Policy & Compliance

  • August 04, 2026

    Fla. High Court Won't Touch Reversal Of $213M 'Maya' Award

    The Florida Supreme Court said Tuesday it would not hear the appeal of a decision that reversed a $213 million judgment against a Florida hospital in favor of Maya Kowalski, the subject of the Netflix documentary "Take Care of Maya."

  • August 04, 2026

    HHS Disclosures, Trans Care Bar Targeted In New Suits

    Law360 Healthcare Authority looks at new suits filed over the past week, including challenges to the U.S. Department of Health and Human Services' authorization of disclosures to other agencies and an Office of Personnel Management policy eliminating coverage for gender-affirming care.

  • August 04, 2026

    NYC Retirees Ink $53M In Healthcare Copay Class Action

    New York City and EmblemHealth will pay $53 million to resolve a class action complaint covering more than 250,000 Medicare-eligible retirees who alleged the defendants illegally charged $15 copays onto their healthcare costs, according to a preliminary approval motion filed Friday in New York state court.

  • August 04, 2026

    Rehab Program Participants Seek Collective In Wage Suit

    Former participants in a Texas faith-based addiction recovery program have asked a federal court to certify a collective of workers who allege they were required to perform substantial labor on farms, in retail stores and in other commercial operations without receiving lawful wages, instead earning a points-based system worth roughly $1 per hour.

  • August 04, 2026

    HHS Bolsters 340B Rebate Plan After Legal Setbacks

    The Trump administration beefed up the regulatory record in its latest push to establish rebates in the 340B drug pricing program, setting the stage for a fresh legal fight with hospitals.

  • August 04, 2026

    DOJ Warns Fraud Disclosures Won't Shield Culpable Execs

    A decision by justice officials to decline criminal fraud charges against an optometry practice shows the department's ongoing willingness to pursue indictments against individuals.

  • August 04, 2026

    Lawyers Eye CMS' New Power To Freeze Medicaid Funds

    Amid headlines about the decision by President Donald Trump's administration to withhold $1 billion in Medicaid funds from California and Minnesota, healthcare attorneys are watching what could be a far more consequential development.

  • August 03, 2026

    Albertsons Says Wash. Slow To Warn Of Bad Drug Prescribers

    Washington regulators didn't notify pharmacies or patients about doctors' potentially improper opioid prescribing until months after receiving complaints, Albertsons' counsel told a Seattle judge Monday, as the bench trial over Washington's claims the pharmacy chain helped fuel the state's overdose crisis entered its fourth week.

  • August 03, 2026

    Calif. Justices Back Gilead Over Nondefective Drug Liability

    The California Supreme Court on Monday held that Gilead Sciences Inc. shouldn't face a negligence claim alleging it declined to market a safer HIV drug in order to maximize profits from an older drug with more harmful side effects, rejecting a novel theory that would expose drugmakers to broader liability.

  • August 03, 2026

    21 States Again Fight ACA Changes That Could Increase Costs

    A coalition of 21 states sued the U.S. Department of Health and Human Services and Centers for Medicare and Medicaid Services in California federal court Friday, challenging an Affordable Care Act rule that shifts costs onto enrollees while reimposing certain provisions that a Maryland federal court vacated for being unlawful and arbitrary.

  • August 03, 2026

    Boston Eye Biz To Pay $3.9M For Improper Medicaid Billing

    A Boston ophthalmology office has agreed to pay $3.9 million to settle allegations it improperly billed Medicare and Medicaid for eye injections performed during office visits, according to a U.S. Department of Justice announcement.

  • August 03, 2026

    How State SG Offices Became A Judicial Pipeline

    The rapid growth of Missouri's solicitor general's office illustrates the import of top state appellate roles, which offer young lawyers a chance to gain courtroom experience they might never acquire in BigLaw. The gig is also, for young conservatives especially, one of the fastest paths to the federal bench.

  • August 03, 2026

    Workers Say OPM Unlawfully Nixed Gender-Affirming Benefits

    A group of federal employees on Monday accused the Trump administration of unlawfully eliminating coverage of gender-affirming care from their health insurance benefits, forcing thousands of transgender workers and their dependents to pay out of pocket for treatment.

  • July 31, 2026

    Law360 Names 2026's Top Attorneys Under 40

    Law360 is pleased to announce the Rising Stars of 2026, our list of more than 160 attorneys under 40 whose legal accomplishments belie their age.

