Policy & Compliance
-
June 27, 2025
Feds Prevail Over J&J In Another 340B Rebate Dispute
A D.C. federal judge granted a summary judgment win Friday to the U.S. Health Resources and Services Administration over Johnson & Johnson, finding the agency acted within its discretion when it rejected the company's program to offer rebates instead of discounts in a decades-old drug pricing program.
-
June 27, 2025
Patient Monitoring Co. To Pay Feds $1.3M To Settle FCA Suit
A Georgia healthcare patient monitoring company has agreed to pay nearly $1.3 million to resolve a False Claims Act suit alleging it gave referral kickbacks to doctors' offices in half a dozen states, ripping off Medicare and Medicaid in the process.
-
June 27, 2025
Judge Lets DOGE Access Go On But Cites 'Grave' Concerns
A D.C. federal judge Friday voiced his "grave" concerns about the White House's Department of Government Efficiency obtaining personal information, but the district court declined to stop the U.S. Department of Labor and U.S. Department of Health and Human Services from giving this access.
-
June 27, 2025
Feds Say Transnational Crime Ring Stole $10B From Medicare
New York federal prosecutors have charged 11 members of a "transnational criminal organization, based in Russia and elsewhere," with submitting more than $10 billion worth of fraudulent Medicare claims over the last three years and funneling the proceeds overseas, according to a newly unsealed indictment.
-
June 27, 2025
Pregnancy Loss Draws Police Scrutiny Following Dobbs
The nation's abortion debate has played out in civil courtrooms and state capitols across the country since the overturning of Roe v. Wade three years ago. But the battle is also emerging in another arena: the criminal courts.
-
June 27, 2025
Full 5th Circ. To Hear Planned Parenthood Atty Immunity Row
The full Fifth Circuit will rehear a panel's decision concluding that Planned Parenthood is entitled to attorney immunity in a whistleblower suit accusing the organization of improperly billing Medicaid programs.
-
June 27, 2025
DC Judge Says Teen Health Projects Can 'Shutter' Temporarily
Five Planned Parenthood affiliates will not be irreparably harmed by changes to federal guidance for teen health programs instructing grantees to demonstrate alignment with executive orders from the Trump administration rejecting transgender identity and diversity programs, a D.C. federal judge has ruled.
-
June 27, 2025
Justices Back Task Force That Sets ACA Care Requirements
The U.S. Supreme Court ruled Friday that the U.S. Department of Health and Human Services' secretary had authority over a preventive care task force, rejecting a constitutional challenge to an Affordable Care Act clause that requires health insurers to cover certain treatments at no cost to patients.
-
June 26, 2025
Nurse Wins $27M In Retaliation Case Against Dignity Health
A former chief nursing officer who sued the West Coast hospital system Dignity Health alleging she was illegally terminated for raising serious safety concerns was awarded $27.5 million from a Los Angeles jury, her attorneys announced Thursday.
-
June 26, 2025
Hims & Hers Face Investor Suits Over Wegovy Collab
Telehealth company Hims & Hers Health Inc. has been hit with investors' proposed class actions accusing it of exploiting its partnership with Novo Nordisk, the distributor of weight loss drug Wegovy, to sell "knockoff" drugs, causing Hims shares to fall 35% when Novo Nordisk announced earlier this week the collaboration had been terminated.
-
June 26, 2025
UHC Accused Of Withholding $2M In Claims From NC Provider
UnitedHealthcare Insurance Co. siphoned millions of dollars from a North Carolina emergency medicine provider in an "extortionate scheme" by refusing to pay its customers' emergency medical claims, the provider has alleged in North Carolina federal court.
-
June 26, 2025
6th Circ. Backs Mich. Newborn Blood Testing Program
A Sixth Circuit panel reversed a win for a group of parents challenging a Michigan newborn health screening program, finding that the way blood samples are stored and used in the program does not violate the parents' right to make medical decisions for their children.
-
June 26, 2025
Judge Casts Doubt On Plea Deals In Blood Test Defect Case
A set of plea agreements between Massachusetts federal prosecutors and former Magellan Diagnostics executives has been thrown into uncertainty amid a dispute over whether the executives admitted to fraud related to defective blood tests or merely an intent to mislead, a question a judge said Thursday might be "a very expensive rabbit hole."
-
June 26, 2025
Ex-FDA Regulator Joins ArentFox Schiff's Pharma Practice
ArentFox Schiff LLP has hired a career U.S. Food and Drug Administration compliance professional, whose oversight focused on ensuring pharmaceutical industry participants' compliance with drug supply chain rules and other governing regulations, as counsel in the firm's food, drug, medical device and cosmetic practice in Washington.
-
June 26, 2025
Former Hoops Star Telfair Gets 6 Mos. For Violating Release
A Manhattan federal judge sentenced former high school basketball star and ex-NBA player Sebastian Telfair to six months in prison Thursday for violating the terms of his supervised release, after sparing him prison last year for defrauding the league's health plan.
