Policy & Compliance

  • June 17, 2025

    'A Warning Shot?' Experts Eye Surge In Drug Ad Enforcement

    Despite its recent staff cuts and leadership changes, the U.S. Food and Drug Administration has launched a burst of enforcement activity targeting prescription drug promotion, singling out a "sex pill" post on Instagram and an exhibit panel touting a diuretic.

  • June 17, 2025

    Medical AI Co. Calls Rival's Suit A Ploy To Kill Competition

    A Canadian artificial intelligence company focusing on medical information has asked a Massachusetts federal judge to toss out a recent trade secrets lawsuit, saying the complaint is an attempt to thwart competition based solely on speculation.

  • June 16, 2025

    Life Spine Accuses Ex-CEO Of Stealing Money, Trade Secrets

    Spinal device maker Life Spine slapped its founder with a civil suit in Illinois state court Friday accusing him of embezzling millions of dollars from the company through fraudulent credit card charges for motorsports, a lavish Mexico vacation for his family, customized golf clubs, jewelry and a Porsche for his wife. 

  • June 16, 2025

    Ohio Tells 6th Circ. PBM Case Doesn't Target Federal Work

    Ohio urged the Sixth Circuit to send its case accusing Express Scripts and Prime Therapeutics of driving up prescription drug prices through rebate schemes back to state court, arguing the case doesn't target any federal government work by the pharmacy benefit managers.

  • June 16, 2025

    HIV, AIDS Patients Denied Class Cert. In CVS Bias Fight

    A California federal judge has refused to certify a proposed class of HIV and AIDS patients alleging CVS Pharmacy Inc. violated federal disability bias protections by making their medication harder to access, finding the proposed group failed to meet the commonality standards under federal law. 

  • June 16, 2025

    Mass. Judge Blocks NIH Grant Cuts, Points To 'Discrimination'

    A Massachusetts federal judge on Monday blocked the National Institutes of Health from cutting hundreds of grant programs to universities, hospitals and other organizations, saying that in his 40 years on the bench he had never seen such "palpable" racial and LGBTQ discrimination from the government.

  • June 16, 2025

    Justices Turn Away Merck's Bone Drug Warning Label Row

    The U.S. Supreme Court on Monday rejected Merck Sharp & Dohme Corp.'s request to review a Third Circuit decision that more than 1,000 failure-to-warn claims over its osteoporosis drug Fosamax can continue despite the company's assertion that the litigation is barred by federal law.

  • June 16, 2025

    Justices Take Up NJ Anti-Abortion Group's Subpoena Fight

    The U.S. Supreme Court on Monday agreed to review the Third Circuit's dismissal of an anti-abortion pregnancy center's federal lawsuit challenging a subpoena from the New Jersey attorney general demanding information about its donors.

  • June 13, 2025

    Injunction Sought After J&J Unit's Catheter Antitrust Loss

    Innovative Health is seeking a permanent injunction that would ban Johnson & Johnson health tech unit Biosense Webster from conditioning the provision of cardiac mapping services on purchases of cardiac catheters, after Innovative Health netted a $442 million trial win on its antitrust claims.

  • June 13, 2025

    5th Circ. Says No Private Right Of Action In No Surprises Act

    The Fifth Circuit has ruled a pair of flight ambulance providers cannot pursue their lawsuit seeking to enforce out-of-network billing dispute resolution awards against a health insurance company, saying there's no private right of action built into a 2022 law that protects patients from surprise medical bills.

  • June 13, 2025

    Pa. Home Care Agency Owner Gets Prison, $235K Restitution

    The New York-based owner of a Berks County, Pennsylvania, home care agency has been sentenced to spend a month in jail and repay $235,778 in fraudulently billed Medicaid claims, the Pennsylvania Attorney General's Office announced Friday.

  • June 13, 2025

    EEOC Says Henry Ford Ignored Subpoena Over Bias Charge

    Michigan's Henry Ford health system has ignored a subpoena from the U.S. Equal Employment Opportunity Commission seeking information into a worker's bias charge, according to a federal court filing from the agency seeking an order enforcing the request.

