Policy & Compliance

  • March 17, 2025

    US Chamber Says FCA Qui Tam Provisions Unconstitutional

    The U.S. Chamber of Commerce on Monday endorsed a legal challenge aimed at bringing down the whistleblower provisions in the False Claims Act, arguing there is a "manifest conflict between the modern FCA's qui tam provisions and Article II's text."

  • March 17, 2025

    Gutting USAID Threatens US Credibility, 22 Ex-Officials Say

    A bipartisan group of former high-ranking national security and defense officials on Monday voiced opposition to the Trump administration's decision to dismantle the U.S. Agency for International Development, saying in an amicus brief filed in D.C. federal court that the shutdown undermines the United States' credibility while allowing China and Russia to build theirs.

  • March 17, 2025

    New Bills Target 'Patent Thickets' And 'Product Hopping'

    A bipartisan group of senators is backing two bills it says will use the patent system to lower the price of prescription drugs, in part by targeting "patent thickets" and making "product hopping" a violation of antitrust laws. 

  • March 17, 2025

    PBMs Hit With Antitrust Suit Over GoodRx Generics Program

    A Denver pharmacy has filed a proposed class action against GoodRx, CVS and other major pharmacy benefit managers in Colorado federal court, alleging they engaged in an illegal price-fixing scheme that artificially suppressed the prices paid to independent pharmacies for reimbursement of generic drug claims.

  • March 17, 2025

    VA To End Medical Care For Gender Dysphoria

    The U.S. Department of Veterans Affairs will stop offering medical treatments for gender dysphoria in order to comply with an executive order by President Donald Trump, the agency announced Monday.

  • March 17, 2025

    Full 7th Circ. Won't Revive Suit Over Late Medicaid Payments

    The full Seventh Circuit has answered the "enormous question" of whether a Chicago hospital can sue the state of Illinois to force the managed-care organizations it contracts with to make timely Medicaid payments, concluding the hospital doesn't have a federal right to prompt payments for fear of turning federal trial courts into "de facto Medicaid claims processors."

  • March 17, 2025

    May Trial Set For Ex-Conn. Official's New Corruption Charges

    A Connecticut federal judge said Monday that former Constitution State budget official Konstantinos Diamantis and ex-lawmaker Christopher Ziogas will go to trial on May 7 for claims they respectively took and paid bribes to stop a state audit of Ziogas' fiancée, who has admitted to healthcare fraud.

  • March 17, 2025

    House Panel Probes Medical Residency Antitrust Exemption

    The chair of the House Judiciary Committee's antitrust panel is looking into whether to do away with an antitrust exemption Congress granted over 20 years ago to the medical residency matching system, which the congressman said could be harming new doctors and even patients.

  • March 17, 2025

    Houston Midwife Arrested In Texas' 1st Criminal Abortion Case

    A Houston-area midwife has been arrested after an investigation by the Texas attorney general's office for allegedly providing illegal abortions, Attorney General Ken Paxton announced Monday, the first such criminal charges brought since the state issued its near-total abortion ban.

  • March 17, 2025

    Feds Defend Prof's Deportation As Arnold & Porter Withdraws

    Government lawyers told a Massachusetts federal judge Monday they did not disobey a court order halting the deportation of a Brown University doctor and professor with an H-1B visa, as a team of Arnold & Porter Kaye Scholer LLP lawyers who lobbed that claim abruptly withdrew from the case.

  • March 17, 2025

    Seeger Weiss Atty Tapped To Lead Depo-Provera Plaintiffs

    A Florida federal judge on Sunday selected Christopher Seeger of Seeger Weiss LLP to lead the team representing plaintiffs in the multidistrict litigation claiming Pfizer Inc. failed to adequately warn patients and doctors about the risk of brain tumors associated with the hormonal contraceptive drug Depo-Provera.

  • March 14, 2025

    Ga. Panel Says COVID-Era Legal Shield Blocks Amputee's Suit

    A divided Georgia Court of Appeals on Friday said a trial court should have dismissed a wrongful amputation suit against a Marietta hospital, holding that the patient who lost his right leg after being admitted for COVID-19 symptoms could not beat the legal immunity granted to the hospital by a pandemic-era state law.

