Policy & Compliance

  • April 21, 2025

    NJ Panel Revives Ex-Group Home Worker's Whistleblower Suit

    A New Jersey appeals court reinstated a group home worker's lawsuit alleging she was fired for raising concerns about staffing levels and training, reasoning Monday that she met the pleading standards for the state's whistleblower law.

  • April 21, 2025

    Unions Demand Halt To DOGE's Info Access At DOL, HHS

    A D.C. federal judge must block Elon Musk's Department of Government Efficiency from accessing sensitive systems in the U.S. Department of Labor and Department of Health and Human Services, unions argued in a preliminary injunction bid, saying the government's search for "waste, fraud and abuse" doesn't warrant access.

  • April 21, 2025

    HCA, Workers Eye Mediation in Wage Suit

    HCA Healthcare Inc. asked a North Carolina federal court to press pause on a respiratory therapist's class and collective action accusing the company of manipulating workers' time sheets to pay them less overtime wages, saying the parties are planning to attend mediation in July.

  • April 21, 2025

    Justices Mull 5th Circ. Redo In ACA Preventive Care Fight

    The U.S. Supreme Court on Monday appeared skeptical of a Fifth Circuit ruling that found members of a task force setting preventive services coverage requirements under the Affordable Care Act were unconstitutionally appointed, with multiple justices suggesting kicking the case back down to the circuit court for additional arguments.

  • April 21, 2025

    Justices Kick Flavored-Vape Dispute Back To 5th Circ.

    After the U.S. Supreme Court affirmed the U.S. Food and Drug Administration's authority to reject an e-cigarette company's application to market flavored vapes, the high court on Monday granted summary disposition on one other pending case on the same subject, while denying certiorari to three others.

  • April 19, 2025

    Up Next At High Court: Preventive Healthcare, LGBTQ Books

    The U.S. Supreme Court will hear arguments in five cases this week, including disputes over the constitutionality of a task force that sets preventive healthcare coverage requirements, a school district's introduction of LGBTQ-themed storybooks and whether parties can establish standing based on harms affecting third parties. 

  • April 18, 2025

    Walgreens To Pay DOJ $300M Over Invalid Prescriptions

    Walgreens revealed in a U.S. Securities and Exchange Commission filing Friday that it will pay upward of $300 million to resolve U.S. Department of Justice allegations that it knowingly filed millions of prescriptions for opioids and other drugs that didn't have a legitimate medical purpose or weren't valid.

  • April 18, 2025

    Lilly Blasts Compounders' 'Scattershot' Bid To Reverse FDA

    Eli Lilly urged a Texas federal judge to deny a request from pharmacies that produce copycat doses of its popular weight loss drug to have the court reverse an FDA decision taking the drug off a national shortage list, saying the bid was filled with unreliable "scattershot" arguments.

  • April 18, 2025

    Mass General Inks $8.25M Deal To End Retirement Fee Suit

    Boston-based healthcare system Mass General Brigham Inc. agreed to pay $8.25 million to settle a proposed class action alleging it unlawfully allowed its employee retirement plan to pay excessive administrative fees, according to a filing in Massachusetts federal court.

  • April 17, 2025

    Incyte Can Get Novartis' Privileged Info On Drug Royalty Deal

    Novartis must produce certain privileged documents to Incyte concerning its understanding of their contract for royalty payments from sales of Incyte's blood cancer drug, unless Novartis agrees its former outside counsel, who negotiated the terms, won't testify about that topic at the upcoming contract breach trial, a New York federal judge said Thursday.

  • April 17, 2025

    RI Judge Wants To Know Who's Behind $11B Health Grant Cuts

    A Rhode Island federal judge on Thursday pressed the Trump administration for details about the decision-makers behind the cancellation of billions in grants supporting state public health programs.

  • April 17, 2025

    Arkansas Bans PBMs From Owning Pharmacies

    Pharmacy benefit managers operating in Arkansas will soon be prohibited from owning pharmacies in the state after Gov. Sarah Huckabee Sanders signed a bill that lawmakers say is meant to minimize conflicts of interest and safeguard patients.