  • June 13, 2025

    CVS Wants To Halt Ark. Law Banning PBM-Owned Pharmacies

    CVS urged an Arkansas federal judge to block a new state law from taking effect that would ban pharmacy benefits managers from owning pharmacies in the state, arguing the law shirks the U.S. Constitution by tamping down competition and discriminating against out-of-state businesses.

  • June 12, 2025

    Florida, Sandoz Say They've Fixed Generic Drug Price-Fix Deal

    The Florida Attorney General's Office and Sandoz Inc. have told a Connecticut federal court they've fixed the problems the court identified with a generic drug price-fixing settlement after other states with claims in the case objected to a clause in the deal.

  • June 12, 2025

    'Forum Shopping' Center Stage At 6th Circ. Drug Pricing Args

    As part of an expansive effort to tee up U.S. Supreme Court review, pharmaceutical industry-backed opponents of Medicare's drug price negotiations entered less-than-hospitable territory at the Sixth Circuit, where judges pointedly questioned a local business group's basis for challenging a national healthcare program.

  • June 12, 2025

    Humana, Aetna Underpaid For 340B Drugs, New Suits Say

    Humana and Aetna are facing new claims in a trio of suits filed in North Carolina federal court alleging they underpaid health systems for drugs purchased through the federal 340B drug discount program.

  • June 12, 2025

    11th Circ. Won't Revive Nurses' African Bias, Retaliation Suit

    The Eleventh Circuit on Thursday backed an Atlanta hospital's defeat of a lawsuit claiming it disciplined and fired two nurses who complained that a supervisor made derogatory comments about African employees, saying neither woman could overcome evidence of their misconduct.

  • June 12, 2025

    Fla. Death Damages Row Signals Insurers' Tort Reform Focus

    Florida Gov. Ron DeSantis' veto of a bill that would have repealed limits on noneconomic damages in fatal medical malpractice cases — despite state lawmakers' overwhelming support of the measure — signals broad concerns over how tort reform legislation could impact the insurance industry.

  • June 11, 2025

    Seattle Hospital Hit With Class Suit Over 'Diverted' Pain Meds

    A Seattle-based hospital system has been slapped with a proposed class action in Washington state court over claims that hundreds of patients suffered unwarranted pain and risk of infection because a staff member may have been pocketing painkillers.

  • June 11, 2025

    RFK Jr. Picks Vaccine Critics As Part Of CDC Panel Overhaul

    Robert F. Kennedy Jr., secretary of the U.S. Department of Health and Human Services, announced Wednesday he appointed eight new members to a vaccine advisory panel, just two days after he removed 17 existing members of the panel, which provides advice and guidance on the use of vaccines to the Centers for Disease Control and Prevention.

  • June 11, 2025

    UNC Hospital System Must Face Ex-Resident's Bias Suit

    The University of North Carolina's hospital system must face a discrimination lawsuit filed by a fired surgical resident, a North Carolina federal judge ruled Wednesday, tossing the system's motion to dismiss claims that the discharge decision was motivated by bias against the resident's mental health conditions.

  • June 11, 2025

    Children's Healthcare Nonprofit Settles Retirement Fee Suit

    A Florida-based nonprofit children's healthcare network and ex-workers who alleged their employee retirement savings were dragged down by excessive fees told a Florida federal court Wednesday they'd worked out a class action settlement of the dispute after mediation.

  • June 11, 2025

    Ga. Hospice Provider Pays $9.2M To End Kickback Case

    A Georgia hospice care provider and its CEO forked over $9.2 million to settle claims that they violated federal fraud laws by participating in a kickback scheme with medical directors who referred hospice patients to the group, prosecutors announced Wedesnday.

  • June 11, 2025

    Aetna Resolves Lipedema Patients' Coverage Class Action

    Aetna has agreed to end a class action alleging it unlawfully refused to cover liposuction as a treatment for over two dozen patients afflicted with a rare chronic condition called lipedema, according to a Wednesday filing in California federal court.

  • June 11, 2025

    Cigna Accused Of Misusing $17M In 401(k) Forfeitures

    Retirement plan participants and beneficiaries at Cigna say the company violated the Employee Retirement Income Security Act by using up to $17 million given up by participants who quit early to reduce the company's matching contributions, rather than using it to pay for the plan's administrative costs.

Expert Analysis

  • Deregulation Memo Presents Risks, Opportunities For Cos.