  • March 14, 2025

    Md. Judge Joins Calif. In Reversing Federal Workers' Firing

    A Maryland federal judge has ordered the reinstatement of thousands of probationary employees who were abruptly fired from 18 federal agencies, saying the Trump administration's lack of required notice left states "scrambling" to pick up the pieces.

  • March 14, 2025

    NC Ex-Doctor Gets 2.5 Years For Drug Test Billing Scheme

    A 72-year-old doctor in North Carolina was sentenced Friday to two and a half years in prison and ordered to hand over $2 million in restitution for a fraudulent billing scheme involving medically unnecessary drug tests, prosecutors said.

  • March 14, 2025

    FTC Urges 8th Circ. Not To Pause Insulin Pricing Case

    The Federal Trade Commission has urged the Eighth Circuit not to pause its in-house case accusing Caremark Rx, Express Scripts and OptumRx of artificially inflating insulin prices, telling the appeals court the pharmacy benefit managers have no chance of winning on their constitutional claims.

  • March 14, 2025

    Dr. Oz Pledges 'Upcoding' Crackdown If Confirmed At CMS

    Dr. Mehmet Oz told lawmakers he would combat rising healthcare costs by showing there's a "new sheriff in town" opposed to so-called upcoding by Medicare Advantage plans, as he sought support Friday for his nomination to lead the U.S. Centers for Medicare and Medicaid Services.

  • March 14, 2025

    Sutter Health Reaches $4.3M Deal To End Retirement Suit

    Nonprofit healthcare system Sutter Health will pay $4.3 million to settle a class action from workers alleging their employee retirement plan was saddled with excessive fees and poorly performing investments, according to filings in California federal court.

  • March 14, 2025

    Feds Say North Carolina Cardiologist Owes $7.9M In Taxes

    A North Carolina cardiologist owes the federal government $7.9 million in taxes, fees and interest, according to a new civil complaint brought against him by the tax division of the U.S. Department of Justice seeking to hold him liable for the purportedly unpaid sum.

  • March 13, 2025

    Colo. Says Its Abortion 'Reversal' Ban Doesn't Discriminate

    The Colorado Medical Board and Colorado Board of Nursing have urged a federal court to leave in place a state law banning the use of medication to "reverse" the abortion pill, arguing that it merely regulates "substandard ineffective medical practices" and doesn't discriminate against religious health providers.

  • March 13, 2025

    Ohio Health Insurer Wins $24M Verdict ln Racketeering Case

    An Ohio jury has awarded Medical Mutual of Ohio more than $24 million in damages, after the insurer accused its rivals FrontPath Health Coalition and HealthScope Benefits of undercutting the bidding process for healthcare contracts with the city of Toledo.

  • March 13, 2025

    NY AG James Pitches Bill To Expand Consumer Protection Law

    New York Attorney General Letitia James on Thursday announced legislation that would expand the state's ban on deceptive business practices to also protect against unfair and abusive practices, an idea backed by Biden-era Federal Trade Commission and Consumer Financial Protection Bureau heads.

  • March 13, 2025

    Calif. AG Appealing State Limits On Pay-For-Delay Ban

    California enforcers are appealing to the Ninth Circuit after a lower court found that a new state law restricting "reverse payment" settlements between brand-name and generic-drug makers cannot be used to regulate deals that were struck outside the state.

  • March 13, 2025

    PBMs Tell FTC 5-Month Delay Too Long For In-House Insulin Trial

    The nation's "Big Three" pharmacy benefit managers say they want to get to trial in the Federal Trade Commission's administrative suit against them sooner rather than later, arguing that the agency's request for a five-month delay would be too long, but they're open to a three-week postponement.

  • March 13, 2025

    HHS Calls Back Terminated Attys Clearing Medicare Appeals

    The U.S. Department of Health and Human Services on Thursday moved to reinstate about 15 attorneys who were cut loose in recent weeks, restoring staff many in the agency saw as critical to clearing a backlog of Medicare appeals.

  • March 13, 2025

    9th Circ. Ends Idaho Abortion Law Row After Mutual Dismissal

    A Ninth Circuit panel has dropped an appeal from Idaho claiming the state's strict abortion ban doesn't conflict with a federal law protecting emergency abortions, after the Trump administration announced its decision to drop the Biden-era legal challenge. 