  • April 17, 2025

    Tenet Asks Court To Enforce Dead Arbitrator's $546K Award

    Tenet Healthcare Corp. has asked a Washington, D.C., federal judge to require the Service Employees International Union to follow an arbitrator's final order to pay $546,000 after making derogatory statements, despite the arbitrator dying before ruling on the union's post-judgment reconsideration motion.

  • April 17, 2025

    AFL-CIO, Unions Can Pursue Some DOGE Access Claims

    The AFL-CIO, unions and advocacy groups may pursue allegations that Elon Musk's Department of Government Efficiency lacks the power to access data from the U.S. Department of Labor and other federal agencies, a D.C. federal judge ruled while tossing some claims under federal administrative and privacy law.

  • April 17, 2025

    3rd Circ. Questions Walmart's Duty To Disclose Opioid Probe

    The Third Circuit on Thursday questioned the extent to which Walmart knew of the government's interest in prosecuting it for opioid sales, as it considered a bid by investors to revive class claims alleging the retail chain failed to disclose it was under investigation.

  • April 16, 2025

    Wyo. Justices Skeptical Of State Abortion Bans' Legality

    The Wyoming Supreme Court on Wednesday seemed poised to side with a lower court judge that recent abortion bans violate the state's constitution, hinting that the Legislature doesn't have the authority to determine when life begins and thus cannot establish a compelling interest for the laws. 

  • April 16, 2025

    UnitedHealthcare Owes $1M Medicare Shortfall, Hospital Says

    UnitedHealthcare owes Connecticut's Danbury Hospital more than $1 million after bungling local Medicare Advantage cost calculations and refusing to correct its payment errors after the hospital provided notice of the problem, the healthcare facility alleged in a state court lawsuit.

  • April 15, 2025

    DC Asks Judge To Narrow Nursing Home Ruling

    The District of Columbia urged a D.C. federal judge on Tuesday to narrow an injunction requiring it to do more to help disabled nursing home residents transition into the community, arguing the order reaches beyond the class of plaintiffs and is too vague.

  • April 15, 2025

    Food Service Co. Can't Escape Tobacco Surcharge Suit

    A food service company can't dodge a proposed class action alleging it unlawfully charges tobacco users an additional fee to obtain health insurance, an Illinois federal judge ruled Tuesday, rejecting the company's assertion that federal benefits law doesn't require retroactive reimbursement for completing a cessation program.

  • April 15, 2025

    FDA Drug Rules Under Fire in Pharma Free Speech Fight

    Vanda Pharmaceuticals says it spent years establishing that one of its flagship, FDA-approved products is an effective and safe treatment for jet lag. But after being denied agency approval for that use, the company launched a novel First Amendment challenge meant to dismantle federal rules for “off-label” drug promotion.

  • April 15, 2025

    39 AGs Urge Congress To Ban PBM Pharmacy Ownership

    A bipartisan coalition of attorneys general have urged congressional leadership to pass legislation banning pharmacy benefit managers, their parent companies and affiliates from owning and operating pharmacies in order to boost competition and fairness.

  • April 15, 2025

    UBH Can't Nix Class Status In Coverage Guidelines Suit

    United Behavioral Health can't unwind class certification in a lawsuit claiming it unlawfully imposed overly restrictive guidelines for coverage of residential mental health treatments, a California federal judge ruled, saying the group's parameters could be adjusted to meet a recent Ninth Circuit standard.

  • April 15, 2025

    Anthem Strikes Deal To End Mental Health Class Action

    Anthem agreed to settle a class action from participants in employee health plans the insurer administered who alleged that coverage denials for inpatient mental health and substance use disorder treatments violated federal benefits and metal health parity laws, the parties told a New York federal court Tuesday.

  • April 15, 2025

    Minn. Couple Accused Of $15M Healthcare Fraud Scheme

    A Minnesota couple whose company was hit with a default civil judgment last year now face an indictment alleging they carried out a $15 million scheme to defraud Medicare, Medicaid and insurance companies by overbilling for neurofeedback therapy and other medical services.

  • April 15, 2025

    Legislation Roundup: States Consider Slew Of Abortion Bills

    Nearly three years after the U.S. Supreme Court's Dobbs decision upended federal abortion access protection, dozens of abortion-related bills are moving through state legislatures this year.