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    A recent Trump administration memo providing direction to agencies tasked with rescinding regulations under an earlier executive order — without undergoing the typical notice-and-review process — will likely create much uncertainty for businesses, though they may be able to engage with agencies to shape the regulatory agenda, say attorneys at Blank Rome.

  • The IRS Shouldn't Go To War Over Harvard's Tax Exemption

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    If the Internal Revenue Service revokes Harvard's tax-exempt status for violating established public policy — a position unsupported by currently available information — the precedent set by surviving the inevitable court challenge could undercut the autonomy and distinctiveness of the charitable sector, says Johnny Rex Buckles at Houston Law Center.

  • New Hospice Regulations Should Enforce Core Principles

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    As the U.S. Department of Health and Human Services' Office of Inspector General prepares to research and expand on oversight of Medicare hospice care, the OIG should keep in mind certain core principles, such as an emphasis on preventing the entry of hospices that raise red flags, says Bill Dombi at Arnall Golden.

  • 7 Considerations For Conducting Drug Clinical Trials Abroad

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    With continuing cuts to U.S. Food and Drug Administration staffing motivating some pharmaceutical companies to consider developing drugs abroad, it's important to understand the additional risks and compliance requirements associated with conducting clinical studies in other countries, say attorneys at Morgan Lewis.

  • Compliance Lessons From Warby Parker's HIPAA Fine

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    The U.S. Department of Health and Human Services' civil money penalty against Warby Parker highlights the emerging challenges that consumer-facing brands encounter when expanding into healthcare-adjacent sectors, with Health Insurance Portability and Accountability Act compliance being a potential focus of regulatory attention, say attorneys at Saul Ewing.

  • 5th Circ. Ruling Is Latest Signal Of Shaky Qui Tam Landscape

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    In his recent concurring opinion in U.S. v. Peripheral Vascular Associates, a Fifth Circuit judge joined a growing list of jurists suggesting that the False Claims Act's whistleblower provisions are unconstitutional, underscoring that acceptance of qui tam relators can no longer be taken for granted, say attorneys at Miller & Chevalier.

  • Medicare Advantage Enforcement Strong Amid Agency Cuts

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    The second Trump administration's actions thus far suggest that Medicare Advantage enforcement remains a bipartisan focus despite challenges presented by evolving trends in federal agency staffing and resources, say attorneys at Ropes & Gray.

  • A New Tool For Assessing Kickback Risks In Health Marketing

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    The Seventh Circuit's recent decision in U.S. v. Sorensen, reversing a conviction after trial of a durable medical equipment distributor, highlights two principle considerations for determining whether payments to marketers in healthcare are unlawful under the Anti-Kickback Statute, says Elisha Kobre at Sheppard Mullin.

  • How Trump Orders Affect Health Orgs.' Care For Trans Minors

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    Two recent executive orders issued by President Donald Trump regarding gender-affirming care for minors have put healthcare organizations in a precarious situation, and these institutions should prepare for various implications and potential scenarios, say attorneys at ArentFox.

  • Reproductive Health Under Trump So Far, And What's Next

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    Based on priorities stated so far, the Trump administration will likely continue to weaken Biden-era policies that protect reproductive health, with abortion, in vitro fertilization and contraception all being issues to watch closely amid a post-Dobbs shift, say attorneys at McDermott.

  • What's Next For Lab Test Regulation Without FDA Authority

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    A recent Texas federal court decision vacating the U.S. Food and Drug Administration's final rule that would apply FDA regulations to laboratory-developed tests signals potential positive impacts in the diagnostic space, and could inspire more healthcare entities to litigate against the government, say attorneys at Hooper Lundy.

  • 6 Criteria Can Help Assess Executive Branch Actions

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    With new executive policy changes announced seemingly every day, several questions can help courts, policymakers and businesses determine whether such actions are proper, effective and in keeping with our democratic norms, say Marc Levin and Khalil Cumberbatch at the Council on Criminal Justice.

  • Learning From COVID-19 Enforcement Against Nursing Homes

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    Five years after the COVID-19 outbreak caused a high number of deaths in nursing homes, an examination of enforcement actions against nursing homes in New York and elsewhere in the country highlights obstacles that may arise when bringing cases of this type, and ways to overcome them, says Kenneth Levine at Stone & Magnanini.