Policy & Compliance
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December 10, 2025
Nursing Home Owners Defrauded Medicaid For Years, NJ Says
The owners of two New Jersey nursing homes diverted nearly $100 million in Medicaid funds to themselves while intentionally understaffing the facilities and neglecting the residents, according to a state comptroller report released Wednesday that called for more scrutiny of for-profit residential care facility operators.
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December 10, 2025
Med Delivery Co. Fired Workers For Pay Complaints, Suit Says
A pharmaceutical delivery company misclassified drivers as independent contractors even though it controlled nearly every aspect of their work and fired 12 named drivers at once for speaking up about it, according to a proposed class action filed in Kentucky federal court.
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December 10, 2025
Feds Seek 10 Years For Ex-Harvard Morgue Manager
Federal prosecutors in Pennsylvania have recommended that the court impose a 10-year prison sentence for former Harvard Medical School morgue manager Cedric Lodge following his admission to stealing and selling body parts from cadavers donated to the school for scientific research.
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December 09, 2025
Fla. AG Targets Pediatric Org. In Gender-Affirming Care Suit
The office of Florida Attorney General James Uthmeier sued the American Academy for Pediatrics along with the World Professional Association for Transgender Health and the Endocrine Society in Florida state court Tuesday for allegedly misleading the public about the safety of gender-affirming care for minors.
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December 09, 2025
Meet The Attys For Humana In Price-Fixing MDL Set For Trial
Attorneys from Lowey Dannenberg PC and Schneider Wallace Cottrell Kim LLP are teaming up to represent insurance giant Humana in the first bellwether case set for trial in multidistrict litigation accusing pharmaceutical companies of fixing generic drug prices.
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December 09, 2025
Lax Enforcement Spurs Suits Over Insurers' 'Ghost' Networks
More patients are alleging that what are known as insurers' ghost networks — directories full of unreachable providers — deny them access to mental health care. Their counsel say scarce enforcement is just one of the problems.
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December 09, 2025
Vax Critic Atty Wants To 'Depoliticize' Shots
Attorney Aaron Siri, who specializes in vaccine cases and has close ties to Health and Human Services Secretary Robert F. Kennedy Jr., sparked concerns after he spoke at a highly publicized Centers for Disease Control and Prevention vaccine meeting. Siri told Law360 he doesn’t see a conflict between his litigation work and his advocacy.
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December 09, 2025
Conn. Seems Open To Limits On Drug Price Cap Enforcement
The state of Connecticut suggested Tuesday that drug sales to the state were not the same as drug sales "in this state" as defined by state law, a stance drug manufacturers promised to leverage in their efforts to block an impending drug price cap.
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December 09, 2025
4th Circ. Probes Limit Of HIV-Positive Military Hopefuls' Suit
A federal appellate judge on Tuesday repeatedly pressed an attorney representing people who were denied admission to the U.S. military due to an HIV diagnosis, asking him to explain why his argument wouldn't force the U.S. Department of Defense to accept anyone with a medically controlled, chronic condition.
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December 09, 2025
FCA Bar Eager To Scrutinize 11th Circ. Qui Tam Debate
An Eleventh Circuit panel this week will help decide the fate of the qui tam provisions of the False Claims Act. The FCA bar is watching closely a case with potentially massive ramifications for federal fraud enforcement.
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December 09, 2025
Mistrial Declared In Fla. Opioid Case Against Pharmacies
A Florida state judge declared a mistrial following a hung jury after two weeks of deliberations in a lawsuit brought by hospitals alleging that Walmart, Walgreens and CVS pharmacies negligently doled out painkillers and contributed to the opioid crisis.
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December 09, 2025
Hagens Berman's Novel DOJ Referral May Have Chilling Effect
A Pennsylvania federal judge's unusual decision to refer prominent plaintiffs firm Hagens Berman LLP to the U.S. Department of Justice for possible criminal investigation over its pursuit of claims related to morning sickness drug thalidomide could have a chilling effect on lawyers' advocacy, law professors and attorneys said.
