Policy & Compliance

  • May 29, 2025

    CMS Seeks Hospital Responses On Gender Dysphoria Care

    The Centers for Medicare & Medicaid Services is asking hospitals to produce information on gender dysphoria care provided to children and adolescents, noting in an oversight letter that the U.S. government has "serious concerns" surrounding hormone therapy and other gender-affirming medical interventions.

  • May 29, 2025

    Ga. BCBS Says Providers Are Gaming Billing Dispute System

    Blue Cross Blue Shield of Georgia has accused a healthcare consulting firm and a handful of Peach State providers of systematic abuse of a federal dispute resolution process for surprise medical bills, accusing them of "flooding" the system with bogus dispute claims.

  • May 29, 2025

    Express Scripts Says Arkansas Can't Ban PBM Pharmacies

    Pharmacy benefits manager Express Scripts sued the state of Arkansas in federal court Thursday, alleging that the state's recently enacted law banning PBMs from owning pharmacies in the state violated the U.S. Constitution and ran afoul of federal law governing military employee benefits.

  • May 29, 2025

    Split 9th Circ. Says Spa's Rule On Certain Trans Women Biased

    A divided Ninth Circuit refused to reinstate a Korean spa's constitutional challenge against the Washington State Human Rights Commission and ordered it to rescind its policy denying admission to trans women without gender-affirming surgery, noting Thursday the policy violated state law prohibiting discrimination based on sexual orientation and gender identity.

  • May 28, 2025

    Elon Musk Is Leaving White House Role, Trump Admin Says

    Billionaire Elon Musk is ending his work with President Donald Trump and the federal Department of Government Efficiency, a White House official confirmed Wednesday evening.

  • May 28, 2025

    Justices Told Del. Expert Law Doesn't Apply In Federal Court

    A retired attorney who claims he was negligently injured by healthcare providers urged the U.S. Supreme Court on Tuesday to hold that a Delaware federal court need not apply a state statute requiring an expert affidavit for all medical malpractice suits.

  • May 28, 2025

    Judge Rejects Johns Hopkins Unit's Claim FCA Suit Is Untimely

    A Maine federal judge on Wednesday denied Johns Hopkins Medical Services Corp.'s bid to dismiss a False Claims Act suit as untimely, ruling it must face allegations it failed to report being overpaid for healthcare services for military personnel, retirees and their families.

  • May 28, 2025

    Feds Urge Supreme Court To Let 10th Circ. PBM Ruling Stand

    The federal government urged the U.S. Supreme Court not to take up the state of Oklahoma's challenge to a Tenth Circuit decision that found parts of a law regulating pharmacy benefit managers were preempted by federal benefits and healthcare laws, arguing the case doesn't warrant further review from the justices.

  • May 28, 2025

    Colorado, Feds Clash Over $6.7M From Collapsed Insurer

    A Colorado federal judge pressed the state Wednesday on how its bid to pay out $6.7 million from a defunct health insurer to a Denver Health plan doesn't conflict with the federal government's interests, noting the disbursement would result in less money to a federal risk program.

  • May 28, 2025

    DOJ Says Justices' Ruling Backs Nursing Exec's Conviction

    The U.S. Department of Justice is pointing to a recent U.S. Supreme Court ruling to bolster its fight against a new trial being sought by a convicted Nevada nursing home executive, saying that the new high court decision establishes that economic loss isn't needed to prove wire fraud.

  • May 28, 2025

    Cooley Adds Ex-FDA Attorney To DC Life Sciences Group

    Cooley LLP has hired a former U.S. Food and Drug Administration attorney, who for the majority of her public service career worked as an associate chief counsel, trying civil actions and criminal prosecutions against those accused of violating regulations for a range of products.

  • May 27, 2025

    Musk, DOGE Fail To Nix States' Suit Against 'Limitless' Power

    Fourteen states can proceed in their lawsuit challenging Elon Musk and the Department of Government Efficiency's influence in the federal government after a D.C. federal judge Tuesday refused to toss their suit, rejecting the government's contention that Musk wasn't subject to the U.S. Constitution's appointments clause.

  • May 27, 2025

    CMS Heightens Medicaid Oversight For Immigrant Care

    The Centers for Medicare & Medicaid Services on Tuesday said it is ramping up its financial oversight of states to detect misuse of federal Medicaid dollars, telling states it will seek to recoup federal funds spent on nonemergent care for "illegal aliens."

  • May 27, 2025

    Healthcare Hires: Wilson Sonsini, BCLP, Proskauer And More

    Wilson Sonsini Goodrich & Rosati PC has bolstered its regulatory practice with the addition of a U.S. Department of Health and Human Services attorney who most recently led Crowell & Moring LLP's digital health group.

  • May 27, 2025

    What The MAHA Report Tells Us About Its Future Agenda

    A long-awaited report from a commission tasked with addressing childhood chronic disease in the United States signals key parts of the healthcare system that may soon see policy changes as part of the larger Make America Healthy Again agenda.