  • July 31, 2026

    Case Challenging Ban On 'Conversion Therapy' Reopened

    A Washington federal judge has partly revived a family therapist's constitutional challenge of the state's prohibition on a practice commonly known as conversion therapy in the wake of the U.S. Supreme Court's March decision finding that a similar Colorado ban amounted to viewpoint discrimination against a Christian counselor.

  • July 31, 2026

    Lab, Ex-CEO, Fla. Resident To Pay $36M Over Kickback Claims

    A Texas-based laboratory, its former CEO and a Florida businessman have each entered into settlements with the U.S. government totaling $36.4 million to resolve claims they paid kickbacks and billed Medicare and Medicaid for unnecessary medical genetic testing, in violation of the False Claims Act.

  • July 31, 2026

    NC Judge Deems Alleged $55M Medicare Clawbacks Unfair

    The U.S. Department of Health and Human Services didn't give a hospital operator fair notice of its interpretation of the term "provider" in Medicare regulations that HHS relied on to claw back millions of dollars in reimbursements, a North Carolina federal judge ruled.

  • July 31, 2026

    DC Circ. Backs Ex-Steward CEO's Contempt Charge

    The D.C. Circuit on Friday upheld a U.S. Senate committee's criminal and civil contempt finding against former Steward Health Care System LLC Chief Executive Ralph de la Torre after he refused to appear before lawmakers despite a subpoena, calling his appellate arguments "wholly meritless."

  • July 31, 2026

    No Standing For NY 'Aid-In-Dying' Law Challenge, Judge Rules

    A New York federal judge tossed a challenge by disability rights organizations and individuals to a state law enacted this year allowing patients with terminal illnesses to seek a doctor's assistance in ending their lives, finding the group lacked standing.

  • July 31, 2026

    Voluntary Benefits Suits Emerge As New ERISA Battleground

    A recent crop of proposed class actions targeting employers' insurance-related voluntary benefits offerings — for things like critical illness or hospital indemnity — marks a litigation trend that appears to be gaining, experts say.

  • July 30, 2026

    Health Plans Ask 2nd Circ. To Revive Celgene Cancer Drug Row

    Health plans and pharmacies backed by Cigna are asking the Second Circuit to revive a proposed class action alleging Bristol-Myers Squibb Co. and its Celgene subsidiary fraudulently obtained patents, filed sham lawsuits and paid off generic-drug makers to maintain a monopoly on the blockbuster blood cancer drug Pomalyst.

  • July 30, 2026

    Albertsons Can't Nix 14 Years Of Opioid Claims At Wash. Trial

    Albertsons and Safeway can't dodge 14 years' worth of claims in Washington state's lawsuit accusing the grocery stores' pharmacies of irresponsibly dispensing prescription opioids and fueling the state's overdose crisis, according to a Seattle judge's ruling Wednesday striking the companies' statute-of-limitations defense.

  • July 30, 2026

    O'Reilly Auto Parts Can't Dodge Tobacco Surcharge Suit

    O'Reilly Automotive Inc. must face a former employee's lawsuit alleging he was unlawfully charged hundreds of dollars more per year for health insurance because he used tobacco, with a Missouri federal judge ruling Thursday that his claims were detailed enough to stay in court.

  • July 30, 2026

    Judge Keeps New Medicaid 'Frailty' Proof Rule In Place

    A Massachusetts federal judge late Wednesday declined to block the government from requiring medically frail Medicaid recipients to prove they are significantly impaired to avoid a new requirement that they engage in 80 hours of work or volunteering per month or attend school part-time.

  • July 29, 2026

    Albertsons Pharmacy Work Was 'House Of Cards,' Judge Told

    Albertsons pharmacists in Washington state repeatedly warned supervisors that busy workloads and limited staffing were making it difficult to review prescriptions before filling them, a state judge in Seattle heard Monday, during a bench trial in Washington's case accusing Albertsons and its Safeway subsidiary of fueling the state's opioid crisis.

Expert Analysis

  • A Shift In Fed. Circ.'s Approach To Patent Summary Judgment

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    The Federal Circuit's recent decision in Range of Motion v. Armaid may come to be seen as a seminal opinion for potentially exposing and entrenching the Federal Circuit's movement away from its previous framework for identifying obvious noninfringement cases, says Nicholas Nowak at Nowak IP Group.

