Policy & Compliance

  • August 11, 2025

    Aetna, CVS Want Lab's $21M Payment Suit Tossed For Good

    Aetna and its parent company, CVS Health Corp., said a medical laboratory can't stand in the shoes of patients who were allegedly denied coverage by the insurer for lab tests, and they have asked a Connecticut federal judge to toss the lab's lawsuit for good.

  • August 11, 2025

    Rural Health Providers Say FCC Subsidy Rules Unclear

    Rural healthcare providers still don't know what is and isn't covered by the Universal Service Fund and could use some clarification and guidance from the Federal Communications Commission, a group has told the agency.

  • August 11, 2025

    Proskauer Hires Epstein Becker Lawyer For DC, LA Practices

    A healthcare litigator with experience in-house, at the U.S. government and in private practice, has joined Proskauer Rose LLP as a partner to continue working on healthcare, white collar defense and investigation, the firm announced Monday.

  • August 08, 2025

    Trump EO Requires Appointee Oversight Of US Grantmaking

    President Donald Trump has issued an executive order requiring that all funding opportunity announcements and grant awards be reviewed by his political appointees and allowing for grants to be terminated that fall outside the administration's priorities. 

  • August 08, 2025

    DC Medicaid Recipients Win Class Cert. For Notice Row

    A D.C. federal judge granted a class certification motion lodged by a group of Medicaid beneficiaries who allege the district has violated their due process rights by failing to provide individualized written notices explaining prescription coverage denials and appeal rights.

  • August 08, 2025

    Administration Says States Can't Second-Guess ACA Changes

    The Trump administration urged a Massachusetts federal court to reject a request by a group of states seeking to stay implementation of new rules that will reduce Affordable Care Act healthcare marketplace subsidies and enforce certain enrollment restrictions.

  • August 08, 2025

    Iowa PBM Law Challengers Seek Wider Block At 8th Circ.

    Employers and benefit plans challenging an Iowa law aiming to limit pharmacy benefit managers' power to set drug prices will seek Eighth Circuit review of a district court judge's decision from July that temporarily blocked parts of the new policy as preempted by federal benefits law.

  • August 08, 2025

    Attys Seek Final OK Of $100M Walgreens Rx Cost Settlement

    An Illinois federal judge should greenlight a $100 million settlement to claims that Walgreens overcharged insured customers for generic prescription drugs, the plaintiffs' attorneys said, asking the judge to wrap up the 8-year-old consumer protection litigation.

  • August 07, 2025

    Health Insurance Telemarketers Cough Up $145M In FTC Suits

    Two telemarketing companies will pay $145 million to settle Federal Trade Commission claims that they misled millions of consumers into buying phony health insurance plans, the FTC said in a Thursday announcement accusing the telemarketers of making false promises that didn't provide what they offered.

  • August 07, 2025

    HHS Wins Another Round In Medicare Drug Negotiation Battle

    A Texas federal court dealt another blow to the pharmaceutical industry Thursday when it ruled in favor of Medicare's Drug Price Negotiation Program, turning away arguments that the program is unconstitutional — the third such decision in two days.

  • August 07, 2025

    BioPharma Co.'s $15M Deal Over Ruined J&J Vaccines OK'd

    A Maryland federal judge on Thursday granted final approval to a $15 million settlement to close out a stockholder derivative suit claiming Emergent BioSolutions Inc. and its top brass made a mint selling stock before their allegedly lax oversight led to the contamination of over 15 million Johnson & Johnson COVID-19 vaccine doses.

  • August 07, 2025

    Michigan AG Fights Bid To Pause PBM Price-Fixing Suit

    Michigan's attorney general has said there is no reason to pause her price-fixing suit against pharmacy benefit managers Express Scripts and Prime Therapeutics for a pending dismissal motion, urging a federal judge not to put discovery on ice. 

  • August 07, 2025

    10th Circ. Upholds Okla. Law Banning Trans Care For Minors

    The Tenth Circuit declined to block an Oklahoma law banning gender-affirming care for transgender minors, ruling that a recent U.S. Supreme Court opinion backing a similar law from Tennessee undermines state residents' claims that the statute is discriminatory.

  • August 07, 2025

    2nd Circ. Axes Challenge To Medicare Drug Price Negotiations

    In a published opinion Thursday, the Second Circuit turned away Boehringer Ingelheim's constitutional and administrative challenge to the Medicare Drug Price Negotiation Program, finding that the program is voluntary and it was lawfully implemented under the Inflation Reduction Act.

