Policy & Compliance
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March 25, 2026
PBMs Say Mich. Price-Fixing Suit Lacks Specifics
For the second time, pharmacy benefit managers Express Scripts Inc. and Prime Therapeutics LLC asked a Michigan federal judge on Monday to toss a price-fixing suit filed by Michigan Attorney General Dana Nessel, arguing that the state has no standing to file the suit.
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March 25, 2026
Judge Trims SEC Fraud Case Over Cancer Drug Claims
A Massachusetts federal judge greenlighted U.S. Securities and Exchange Commission claims against two of three former pharmaceutical executives accused of concealing from investors the U.S. Food and Drug Administration's "harsh critiques" about a cancer drug.
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March 25, 2026
Foreign Aides' RICO Labor Suit Against PruittHealth Hits NC
A Tennessee federal judge has agreed to transfer to North Carolina a year-old class action in which foreign workers say a healthcare system and recruiter trapped them in punitive contracts and buried them in grueling labor, after a judge said the action could have been filed in the Tar Heel State in the first place.
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March 24, 2026
Nicotine Pouch Maker To Refile FDA Suit In DC After Transfer
The maker and seller of Zone nicotine pouches on Tuesday dismissed its own lawsuit accusing the U.S. Food and Drug Administration of unfairly holding up a market application for its product, promising to refile in D.C. federal court after a Texas federal court transferred it to South Carolina federal court.
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March 24, 2026
Biz Services Co. Faces ERISA Suit Over 'Tobacco Surcharge'
Business services company Conduent unlawfully imposes health insurance surcharges on employees who use tobacco products, forcing them to pay more for coverage the company provides, a former employee and plan participant said in a proposed class action in New Jersey federal court.
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March 24, 2026
$5.7M Cigna Ghost Network Deal Receives Final Go-Ahead
An Illinois federal judge gave his final sign-off Tuesday to a $5.7 million settlement in what he called an "interesting" case accusing Cigna of improperly advertising out-of-network providers as though they're in-network for certain benefit plans it administered.
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March 24, 2026
Health Co. Escapes Workers' 401(k) Forfeiture Suit In La.
A Louisiana federal judge agreed to toss a federal benefits lawsuit against a health company from workers who alleged the company misspent forfeitures from their employee 401(k) plan, rejecting the workers' argument that funds should have gone toward defraying expenses instead of lowering employer-side contribution obligations.
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March 24, 2026
Utah Hospitals To Track Violence As States Step Up Reporting
Under a new law, Utah hospitals will join a national effort to better understand the risks facing healthcare workers.
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March 24, 2026
Ohio Justices Likely Split On Trans Care Restrictions
The Ohio Supreme Court appeared split Tuesday as to whether a new state law banning gender-affirming care for minors trumps a decade-old healthcare freedom provision passed by voters that says state laws can't block a patient from obtaining healthcare.
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March 24, 2026
Fraud Task Force May Boost White Collar Defense Work
A new federal anti-fraud task force involving at least a dozen federal agencies could soon expose more state and local governments, contractors, companies and others to compliance risks, particularly in healthcare fraud and False Claims Act cases, experts say.
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March 24, 2026
Justices Won't Review Class Cert. In Diabetes Drug Risk Case
The U.S. Supreme Court has declined to review whether a federal court can certify a class of third-party payors who claim drugmakers hid the cancer risks of an anti-diabetes drug.
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March 24, 2026
Mass General Accused Of Shaving Time From Workers' Pay
Boston-based healthcare system Mass General Brigham shaved as much as 14 minutes a day from employees' pay by rounding their clock-in and clock-out times, according to a proposed class and collective action filed in federal court.
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March 23, 2026
J&J Amici Seek Clarity On Goldman Precedent For Class Cert.
Four groups of amici have urged the U.S. Supreme Court to take up Johnson & Johnson's challenge to a Third Circuit decision allowing a securities class action over its talc products to proceed, warning the ruling could reshape how shareholder suits are litigated nationwide.
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March 23, 2026
FTC Stays Focused On Healthcare, Launches Task Force
The Federal Trade Commission announced it is launching a new task force with staff from across the agency to coordinate healthcare policy approaches and initiate investigations meant to help protect patients, healthcare workers and American taxpayers.