  • May 27, 2025

    The Surgical Pay Gap: How Bias May Hurt Women's Health

    Medical and legal professionals warn that systemic sex discrimination in U.S. surgical valuations — in the form of lower pay for procedures on female anatomy — discourages specialization in women's health, leads to delayed care and increased suffering for female patients, and could expose insurers to legal liability.

  • May 27, 2025

    Feds No Longer Advise COVID Shot For Kids, Pregnant Adults

    The nation's public health agency on Tuesday pulled the COVID-19 vaccine from the list of recommended shots for healthy children and pregnant adults, a move that experts say could reduce demand for the vaccine and make it more expensive for some families.

  • May 27, 2025

    Fla. Judge Pauses Suit Over Baseball Player's Death

    A Florida state court judge on Tuesday ordered a temporary halt to a lawsuit alleging medical malpractive against a Minnesota Twins physician over the death of a minor league baseball player, pausing the case while an order denying immunity for the doctor is appealed.

  • May 27, 2025

    Wilson Sonsini Adds Ex-HHS, Crowell & Moring Leader In DC

    A former policy director at the U.S. Department of Health and Human Services who later helped Crowell & Moring LLP launch its healthcare consulting group has joined Wilson Sonsini Goodrich & Rosati PC's Washington, D.C., team, the firm announced Tuesday.

  • May 23, 2025

    Minn. Patient Sues Over Colorado Limits On Aid-In-Dying Care

    A new suit by two Colorado doctors and an out-of-state patient challenges a state restriction barring nonresidents from accessing a form of healthcare legalized in Colorado allowing patients to receive a doctor's help in ending their life.

  • May 23, 2025

    Ex-McKinsey Exec Sentenced For Obstructing Purdue Probe

    A Virginia federal judge has sentenced a disbarred attorney and former McKinsey & Co. partner to six months in prison for obstructing an investigation into the consulting giant's work with opioid manufacturer Purdue, federal prosecutors announced Friday.

  • May 23, 2025

    Trump Admin Must Restore 'Censored' Harvard Docs' Articles

    A Massachusetts federal judge on Friday ordered the U.S. Department of Health and Human Services to restore articles penned by two Harvard Medical School researchers that contained terms like "transgender" and "LGBTQ," calling their removal a "textbook example of viewpoint discrimination."

  • May 23, 2025

    Class Of Health Plans Certified In Avandia Marketing MDL

    A Pennsylvania federal judge has certified a class of health plans in multidistrict litigation over GlaxoSmithKline's alleged deceptive marketing of the drug Avandia in which the plans claim they wouldn't have paid higher premiums for the drug if they'd known about its potential cardiovascular risks.

  • May 22, 2025

    Clinic Tells NC Justices Med Mal Reforms Apply To Practices

    An orthopedic clinic is urging North Carolina's highest court to free it from a family's negligent-retention claim over an allegedly faulty surgery by a doctor who later lost his license, asserting that the lower court incorrectly found that state medical malpractice statutes and subsequent reforms don't apply to medical practices.

  • May 22, 2025

    Justices Urged To Undo Denial Of Fast Track For Gastro Drug

    Vanda Pharmaceuticals Inc. is asking the U.S. Supreme Court to reverse the Food and Drug Administration's decision denying fast-track approval for its gastroparesis drug tradipitant, saying it meets the statutory standard for fast-track review as a new treatment with the "potential to address unmet medical needs."

Expert Analysis

  • 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.

  • Navigating The Potential End Of GLP-1 Drug Shortages

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    The U.S. Food and Drug Administration's determination of whether GLP-1 products are in shortage may affect how compounders provide these products and spur a range of litigation including patent disputes and unfair competition suits, say attorneys at Goodwin.

  • Politicized OIGs Could Target Federal Employees, Contractors

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    After President Donald Trump fired nearly 20 inspectors general last week, it’s worth exploring how the administration could use Offices of Inspectors General to target federal employees and contractors, why it would be difficult to fight this effort, and one possible bulwark against the politicization of these watchdogs, says Sara Kropf at Kropf Moseley.

  • Takeaways From DOJ Fraud Section's 2024 Year In Review

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    Attorneys at Paul Weiss highlight notable developments in the U.S. Department of Justice Fraud Section’s recently released annual report, and discuss what the second Trump administration could mean for enforcement in the year to come.

  • IVF Suits Highlight Need For Better Legal Frameworks

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    The high number of in vitro fertilization embryo losses underscores the need for more cohesive legal and regulatory guidance related to human errors, property versus personhood, and liability, says Jeff Korek at Gersowitz Libo.

  • Takeaways From FDA's Updated Confirmatory Trial Guidance

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    The U.S. Food and Drug Administration's latest draft guidance about accelerated drug approval indicates the FDA's intent to address the significant lag time between accelerated approval and full approval of drugs and may help motivate the industry to complete confirmatory trials, say attorneys at Sheppard Mullin.