  • August 07, 2025

    Mich. Agency Can't Shake Suit Over Fights At Psych Hospital

    The Michigan claims court has ruled that the state's health department must face a lawsuit over the beating of a child at a state-run psychiatric facility because the complaint adequately alleged hospital staff took intentional steps that "directly and predictably" led to the fight. 

  • August 06, 2025

    6th Circ. Rips 'Stalking Horse' Ploy In Drug Negotiation Suit

    The pharmaceutical industry will feel the sting of a Wednesday loss in a wide-ranging war over Medicare's power to negotiate drug prices, as the Sixth Circuit tossed a suit and accused one major company of utilizing a "stalking horse" to sue in a more favorable forum.

  • August 06, 2025

    States Urge Justices To Back Med Mal Laws In Federal Court

    Tennessee and 26 other states on Wednesday urged the U.S. Supreme Court to hold that state statutes requiring an expert affidavit in all medical malpractice suits may be applied in federal court, arguing that overriding these laws under federal procedure rules would undermine state authority.

  • August 06, 2025

    Compelling ERISA Arbitration No Sure Thing, 9th Circ. Shows

    The Ninth Circuit aligned with several other federal appeals courts when it recently struck down a clause in a food service company's employee health plan that barred class or representative actions, marking the latest in a series of setbacks for employers looking to push federal benefits suits into solo arbitration.

  • August 06, 2025

    Texas Hospital Should Face Retirement Plan Suit, Judge Says

    A Houston hospital shouldn't dodge a proposed class action claiming it failed to remove a J.P. Morgan fund from its $2.8 billion employee retirement plan despite the investment option's consistent underperformance, a Texas federal magistrate judge recommended Wednesday, saying the allegations are solid enough to stay in court.

  • August 06, 2025

    Spinal Implant Co. CEO Avoids Prison After Plea Deal

    The founder and CEO of Massachusetts medical device maker SpineFrontier was sentenced Wednesday to a year of supervised release, the first six months on home confinement, for directing employees to mislead the government about the nature of payments to a surgeon who was using the company's products.

  • August 06, 2025

    State AGs Want Final OK For $39M Apotex Price-Fixing Deal

    Nearly every state attorney general in the country has asked a Connecticut federal judge to give final approval to a $39.1 million deal to settle claims that drugmaker Apotex Corp. schemed with others to fix prices and allocate markets for generic drugs, noting that the Florida-based company has already made the payment.

  • August 05, 2025

    Crowell Lands 16 Reed Smith Health Partners Across 4 Cities

    Crowell & Moring LLP announced Wednesday that it is expanding its healthcare practice with dozens of attorneys from Reed Smith LLP, including 16 healthcare litigation partners based in Chicago, Los Angeles, San Francisco and Dallas, where the firm is launching a new shop with a former Reed Smith lawyer at the helm.

  • August 05, 2025

    Wash. Judge Questions Injunctions' Scope In Head Start Case

    A Washington federal judge asked attorneys Tuesday to explain how the U.S. Supreme Court's decision concerning nationwide injunctions might impact efforts by a group of Head Start associations to halt federal directives restricting noncitizen access to the program and use of funds for diversity initiatives.

  • August 05, 2025

    OptumRx Urges Panel To DQ Motley Rice In LA Opioid Suit

    OptumRx told a California appellate panel Tuesday that Motley Rice should be disqualified from representing Los Angeles County in a lawsuit alleging it colluded with drugmakers to fuel the opioid crisis, saying the firm violated state law by using confidential information obtained in the case in other lawsuits it's handling against Optum.

  • August 05, 2025

    Key Opioid Theory Actually Irrelevant, Drug Cos. Tell 4th Circ.

    With federal judges in West Virginia suddenly split over the central legal theory in opioid litigation, major drug distributors are insisting the theory actually doesn't matter, telling the Fourth Circuit it can uphold their triumph in a landmark trial without even touching the hot-button issue.

Expert Analysis

  • FTC Focus: Private Equity Investments In Healthcare

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    As the Federal Trade Commission is tightening its scrutiny of private equity investment in healthcare, the agency is finding novel grounds to challenge key focus areas, including rollup acquisitions, the flip-and-strip approach and minority investments in rival providers, say attorneys at Proskauer.