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March 23, 2026
Progressive Escapes Workers' Tobacco, Vaccine Fee Suit
Allegations that Progressive Corp. wrongly charged higher health premiums from workers who used tobacco or refused the COVID-19 vaccination failed to state a claim for violating federal benefits law, an Ohio federal judge ruled as he tossed a proposed class action against the insurance giant.
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March 23, 2026
Feds Approve Minnesota's Plan To Combat Medicaid Fraud
Minnesota may soon receive the release of $243 million in deferred Medicaid funds after the Centers for Medicare & Medicaid Services approved the state's updated plan to combat Medicaid fraud, Minnesota state health officials told a federal court last week.
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March 23, 2026
Health Insurers Can't Force Conn. ERISA Row Into Arbitration
Elevance Inc. can't compel arbitration of a union health plan's allegations the insurer caused it to pay excessive administrative fees and medical costs, a Connecticut federal judge ruled, finding the insurer and its subsidiaries waived that right by seeking to dismiss the proposed class action.
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March 23, 2026
High Court Won't Hear Mich. Newborn Blood Testing Case
The U.S. Supreme Court on Monday declined to hear a petition from parents seeking to revive claims that the way newborn blood samples are collected and stored in a Michigan health screening program violates their rights to make medical decisions for their children.
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March 23, 2026
Justices Won't Review Lab Owner's Kickback Conviction
The U.S. Supreme Court on Monday declined to review the conviction of a former California biotech president sentenced to eight years in prison for lying about the efficacy of his company's COVID-19 and allergy testing and conducting a $70 million Medicare fraud scheme.
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March 23, 2026
High Court Won't Hear Calif. Border Hospital Medicaid Fight
The U.S. Supreme Court said Monday it would not consider a case challenging California's exclusions of hospitals in neighboring states from supplemental federal payments going to providers that serve Medi-Cal beneficiaries.
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March 20, 2026
Feds Rip Ex-NFL Player's New Trial Bid Over Medicare Scheme
The federal government opposed a new trial bid by Keith Gray, a former NFL player and Texas laboratory owner convicted in a $328 million scheme involving billing for unnecessary cardiovascular genetic testing for Medicare beneficiaries, arguing Thursday he lacks any valid basis to "disturb the jury's sound verdict."
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March 20, 2026
EPA's Ethylene Oxide Plan May Hinder Other Air Toxics Regs
A new proposal from the U.S. Environmental Protection Agency to weaken emission standards for a medical sterilizer could have broader implications for the agency's power to tighten air pollution limits when new science becomes available.
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March 20, 2026
Pa. Hospital Must Pay $109M For Brain Injury During Birth
Jefferson Health and its subsidiary Einstein Healthcare Network have been hit with a nearly $109 million verdict by a Philadelphia jury in a lawsuit accusing them of negligence leading to debilitating brain injuries sustained by a child delivered at one of their hospitals.
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March 20, 2026
Mich. BCBS Unit Gets Health Plans' Claims Fight Transferred
A federal judge granted Blue Cross Blue Shield of Michigan's request to transfer a proposed class action alleging the insurance company violated federal benefits law by mismanaging claims in self-funded employee healthcare plans it administered, given that a similar, earlier-filed action was proceeding in an adjacent district.
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March 20, 2026
Eye On ERISA: A Chat With King & Spalding's Darren Shuler
Increased scrutiny of health plans and the high costs of care are fueling a litigation uptick that's coming not just from plan participants but also from employers frustrated with their third-party administrators, said Darren Shuler, a partner at King & Spalding LLP. Here, Shuler speaks with Law360 about litigation trends involving the Employee Retirement Income Security Act.
Expert Analysis
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Trans Care Enforcement Landscape Is Evolving Quickly
The recent coordinated federal effort to reshape pediatric gender-affirming care through enforcement and funding pressure has created a rapidly evolving regulatory environment marked by shifting risk assessments and potential downstream market effects for healthcare institutions and life sciences companies, say attorneys at Arnall Golden.