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December 09, 2025
US Asks 5th Circ. To Revive ACA Employer Tax Penalties
The IRS properly penalized a janitorial services company for failing to provide employees with healthcare coverage under the Affordable Care Act, the U.S. government said, urging the Fifth Circuit to reverse a Texas federal court ruling that voided regulations promulgating the penalties.
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December 09, 2025
Insurer Says Whistleblower Stole Docs In Medicare FCA Case
An insurer accused of running a kickback scheme to steer customers to its Medicare Advantage plan is seeking to question the whistleblower that sparked the False Claims Act suit, telling a Massachusetts federal judge on Tuesday that he snapped unauthorized photos of company files.
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December 09, 2025
Gender Care Ban Sets Catholic Hospitals On Uncharted Path
An overwhelming majority of U.S. bishops recently backed new directives for Catholic health systems to prohibit gender transition treatments. Some experts say the move could make it more difficult for Catholic hospitals to navigate state laws protecting gender-affirming care.
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December 08, 2025
Confluence Health Refunds $1.8M Following Wash. AG's Probe
Central Washington healthcare operator Confluence Health has refunded more than $1.8 million to low-income patients who paid for hospital care despite being eligible for financial assistance under the state's Charity Care Act, Washington Attorney General Nick Brown announced Monday.
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December 08, 2025
1st Circ. Keeps Planned Parenthood Funding Ban In Place
The First Circuit on Monday issued an administrative stay that temporarily keeps in place a ban on Medicaid funding for Planned Parenthood, pausing a lower court's ruling.
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December 08, 2025
Smith & Nephew Settles 401(k) Fee Dispute
A Massachusetts federal judge stayed a proposed federal benefits class action Monday against Smith & Nephew that accused the medical device company of imposing excessive fees on an employee 401(k) plan, after the parties told the court they had agreed to settle their dispute.
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December 08, 2025
11th Circ. Won't Pause Medicaid Rule Amid Fla. Hospital Audit
An Eleventh Circuit panel revived Florida's lawsuit against a federal rule that reduces Medicaid funding based on agreements between hospitals, but upheld a lower court's decision to deny the state's request for an injunction after finding it wouldn't likely succeed on the merits of its complaint.
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December 08, 2025
Hi-Tech Pharma, CEO Want New Trial In Feds' Fraud Case
A health supplement company's CEO, who was largely acquitted of federal fraud and conspiracy charges last month, asked a Georgia federal judge Friday to toss the lone conviction he faced, arguing that allowing the charge to stand "would constitute a miscarriage of justice."
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December 08, 2025
Justices Say Louisiana Law Can't Bar HIV Discrimination Suit
The U.S. Supreme Court told a Louisiana appeals court Monday that it incorrectly found that a state law protecting healthcare providers from civil liability during public health emergencies bars an HIV patient from alleging federal discrimination claims after being denied aquatherapy during the COVID-19 pandemic.
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December 08, 2025
Justices Pass On Challenge To NJ Hospital Charity Rule
The U.S. Supreme Court said Monday it won't review a New Jersey Supreme Court decision that a state requirement to treat patients regardless of the patient's ability to pay does not amount to an unconstitutional per se or regulatory taking.
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December 08, 2025
High Court Wants Feds' Input On Health Workers' Vax Fight
The U.S. Supreme Court asked Monday for the federal government's input on a group of religious workers' challenge to a pandemic-era New York state policy requiring healthcare providers to make their employees be vaccinated against COVID-19.
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December 05, 2025
Juror Who Alleged Misconduct Dismissed From Opioid Trial
A juror in Florida hospitals' $1.5 billion trial against the three major pharmacy chains over opioid dispensing was dismissed Friday after a judge found that her allegations of serious misconduct against another juror were largely unwarranted.
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December 05, 2025
9th Circ. Won't Unfreeze Trump Cuts To Student Mental Health
The Ninth Circuit rejected the Trump administration's effort to undo a lower court's pause on federal funding reductions to K-12 mental health services, siding with a coalition of 16 states seeking to preserve programs established in the wake of high-profile school shootings.