  • DOJ Actions Suggest Expansion Of Healthcare Enforcement

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    Recent actions by the U.S. Department of Justice and U.S. Food and Drug Administration suggest that federal healthcare enforcement efforts are moving away from traditional program-based fraud and toward cases centered on product integrity, regulatory transparency and telehealth marketing, effectively widening the government's enforcement playbook, say attorneys at MoFo.

  • New Orphan Drug Law Provides A Key Fix For Pharma Cos.

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    The Consolidated Appropriations Act enacted last month restores the U.S. Food and Drug Administration's long-standing interpretation of "same disease or condition," related to orphan drug exclusivity, resolving years of regulatory uncertainty and litigation that have discouraged rare disease research, say attorneys at Spencer Fane.

  • FDA User Fee Talks Offer Clues On Upcoming Reforms

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    As the U.S. Food and Drug Administration undergoes the User Fee Act reauthorization process and renegotiates its user fee agreements over the next several months, the agency's consultation meetings with relevant industries can shed light on the FDA's priorities, and provides stakeholders an opportunity to participate in the reform process, say attorneys at Holland & Knight.

  • Changes Coming To The SBIR And STTR Programs

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    Legislation recently approved by Congress to reauthorize the Small Business Innovation Research and Small Business Technology Transfer Programs includes changes focused on national security that would improve transparency but also increase applicants' administrative burdens, slow the awards process and likely increase litigation, say attorneys at Fluet & Associates.

  • FDA Framework For Personalized Therapies Raises Questions

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    The U.S. Food and Drug Administration's new plausible mechanism framework for developing individualized therapies reflects the agency's focus on rare-disease drugs, but numerous significant, unresolved issues cast uncertainty on how effective the framework will be in practice, say attorneys at Ropes & Gray.

  • Scrutiny Of Nursing Home Practices Marks Inflection Point

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    Recent congressional inquiries into UnitedHealth Group's Medicare Advantage-linked nursing home practices raise questions about whether financial metrics are allowed to influence decisions governed by the standard of care, and could implicate duties imposed by federal regulations, state negligence laws and elder abuse statutes, says Lindsey Gale at Rafferty Domnick.

  • 7 Steps For Gov't Contractors In Post-IEEPA Tariff Landscape

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    In response to U.S. Supreme Court's recent decision to strike down tariffs issued by the Trump administration under the International Emergency Economic Powers Act, there are several actions federal contractors should take to preserve their place in any refund waterfall, and to manage audit, overpayment and False Claims Act risk, say attorneys at Holland & Knight.

  • CMS Healthcare Enforcement Initiatives May Cause Disruption

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    The Centers for Medicare & Medicaid Services' recently announced enforcement actions against healthcare fraud mark a significant escalation, and CMS' prior approach in the hospice sector suggests that even compliant providers and suppliers should brace for impact, say attorneys at Morgan Lewis.

  • What We Know About DOJ's New FCA Enforcement Priorities

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    Recent remarks from the leader of the Justice Department’s commercial litigation branch provide key insights on how False Claims Act cases — especially healthcare fraud, trade fraud, antidiscrimination and cybersecurity claims — will be evaluated, prioritized and pursued as heightened enforcement becomes the new normal, say attorneys at Latham.

  • How PBMs Can Adapt To Plan Sponsors' Disclosure Demands

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    As federal reforms, growing state regulation and litigation threats push plan sponsors to expect visibility into revenue streams, pharmacy benefit managers should leverage transparency strategically, including by simplifying how they get paid, offering clients audit-ready data and co-designing contracts that are easy for fiduciaries to explain and defend, says Kristie Blase at Frazer + Blase.

  • How To Engage With Gov't's Direct-To-Consumer Drug Policy

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    The U.S. Department of Health and Human Services' recent request for industry input on manufacturers' direct-to-consumer drug sales reflects the government's caution in this arena, and allows stakeholders a rare opportunity to help shape policy, says Mary Kohler at Kohler Health Law.

  • When Fraud Involvement Disqualifies FCA Whistleblowers

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    A Massachusetts federal court's recent dismissal of a False Claims Act relator in U.S. ex rel. Perry v. First Psychiatric Planners provides instructive insight into when whistleblowers may be denied their share of settlement proceeds, even if their involvement in the underlying fraud is a step removed, say attorneys at Holland & Knight.