  • High Court's Expert Ruling May Help Health Fraud Defendants

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    The U.S. Supreme Court's decision in Diaz v. U.S. appears to give the government a powerful new tool in calling its own agents as expert witnesses, but it could also benefit defense counsel in criminal healthcare fraud and other white collar criminal cases that arise in complex legal or regulatory environments, say attorneys at Holland & Knight.

  • Unpacking HHS' Opinion On Cell Therapy Refund Programs

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    A recent advisory opinion from the U.S. Department of Health and Human Services, determining that a biopharma company's refund program for its cell therapy will not be penalized, indicates an encouraging willingness to engage, but the regulator's assumptions about the program's limited term warrant a closer look, says Mary Kohler at Kohler Health.

  • DOJ Innovasis Settlement Offers Lessons On Self-Disclosure

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    The recent $12 million settlement with Innovasis and two of its executives demonstrates the U.S. Department of Justice's continued prioritization of Anti-Kickback Statute enforcement amid the growing circuit split over causation, and illustrates important nuances surrounding self-disclosure, say Denise Barnes and Scott Gallisdorfer at Bass Berry.

  • How Orange Book Antitrust Scrutiny Is Intensifying

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    Pharmaceutical patent holders should be reviewing Orange Book listing practices, as the Federal Trade Commission takes a more aggressive antitrust approach with actions such as the Teva listing probe, and the U.S. Food and Drug Administration calls attention to potentially improper listings, say attorneys at McDermott.

  • After Chevron: Slowing Down AI In Medical Research

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    The U.S. Supreme Court's recent decision overturning the Chevron doctrine may inhibit agencies' regulatory efforts, potentially slowing down the approval and implementation of artificial intelligence-driven methodologies in medical research, as well as regulators' responses to public health emergencies, say Ragini Acharya and Matthew Deutsch at Husch Blackwell.

  • FDA's Multifaceted Role On Display In MDMA Therapy Scrutiny

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    Ongoing deliberations at the U.S. Food and Drug Administration regarding MDMA-assisted therapy for post-traumatic stress disorder serves as a window into the intricate balance of scientific innovation and patient safety oversight, and offers crucial insights into regulatory nuances, say Kimberly Chew at Husch Blackwell and Kevin Lanzo at Pharmaka Clinical Consulting.

  • Analyzing FDA Draft Guidance On Clinical Trial Diversity

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    In light of the U.S. Food and Drug Administration's draft guidance on clinical trial diversity action plans, there are several important considerations for sponsors and clinical researchers to keep in mind to prevent delay in a drug or device application, say attorneys at Crowell & Moring.

  • In The CFPB Playbook: Making Good On Bold Promises

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    The U.S. Supreme Court's decision upholding the Consumer Financial Protection Bureau's funding structure in the second quarter cleared the way for the bureau to resume a number of high-priority initiatives, and it appears poised to charge ahead in working toward its aggressive preelection agenda, say Andrew Arculin and Paula Vigo Marqués at Blank Rome.

  • Critical Questions Remain After High Court's Abortion Rulings

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    The U.S. Supreme Court's decisions in two major abortion-related cases this term largely preserve the status quo for now, but leave federal preemption, the Comstock Act and in vitro fertilization in limbo, say attorneys at Jenner & Block.

  • Navigating FDA Supply Rule Leeway For Small Dispensers

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    As the November compliance deadline for the U.S. Food and Drug Administration's new pharmaceutical distribution supply chain rules draws closer, small dispensers should understand the narrow flexibilities that are available, and the questions to consider before taking advantage of them, say attorneys at Faegre Drinker.

  • 1st Gender Care Ban Provides Context For High Court Case

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    The history of Arkansas' ban on gender-affirming medical care — the first such legislation in the U.S. — provides important insight into the far-reaching ramifications that the U.S. Supreme Court's decision in U.S. v. Skrmetti next term will have on transgender healthcare, says Tyler Saenz at Baker Donelson.

  • 6 Lessons From DOJ's 1st Controlled Drug Case In Telehealth

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    Following the U.S. Department of Justice’s first-ever criminal prosecution over telehealth-prescribed controlled substances in U.S. v. Ruthia He, healthcare providers should be mindful of the risks associated with restricting the physician-patient relationship when crafting new business models, says Jonathan Porter at Husch Blackwell.