Expert Analysis

  • What Trump's Order Means For The Legal Status Of IVF

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    An executive order signed by President Donald Trump last month signals the administration's potential intention to increase protections for in vitro fertilization services, though more concrete actions would be needed to resolve the current uncertainty around IVF access or bring about a binding legal change, says Jeanne Vance at Weintraub Tobin.

  • Mitigating Tariff Risks For Healthcare In US And Canada

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    Healthcare stakeholders should take steps to evaluate the impact of cross-border tariffs, as the historically strong ties between Canada and the U.S. demonstrate the potential for real disruption and harm to the healthcare industry in both countries, say attorneys at Norton Rose.

  • What's At Stake In High Court Transgender Care Suit

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    The outcome of U.S. v. Skrmetti will have critical implications for the rights of transgender youth and their access to gender-affirming care, and will likely affect other areas of law and policy involving transgender individuals, including education, employment, healthcare and civil rights, say attorneys at ArentFox Schiff.

  • 6 Laws Transforming Calif.'s Health Regulatory Framework

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    Attorneys at Hooper Lundy discuss a number of new California laws that raise pressing issues for independent physicians and small practice groups, ranging from the use of artificial intelligence to wage standards for healthcare employees.

  • Anticipating Calif. Oversight Of PE Participation In Healthcare

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    A new bill recently introduced in the California Senate revives last year's attempt to increase oversight of healthcare transactions involving private equity groups and hedge funds, meaning that attorneys may soon need to assess the compliance status of existing management relationships and consider modifying contract terms, says Andrew Demetriou at Husch Blackwell.

  • Considering The Future Of AI Regulation On Health Sector

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    As Texas looks to become the next state to pass a comprehensive law regulating artificial intelligence, the healthcare industry should consider how AI regulation will continue to evolve in the U.S. and how industry members can keep up with compliance considerations, say attorneys at Kirkland & Ellis.

  • What To Expect From 'Make America Healthy Again' Actions

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    The Make America Healthy Again Commission recently established by President Donald Trump and chaired by Robert F. Kennedy Jr. will potentially bring energy and attention to important public health topics, and stakeholders should be aware of pathways for sharing their input and proactively informing proceedings, says Nicholas Manetto at Faegre Drinker.

  • How Citizen Petitions Have Affected Drug Competition

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    In light of recent citizen petitions and proposed legislation regulating such petitions, Omar Robles at Managing Health analyzes the statistics of the extent to which citizen petitions have been filed, and to what extent they have delayed competition in prescription pharmaceuticals.

  • Drug Kickback Ruling Will Make FCA Liability Harder To Prove

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    The First Circuit's ruling in U.S. v. Regeneron Pharmaceuticals, requiring the government to prove but-for causation to establish False Claims Act liability based on violations of the Anti-Kickback Statute, raises the bar for FCA enforcement and deepens a circuit split that the U.S. Supreme Court may need to resolve, say attorneys at Baker Donelson.

  • Assessing PE Risk After Mass. False Claims Act Amendments

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    A law recently passed in Massachusetts amends the commonwealth's False Claims Act by dramatically expanding potential liability for private equity firms and investors, underscoring the importance of robust diligence and risk assessments for private equity firms conducting transactions in the commonwealth, say attorneys at Gibson Dunn.

  • What Trump Actions Mean For Federal Research Funding

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    New guidance from the National Institutes of Health represents a massive policy shift regarding federal funding for researchers at institutions of higher education, contributing to a perfect storm of significant resource shortfalls in upcoming years, say attorneys at Arnold & Porter.

  • A Look At Healthcare Transaction Oversight In Oregon

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    Understanding Oregon's enforcement authority and its impact on proposed transactions last year provides a road map to the state's plans to strengthen its processes this year, though enforcement could be challenged by ongoing litigation, say attorneys at Ropes & Gray.

  • Rethinking 'No Comment' For Clients Facing Public Crises

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    “No comment” is no longer a cost-free or even a viable public communications strategy for companies in crisis, and counsel must tailor their guidance based on a variety of competing factors to help clients emerge successfully, says Robert Bowers at Moore & Van Allen.