Policy & Compliance
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February 27, 2026
NYC Health Center Sues HHS Over $31M Medicare Repayment
The U.S. Department of Health and Human Services is unlawfully attempting to recoup more than $31 million in Medicare overpayments made during the COVID-19 pandemic, a New York City skilled nursing center told a federal court, saying it shouldn't have to repay the money.
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February 27, 2026
Meta Must Face Worker's Transgender Health Coverage Suit
Meta can't escape a transgender employee's lawsuit claiming the company's health plan unlawfully denied her coverage of gender-affirming surgeries, an Oregon federal judge ruled, rejecting the company's assertion that she hadn't adequately alleged the plan covered her desired procedures.
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February 27, 2026
DOL Extends Comment Window On PBM Transparency Rule
The U.S. Department of Labor said Friday that the public will be given more time to comment on a new proposed rule that would require pharmacy benefit managers to disclose how much money they've received while serving as intermediaries between drugmakers, pharmacies and insurers.
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February 26, 2026
Health Plans Lack Expert In Avandia MDL, 3rd Circ. Told
Counsel for GlaxoSmithKline urged a Third Circuit panel on Thursday to undo an order certifying a class of health plans in the multidistrict litigation over the company's alleged deceptive marketing of the diabetes drug Avandia, arguing the plaintiffs didn't have the experts necessary to support their case.
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February 26, 2026
$95M Kaiser Row Tees Up Challenge For Fund Returns
Kaiser Foundation Health Plan’s lawsuit seeking $95 million in coverage for a recently settled whistleblower action raises an important challenge to policy language that limits coverage for claims related to returning funds received from government agencies, as policyholder attorneys call for a broad interpretation of the policy language.
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February 26, 2026
Feds Back Pharma In 340B Contract Pharmacy Disputes
State laws that block drugmakers from imposing restrictions on federally funded hospitals and the contract pharmacies they use to dispense discounted drugs under the 340B drug discount program are violating federal law, the Trump administration said, siding with manufacturers in their bid to strike down these laws.
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February 25, 2026
Online Abortion Pill Provider Illegally Ships To Texas, AG Says
Texas Attorney General Ken Paxton sued Aid Access, its founder and a California doctor in state court Tuesday alleging they operate an "abortion-by-mail enterprise" that ship abortion-inducing drugs to Texas residents, which is endangering the lives of unborn children and their mothers.
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February 25, 2026
White House Cites Fraud, Freezes $259M In Minn. Medicaid
The Trump administration on Wednesday said it would hold back $259.9 million in Medicaid funding for Minnesota as part of what it called an unprecedented effort to combat fraud in programs that support low-income families.
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February 25, 2026
Fla. Court Blocks Doctor Dispensing Rules For Worker Claims
A Florida panel on Wednesday set aside a state agency's proposed rules that would include doctors in a workers' compensation law that gives patients an "absolute choice" over which pharmacist can fill their prescriptions, saying the proposals go beyond what lawmakers intended.
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February 25, 2026
Centene Says Filed Rate Doctrine Dooms RICO, Fraud Claims
Centene Corp. urged an Illinois federal judge Tuesday to grant it partial judgment in a proposed class action by patients alleging the company violated racketeering laws and cheated them out of billions with bogus policies, arguing the filed rate doctrine bars the refunds they seek for alleged overcharges.
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February 25, 2026
Pakistan Native Pleads Not Guilty To $10M Healthcare Fraud
A native of Pakistan who is living in Texas pled not guilty Wednesday to a Chicago indictment claiming he participated in an alleged $10 million healthcare fraud and money laundering scheme involving fake medical companies that filed claims for items and services they never provided.
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February 25, 2026
9th Circ. Rules K-12 Mental Health Grants Must Continue
The U.S. Department of Education must fund K-12 mental health grants given to public schools to help students cope with school shootings, the Ninth Circuit ruled, denying the agency's emergency request to pause a lower court's permanent injunction pending an appeal.