Expert Analysis
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How New Fraud Enforcement Tool Affects Gov't Contractors
Government contractors will likely face greater scrutiny under the recently enacted Administrative False Claims Act, which broadens federal agencies' authority to pursue low-dollar fraud claims, but contractors may also find the act makes settlement of such claims easier to negotiate, say attorneys at Wiley.
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Consultants Should Be Aware Of DOJ's Potential New Reach
The U.S. Department of Justice's recent first-of-its-kind settlement with McKinsey & Co. indicates not only the DOJ's more aggressive stance toward businesses' potential criminal wrongdoings, but also the benefits of self-disclosure and cooperation when wrongdoing becomes apparent, says Dom Caamano at Kibler Fowler.
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Health Tech Regulatory Trends To Watch In 2025
With an upcoming change in administration and the release of some long-awaited rules, the healthcare industry should prepare for shifting trends, including a growing focus on health data and interest in technology-enabled delivery of healthcare, say attorneys at Orrick.
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10 Noteworthy CFPB Developments From 2024
In a banner year for consumer finance regulation, the Consumer Financial Protection Bureau made significant strides in its efforts to rein in Big Tech and nonbank financial firms, including via rules regarding open banking, credit card late fees, and buy now, pay later products, say attorneys at Wiley.
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The Future Of GLP-1 Policy After Drug Shortage Ends
If and when the U.S. Food and Drug Administration determines that GLP-1 RA drugs are no longer in short supply, regulators will face questions of how to balance access to GLP-1 RAs with statutory and policy considerations applicable to compounded drugs, say attorneys at Skadden.
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Top 10 Whistleblowing And Retaliation Events Of 2024
From a Florida federal court’s ruling that the False Claims Act’s qui tam provision is unconstitutional to a record-breaking number of whistleblower tips filed with the U.S. Commodity Futures Trading Commission, employers saw significant developments in the federal and state whistleblower landscapes this year, say attorneys at Proskauer.
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How White Collar Defense Attys Can Use Summary Witnesses
Few criminal defense attorneys have successfully utilized summary witnesses in the past, but several recent success stories show that it can be a worthwhile trial tactic to help juries understand the complex decision-making at issue, says Jonathan Porter at Husch Blackwell.
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Nutraceutical Patent Insights As Market Heats Up
Companies entering the expanding nutraceutical market and seeking patents to protect their innovations should evaluate successful nutraceutical claim language and common patent challenges in this field, say attorneys at Sterne Kessler.
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How White Collar Attys Can Use Mythic Archetypes At Trial
A careful reading of a classic screenwriting guide shows that fairy tales and white collar trials actually have a lot in common, and defense attorneys would do well to tell a hero’s journey at trial, relying on universal character archetypes to connect with the jury, says Jack Sharman at Lightfoot Franklin.
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What 2024 Election Means For Drugs, Medicare And Medicaid
With Republicans running the White House, U.S. House of Representatives and U.S. Senate, the incoming administration is likely to provide pathways — through new initiatives and others returning from Trump's previous presidency — for a range of potential changes to drug pricing, Medicare and Medicaid, say attorneys at Morgan Lewis.
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Justices Mull Sex-Based Classification In Trans Law Case
After the U.S. Supreme Court heard oral argument in U.S. v. Skrmetti this week, it appears that the fate of the Tennessee law at the center of the case — a law banning gender-affirming healthcare for transgender adolescents — will hinge on whether the majority read the statute as imposing a sex-based classification, says Alexandra Crandall at Dickinson Wright.
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Key Takeaways From FDA's Latest Social Media Warnings
The U.S. Food and Drug Administration's latest untitled letter concerning a drug company's social media promotion provides lessons for how companies should navigate risk presentation, FDA labeling requirements and superiority claims, say attorneys at Sheppard Mullin.
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Rank-And-File DOJ Attorneys Will Keep Calm And Carry On
Career prosecutors at the U.S. Department of Justice often pride themselves on their ability to remain apolitical in order to ensure consistency and keep the department’s mission afloat, and the incoming Trump administration is unlikely to upend this tradition, says Michael Landman at Bird Marella.