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11th Circ. May Bring Tectonic Shift To FCA Qui Tam Actions
The Eleventh Circuit's upcoming decision in Zafirov v. Florida Medical Associates, assessing whether the False Claims Act permits ordinary citizens to stand as officers of the federal government, could significantly limit private relators' ability to bring FCA actions, say attorneys at Saul Ewing.
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To Survive FCA Actions, Small Cos. Must Take Offensive Steps
A fumbled response to False Claims Act allegations can doom lower-middle-market businesses, and with FCA enforcement hitting record levels for two years, smaller companies must have offensive strategies ready that focus their limited resources on defeating civil qui tam and federal criminal actions, says Derrelle Janey at Olshan Frome.
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Record FCA Recoveries Signal Intensified Healthcare Focus
In its recently released False Claims Act statistics, the U.S. government's emphasis on record healthcare recoveries and government-initiated healthcare matters last year indicates robust enforcement ahead, though the administration's focus on current policy objectives also extends beyond the healthcare sector, say attorneys at Epstein Becker.
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A Potential Shift In FDA's Approach To Drug Trial Design
Recent guidance released by the U.S. Food and Drug Administration clarifying how Bayesian approaches — which combine prior knowledge with new data — may be used in clinical trials reflects the agency's continued interest in innovative trial designs that may accelerate drug approvals, say attorneys at Alston & Bird.
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What FDA Guidance Means For Future Of Health Software
Two significant final guidance documents released by the U.S. Food and Drug Administration last month reflect a targeted effort to ease innovation friction around specific areas, including singular clinical decision support recommendations and sensor-based wearables, while maintaining established regulatory boundaries, say attorneys at Covington.
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How State FCA Activity May Affect Civil Fraud Enforcement
A growing trend of state attorneys general enforcing their False Claims Act analogues independently of the U.S. Department of Justice carries potential repercussions for civil fraud enforcement and qui tam litigation considerations, say Li Yu at Bernstein Litowitz, Ellen London at London & Naor and Gwen Stamper at Vogel Slade.
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Wage-Based H-1B Rule Amplifies Lottery Risks For Law Firms
Under the wage-based H-1B lottery rule taking effect Feb. 27, law firms planning to hire noncitizen law graduates awaiting bar admission should consider their options, as the work performed by such candidates may sit at the intersection of multiple occupational classifications with differing chances of success, says Jun Li at Reid & Wise.
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Assessing Compliance Risks Around TrumpRx Participation
As there are novel compliance obligations and potential political opposition related to the new TrumpRx online drug platform, companies intending to participate on the site should consider the pressure points that are likely to draw enforcement scrutiny, say attorneys at Sheppard.
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Predicting Actual Impact From CDC's New Vaccine Guidance
Recent federal changes to the childhood immunization schedule, reducing the number of vaccine recommendations from 18 to 11, do not automatically create enforceable obligations for parents, schools or healthcare providers, but may spur litigation and other downstream effects on school policies and state guidelines, says Mehdi Sinaki at Michelman & Robinson.
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What Rescheduling Means For Cannabis Labels, Marketing
The proposed reclassification of cannabis is expected to bring heightened scrutiny of labeling, advertising and marketing from the U.S. Food and Drug Administration and the Federal Trade Commission, but the brands that tighten evidence, standardize operations and professionalize marketing controls now will see fewer surprises and better outcomes, say attorneys at Wilson Elser.
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What's At Stake In Possible Circuit Split On Medicaid Rule
A recent Eleventh Circuit decision, reviving Florida's lawsuit against a federal rule that reduces Medicaid funding based on agreements between hospitals, sets up a potential circuit split with the Fifth Circuit, with important ramifications for states looking to private administrators to run provider tax programs, say Liz Goodman, Karuna Seshasai and Rebecca Pitt at FTI Consulting.
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Courts' Rare Quash Of DOJ Subpoenas Has Lessons For Cos.
In a rare move, three federal courts recently quashed or partially quashed expansive U.S. Department of Justice administrative subpoenas issued to providers of gender-affirming care, demonstrating that courts will scrutinize purpose, cabin statutory authority and acknowledge the profound privacy burdens of overbroad government demands for sensitive records, say attorneys at ArentFox Schiff.