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February 24, 2026
Ariz., Calif. Lead Suit Over 'Senseless' HHS Vaccine Overhaul
Arizona and California are leading a coalition of states challenging the U.S. Department of Health and Human Services' decision to cut vaccine recommendations for American children, alleging in a lawsuit Tuesday that the "unprecedented attack" stems from HHS Secretary Robert F. Kennedy Jr.'s "unscientific hostility to vaccines."
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February 24, 2026
6th Circ. Affirms Dismissal Of Sotera Toxic Gas Investor Suit
The Sixth Circuit on Tuesday affirmed a lower court's dismissal of an investor lawsuit accusing Sotera Health Co. of concealing the carcinogenic nature of a gas used at its sterilization plants, finding Sotera did not make any actionable false or misleading statements to investors.
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February 24, 2026
Texas Panel Skeptical That Doctor's Hands Are Property
A Texas appellate court appeared dubious at a claim that a doctor's hands count as personal property in a case accusing a state-owned hospital of healthcare negligence, asking Tuesday what to do with the state Supreme Court's instruction to narrowly construe waivers of sovereign immunity.
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February 24, 2026
Abortion Pill Access, Tariff Questions And More In Court
Law360 Healthcare Authority looks at drugmakers' intervention in federal litigation concerning mail-order abortion medication, questions left open by the U.S. Supreme Court's decision striking down tariffs and other significant litigation developments this week.
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February 24, 2026
How To Read FDA's Flip-Flop On Moderna Flu Vaccine
An unusual FDA reversal on a new flu vaccine is raising alarm bells for health experts and attorneys.
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February 24, 2026
Ariz. Bill To Limit 'No Surprises' Arbitration Offers Put On Hold
A powerful Arizona state lawmaker this week agreed to pause his proposal to establish limits on how much medical providers can seek under the No Surprises Act arbitration system, saying the legislation needs more work and he'll bring it back next year.
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February 24, 2026
FDA Expert Panels May Exploit A Legal 'Loophole,' Atty Says
Law360 Healthcare Authority talks to attorney Joseph Daval about the rise of FDA expert panels, federal law, and blurring the lines between expert and stakeholder.
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February 24, 2026
Mallinckrodt's Ch. 11 Blocks Antitrust Payouts, Judge Rules
A Connecticut federal judge has ruled that drugmaker Mallinckrodt PLC shrugged off monetary claims brought by states in a sprawling generic drug antitrust enforcement action when the company emerged from bankruptcy in 2022.
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February 24, 2026
United Wants Partial Fraud Suit Win Against Billing Co.
TeamHealth has been submitting fraudulent claims to get UnitedHealthcare to overpay it by more than $100 million, the insurer argued as it asked a Tennessee federal judge to grant it a partial early win in its suit against the emergency room staffing and billing company.
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February 24, 2026
Philips Unit Escapes CPAP Machine Whistleblower Case
Philips Respironics, a unit of Koninklijke Philips NV, fended off a whistleblower suit alleging it provided kickbacks to CPAP suppliers that bought its products, with a Pennsylvania federal judge ruling that a former Philips manager failed to show that the company willfully engaged in illegal conduct.
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February 24, 2026
PE-Owned Doc Staffing Raises ER Fraud Risk
As private equity firms scoop up physician staffing companies, healthcare litigators say emergency rooms and referrals are fertile ground for fraud and False Claims Act enforcement.
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February 24, 2026
AbbVie Tests Exclusion Strategy In Drug Price Fight
Following a series of drugmaker losses in suits challenging Medicare drug price negotiations, AbbVie Inc. is trying something new in a challenge focused on Botox and a legal exclusion for drugs made from human plasma.
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February 24, 2026
AstraZeneca Drug Price Challenge Falls Short In Hawaii
A federal judge in Hawaii temporarily upheld the state's law that prevents drug manufacturers from blocking safety-net hospitals from contracting with an unlimited number of outside pharmacies to dispense discounted prescription drugs under the 340B Drug Discount Program.
