up. But don't think the industry is ready to wave the white flag.

  • August 19, 2025

    High Court Seeks State Input on Health Sharing Ministry Case

    The U.S. Supreme Court is showing interest in a challenge to state regulatory authority over health care sharing ministries. The nonprofit groups, which offer a cheaper alternative to traditional insurance, are expected to see more demand under major changes coming to the insurance marketplace.

  • August 19, 2025

    Novo Nordisk Gets Forfeiture Claims Cut From 401(k) Suit

    A New Jersey federal judge on Tuesday dismissed workers' allegations that Novo Nordisk unlawfully used forfeited funds in its $2.3 billion 401(k) plan for its own benefit and kept a shoddy fund on its investment roster, leaving an excessive fee claim in play.

  • August 19, 2025

    Panel Weighs Ga. High Court Ruling In Sham Donor Suit

    Customers who accused a sperm bank of selling sperm without disclosing the true medical and criminal histories of donors urged the Georgia Court of Appeals to revive their lawsuits Tuesday, arguing the dismissals were based on a misreading of a 2020 decision from the state's high court.

  • August 19, 2025

    CMS Defeats 'Hair's Breadth' Star Rating Challenge

    Insurance companies challenging the "star" system for rating Medicare Advantage organizations have lost another round in court, with a Texas federal judge saying Elevance Health failed to show federal officials violated the law when rounding down scores.

  • August 19, 2025

    Judge Backs Deal To Overhaul NY Kids' Mental Healthcare

    A New York federal judge has given the green light to allow the state to revamp its Medicaid mental health services for children to expand greater in-home and crisis care to prevent the institutionalization of kids. 

  • August 19, 2025

    Hawaii Abortion Drug Fight: 3 Things To Know

    The drug mifepristone has emerged as a key flash point in legal battles over state abortion restrictions, drug prescribing rules and the legalities of sending abortion medications across state lines. This week, a federal court in Hawaii will hear arguments in a challenge to the FDA's changes to the drug safety review process.

  • August 19, 2025

    Trump's 'Abnormal' Use Of FCA Could Get Tricky In Court

    The Trump administration is wielding the False Claims Act in unusually narrow ways to drive policies on social and cultural issues — including gender-affirming care and diversity, equity and inclusion programs — but the government's potential theories of liability under the federal law remain largely untested and might not hold up in court, experts say.

  • August 18, 2025

    Most Ozempic, Wegovy Claims Survive MDL Dismissal Bid

    Eli Lilly & Co. and Novo Nordisk will have to face most of a multidistrict litigation accusing them of misleading consumers over the risks and benefits of popular weight loss drugs like Ozempic and Trulicity, after a Pennsylvania federal judge only trimmed a few of the dozen claims the drugmakers tried to have tossed.

  • August 18, 2025

    Judge Known For Nixing ACA To Lead Texas' Northern District

    A conservative judge known for declaring Obamacare unconstitutional, among other high-profile rulings, took over as chief judge of the U.S. District Court for the Northern District of Texas on Monday, according to an announcement from the court.

  • August 15, 2025

    DOJ Backs Small Biz In Gender Dysphoria Coverage Dispute

    The U.S. Department of Justice told a New Hampshire federal court Friday that employers are not required under federal anti-discrimination laws to provide medical coverage for gender dysphoria, and that federal religious freedom law protects a turbomachinery company from covering a transgender employee's treatment for the disorder.

  • August 15, 2025

    Microsoft Unit Agrees To Pay $8.5M In MOVEIt Hack MDL

    A Massachusetts federal judge has preliminarily signed off on an $8.5 million settlement reached between Nuance Communications and more than 1 million patients in multidistrict litigation over a 2023 malware attack that exploited a vulnerability in Progress Software's MOVEIt transfer file tool. 

  • August 15, 2025

    Wholesalers Want Final OK For $51M AstraZeneca Settlement

    Drug wholesalers asked a Delaware federal judge Thursday for the final stamp of approval on a combined $51.4 million in settlements AstraZeneca Pharmaceuticals LP and Handa Pharmaceuticals LLC agreed to pay to resolve allegations AstraZeneca paid off generic-drug makers, including Handa, to protect its brand antipsychotic Seroquel XR.

  • August 15, 2025

    AbbVie's Key RICO Claims In Drug Cost Fraud Suit Survive

    An Illinois federal judge on Friday ruled that AbbVie could move ahead with the bulk of its racketeering, tortious interference and fraud claims against a behind-the-scenes healthcare company that the drugmaker alleges colluded with pharmacy benefit managers to fraudulently obtain drugs meant for patients in AbbVie's charitable programs.

Expert Analysis

  • Vertex Suit Highlights Issues For Pharma Fertility Support

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    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.

  • CMS' New 'Breakthrough' Device Policy Shows Little Promise

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    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.

  • A Preview Of AI Priorities Under The Next President

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    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.

  • Managing Community Health Needs Assessments: A Checklist

    Excerpt from Practical Guidance
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    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.

  • Pa. Health Employers Must Prep For Noncompete Restrictions

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    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.

  • FTC Focus: What Access To Patent Settlements Would Mean

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    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.

  • Agencies Should Reward Corporate Cyber Victim Cooperation

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    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.

  • Strategies To Defend Against Healthcare Nuclear Verdicts

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    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.

  • What Drug Cos. Must Know About NY Price Transparency Law

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    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.

  • Whistleblowers Must Note 5 Key Differences Of DOJ Program

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    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.

  • The Licensure Landscape For Psychedelics Manufacturers

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    As the need for bulk manufacturing of psychedelic substances grows, organizations aiming to support clinical trials or become commercial suppliers must navigate a rigorous and multifaceted journey to obtaining a license from the U.S. Drug Enforcement Administration, say Kimberly Chew at Husch Blackwell and Jaime Dwight at Promega Corp.

  • OSHA Workplace Violence Citation Highlights Mitigation Steps

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    The Occupational Safety and Health Administration's recent citation against behavioral health company Circles of Care sheds light on the enforcement risks companies may face for failing to prevent workplace violence, and is a reminder of the concrete steps that can help improve workplace safety, say attorneys at Benesch.

  • 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.