-
June 26, 2025
Justices Say SC Medicaid Patient Can't Sue To Pick Provider
The U.S. Supreme Court on Thursday ruled that a patient can't challenge South Carolina's decision to kick Planned Parenthood from the state Medicaid program because it includes abortions among its services.
-
June 25, 2025
Cigna Says Bristol-Myers Delayed Cancer Drug Generic
Cigna has launched an antitrust suit in New York federal court accusing Bristol-Myers Squibb Co. and its Celgene subsidiary of fraudulently obtaining patents, filing sham litigation and paying off generic-drug makers to maintain a monopoly on their blockbuster blood-cancer drug Pomalyst.
-
June 25, 2025
Trans Worker Says Metal Co.'s Health Plan Discriminatory
A subsidiary of Kaiser Aluminum discriminated against transgender employees by including an exclusion in its health plan barring coverage for medical treatments related to gender-affirming care, according to a new suit filed in Washington federal court.
-
June 25, 2025
CVS PBM Hit With $95M Judgment For Overbilling Medicare
A Pennsylvania federal judge on Wednesday ruled that CVS's pharmacy benefits manager owes the government $95 million for overbilling Medicare Part D-sponsored drugs, leaving the door open for the amount to be tripled later.
-
June 24, 2025
Arkansas Insurance Dept. Fights Teamsters Plan's ERISA Suit
The Arkansas Insurance Department is looking to sink a challenge to a state insurance regulation filed by a Teamsters healthcare plan, telling an Illinois federal judge that the regulation isn't preempted by the Employee Retirement Income Security Act and, besides, the plan can't sue the department.
-
June 24, 2025
Health Data Co. Must Face Revised Investor Fraud Suit
A Connecticut federal judge won't toss an amended class action claiming a healthcare technology company misled investors about a data platform it claimed to operate that didn't actually exist, ruling that statements about the platform's capabilities are not inactionable, forward-looking statements.
-
June 24, 2025
4th Circ. Tosses Trans Man's Appeal Over Canceled Surgery
The Fourth Circuit declined to revive a transgender man's constitutional claims against a religious hospital run by the University of Maryland Medical System over a canceled hysterectomy for gender dysphoria, concluding Tuesday that it couldn't grant further relief, and refused to consider a "late-breaking" argument for emotional distress damages.
-
June 24, 2025
Calif. AG Asks 9th Circ. To Undo Limits On Pay-For-Delay Ban
California enforcers on Monday asked the Ninth Circuit to overturn a district court's decision that a state law restricting "reverse payment" settlements between brand-name and generic-drug makers cannot be used to regulate deals that were struck outside the Golden State.
-
June 24, 2025
Healthcare In Court: 5 Rulings You May Have Missed
A D.C. federal judge rejected a challenge to the federal government's approval of an audit by Johnson & Johnson into five hospitals' compliance with the 340B drug discount program. In Texas, a state appellate court has blocked San Antonio from going forward with a program that could fund travel for residents to access abortion care in other states. Here, Law360 Healthcare Authority looks at those and other healthcare rulings you may have missed over the last week.
-
June 24, 2025
Nichols Liu Co-Founder Andy Liu Launches Solo Venture
Boutique firm Nichols Liu LLP's co-founding partner Andy Liu has launched a solo practice to continue representing government contractors and healthcare industry clients in civil and criminal enforcement matters, telling Law360 Pulse Tuesday he wanted to go out on his own for greater control.
Expert Analysis
-
Top 10 Noncompete Developments Of 2024
Following an eventful year in noncompete law at both state and federal levels, employers can no longer rely on a court's willingness to blue-pencil overbroad agreements and are proceeding at their own peril if they do not thoughtfully review and carefully enforce such agreements, say attorneys at Faegre Drinker.
-
What 2024 Tells Us About Calif. Health Transaction Reviews
Looking back at the California Office of Health Care Affordability's first year accepting notices for material healthcare transactions reveals critical lessons on what the OHCA's review process may mean for the future of covered transactions in the state, say attorneys at Ropes & Gray.
-
Updated HIPAA Rule Is A Necessary Step For Data Protection
The U.S. Department of Health and Human Services' updated rules addressing cybersecurity threats in healthcare will necessitate significant investment in technology, training and compliance infrastructure, but are an essential evolution in safeguarding data in an increasingly digital world, say attorneys at Clark Hill.
-
Courts Must Curb The Drug Price Negotiation Program
The Inflation Reduction Act's drug price negotiation program upends incentive structures that drive medical innovation, and courts must act appropriately to avoid devastating consequences for American healthcare and the pharmaceutical industry, says Jeff Stier at the Consumer Choice Center.
-
The OIG Report: Preparing For Oversight In 2025
Across sectors, Office of Inspector General work plans and challenge reports for 2025 provide a trove of information on the issues and industries that will likely be the focus of government oversight in the year to come, says Diana Shaw at Wiley.
-
5 Drug And Device Developments That Shaped 2024
The last year saw significant legal developments affecting drug and device manufacturers, with landmark decisions and regulatory changes that require vigilance and agility from the industry, say attorneys at Faegre Drinker.
-
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.
-
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.
-
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.
-
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.
-
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.
-
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.
-
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.