Expert Analysis
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Rescheduling Cannabis Marks New Tax Era For Operators
As the attorney general takes steps to move cannabis from Schedule I to Schedule III of the Controlled Substances Act, operators and advisers should prepare by considering the significant changes this will bring from tax, state, industry and market perspectives, says Michael Harlow at CohnReznick.
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Justices' Med Mal Ruling May Spur Huge Shift For Litigators
The U.S. Supreme Court’s recent decision in the medical malpractice suit Berk v. Choy, holding that a Florida procedural requirement does not apply to medical malpractice claims filed in federal court, is likely to encourage eligible parties to file claims in federal court, speed the adjudicatory process and create both opportunities and challenges for litigators, says Thomas Kroeger at Colson Hicks.
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5 Drug Pricing Policy Developments To Watch In 2026
2026 may prove to be a critical year for drug pricing in the U.S., with potential major shifts including several legislative initiatives moving forward after being in the works for years, and more experimentation on the horizon concerning GLP-1s and Section 340B pricing, say attorneys at Manatt.
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Regulatory Uncertainty Ahead For Organ Transplant System
Pending court cases against a Centers for Medicare and Medicaid Services final rule that introduced a competition-centric model for assessing organ procurement organizations' performance will significantly influence the path forward for such organizations and transplant hospitals, say attorneys at Crowell & Moring.
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Key False Claims Act Trends From The Last Year
The False Claims Act remains a powerful enforcement tool after some record verdicts and settlements in 2025, and while traditional fraud areas remain a priority, new initiatives are raising questions about its expanding application, says Veronica Nannis at Joseph Greenwald.
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It's Too Soon To Remove Suicide Warnings From GLP-1 Drugs
The U.S. Food and Drug Administration's decision this month to order removal of warnings about the risk of suicidal thoughts from GLP-1 weight-loss drugs is premature — and from a safety and legal standpoint, the downside of acting too soon could be profound, says Sean Domnick at Rafferty Domnick.
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What To Know About DOL's New FLSA, FMLA Opinion Letters
The U.S. Department of Labor kicked off 2026 by releasing several opinion letters addressing employee classification, incentive bonuses and intermittent leave, reminding employers that common practices can create significant risk if they are handled inconsistently or without careful documentation, say attorneys at Woods Rogers.
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What Changed For Healthcare Transaction Law In 2025
Though much of the legislation introduced last year to expand state scrutiny of healthcare transactions did not pass, investors should pay close attention to the overarching trends, which are likely to continue in this year's legislative sessions, say attorneys at Ropes & Gray.
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Expect State Noncompete Reforms, FTC Scrutiny In 2026
Employer noncompete practices are facing intensified federal scrutiny and state reforms heading into 2026, with the Federal Trade Commission pivoting to case-by-case enforcement and states continuing to tighten the rules, especially in the healthcare sector, say attorneys at DLA Piper.
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CMS 2027 Proposal Is Mixed Bag For Medicare Advantage
The Centers for Medicare and Medicaid Services' recent proposed rule for the Medicare Advantage and Part D programs gives small organizations reason for optimism, although certain elements may be inconsistent with the Centers' desire to enhance competition, says Christine Clements at Sheppard Mullin.
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3 Key Takeaways From Planned Rescheduling Of Cannabis
An executive order reviving cannabis rescheduling represents a monumental change for the industry and, while the substance will remain illegal at the federal level, introduces several benefits, including improving state-legal cannabis operators' tax treatment, lowering the industry's legal risk profile, and leaving state-regulated markets largely intact, say attorneys at Dentons.
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6 Issues That May Follow The 340B Rebate Pilot Challenge
Though the Health Resources and Services Administration withdrew a pending case to reconsider the controversial 340B rebate pilot program, a number of crucial considerations remain, including the likelihood of a rework and questions about what that rework might look like, say attorneys at Spencer Fane.
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2026 State AI Bills That Could Expand Liability, Insurance Risk
State bills legislating artificial intelligence that are expected to pass in 2026 will reshape the liability landscape for all companies incorporating AI solutions into their business operations, as any novel private rights of action authorized under AI-related statutes signal expanding exposures, say attorneys at Wiley.