Expert Analysis

  • The Fate Of Biden-Era Clinical Study Guidance Under Trump

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    Draft guidance about the study of sex and gender differences in medical product development issued by the outgoing Biden administration currently faces significant uncertainty and litigation potential due to the Trump administration's executive orders and other actions, say attorneys at Arnold & Porter.

  • 10 Issues To Watch In Aerospace And Defense Contracting

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    This year, in addition to evergreen developments driven by national security priorities, disruptive new technologies and competition with rival powers, federal contractors will see significant disruptions driven by the new administration’s efforts to reduce government spending, regulation and the size of the federal workforce, say attorneys at Thompson Hine.

  • Dispelling 10 Myths About Health Provider-Based Compliance

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    Congress appears intent on requiring hospitals to submit provider-based attestations for all off-campus outpatient hospital locations, so now is the time for hospitals to prepare for this change by understanding common misconceptions about provider-based status and proactively correct noncompliance, say attorneys at McDermott.

  • A Look At HHS' New Opinion On Patient Assistance Programs

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    A recent advisory opinion from the U.S. Department of Health and Human Services' Office of Inspector General follows a recent trend of blessing patient assistance program arrangements that implicate the Anti-Kickback Statute, as long as they are structured with appropriate safeguards to minimize the risk of fraud and abuse, say attorneys at Sheppard Mullin.

  • 2 Anti-Kickback Developments Hold Lessons For Biopharma

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    The U.S. Department of Justice's Anti-Kickback Statute settlement with QOL Medical and a favorable advisory opinion from the U.S. Department of Health and Human Services provide a study in contrasts, but there are tips for biopharma manufacturers trying to navigate the vast compliance space between them, says Mary Kohler at Kohler Health Law.

  • Tips For Pharma-Biotech Overlap Reporting In New HSR Form

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    While there’s no secret recipe for reporting overlaps to the Federal Trade Commission in the new Hart-Scott-Rodino Act form, there are several layers of considerations for all pharma-biotech companies and counsel to reflect on internally before reporting on any deal, say attorneys at A&O Shearman.

  • A Look At Drug Price Negotiation Program's Ongoing Impact

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    More than two years after the passage of the Inflation Reduction Act and the rapid implementation of the drug price negotiation program, attorneys at Ropes & Gray discuss how the IRA has influenced licensing strategies, and how maximum fair prices under the law have economically affected certain drugs.

  • Preparing For A Possible End To The Subminimum Wage

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    The U.S. Department of Labor's proposed rule to end the subminimum wage for employees with disabilities may significantly affect the community-based rehabilitation and training programs that employ these workers, so certified programs should be especially vigilant about compliance during this period of evaluation and scrutiny, say attorneys at Jackson Lewis.

  • Drug Pricing Policy Trends To Expect In 2025 And Beyond

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    Though 2025 may bring more of the same in the realm of drug pricing policy, business as usual entails a sustained, high level of legal and policy developments across at least six major areas, say attorneys at Ropes & Gray.

  • Top 10 Healthcare And Life Sciences Issues To Watch In 2025

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    Under the new Trump administration, this coming year may benefit some healthcare and life sciences stakeholders, while creating new challenges for others amid an increasingly complex regulatory environment, say attorneys at Debevoise.

  • 4 Keys To Litigating In An Active Regulatory Environment

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    For companies facing litigation influenced by government regulatory action — a recent trend that a politically charged atmosphere will exacerbate — there are a few principles that can help to align litigation strategy with broader public positioning in the regulatory and oversight context, say attorneys at Jenner & Block.

  • How Views On Healthcare Price Transparency Are Changing

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    Regulators' attitudes toward price transparency regulation have shifted over the past several years in ways that may seem contradictory, and research into detailed rate information published by hospitals and health plans has yielded mixed results, says Matthew List at Charles River Associates.

  • EEOC Wearable Tech Guidance Highlights Monitoring Scrutiny

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    The U.S. Equal Employment Opportunity Commission's recent fact sheet on wearable technologies cautions against potential issues with federal anti-discrimination laws and demonstrates growing concern from regulators and legislators about intrusive technologies in the workplace, say attorneys at Littler.