Policy & Compliance

  • 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. 

  • March 13, 2025

    Days Into New Role, FDA's Top Lawyer Is Out

    The top lawyer of the U.S. Food and Drug Administration resigned just two days after she was selected for the role, according to a Thursday announcement by the agency on social media site X.

  • March 13, 2025

    Lacking Votes, White House Pulls Weldon Nomination At CDC

    The White House pulled Dr. Dave Weldon's nomination to lead the Centers for Disease Control and Prevention on Thursday after support among GOP lawmakers wavered, and it became clear he didn't have the votes to clear a Senate committee.

  • March 12, 2025

    GOP Senators Take Aim At CFPB Medical Debt Rule

    Republican senators have introduced a measure to overturn the Consumer Financial Protection Bureau's recent rule banning medical debt from credit reports, one of the latest Biden-era regulations to be targeted for legislative repeal.

Expert Analysis

  • Agencies Should Reward Corporate Cyber Victim Cooperation

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    The increased regulatory scrutiny on corporate victims of cyberattacks — exemplified by the U.S. Securities and Exchange Commission's case against SolarWinds — should be replaced with a new model that provides adequate incentives for companies to come forward proactively and collaborate with law enforcement, say attorneys at McDermott.

  • Strategies To Defend Against Healthcare Nuclear Verdicts

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    The healthcare industry is increasingly the target of megaclaims, particularly those alleging medical malpractice, but attorneys representing providers can use a few tools to push back on flimsy litigation and reduce the likelihood of a nuclear verdict, says LaMar Jost at Wheeler Trigg.

  • What Drug Cos. Must Know About NY Price Transparency Law

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    Drug manufacturers must understand the contours of New York's recently implemented law requiring self-reporting of drug price increases, as well as best practices for compliance and challenges against similar laws in other states, say Elizabeth Bierut and Angie Garcia at Friedman Kaplan.

  • Whistleblowers Must Note 5 Key Differences Of DOJ Program

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    The U.S. Department of Justice’s recently unveiled whistleblower awards program diverges in key ways from similar programs at other agencies, and individuals must weigh these differences and look first to programs with stronger, proven protections before blowing the whistle, say Stephen Kohn and Geoff Schweller at Kohn Kohn.

  • The Licensure Landscape For Psychedelics Manufacturers

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    As the need for bulk manufacturing of psychedelic substances grows, organizations aiming to support clinical trials or become commercial suppliers must navigate a rigorous and multifaceted journey to obtaining a license from the U.S. Drug Enforcement Administration, say Kimberly Chew at Husch Blackwell and Jaime Dwight at Promega Corp.

  • OSHA Workplace Violence Citation Highlights Mitigation Steps

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    The Occupational Safety and Health Administration's recent citation against behavioral health company Circles of Care sheds light on the enforcement risks companies may face for failing to prevent workplace violence, and is a reminder of the concrete steps that can help improve workplace safety, say attorneys at Benesch.

  • When Banks Unknowingly Become HIPAA Biz Associates

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    There appears to be significant confusion regarding the application of the Health Insurance Portability and Accountability Act to financial institutions when serving healthcare-related clients, so these institutions should consider undertaking several steps as a starting point in the effort to achieve compliance, say attorneys at Vorys.

  • The Regulatory Headwinds Facing Lab-Developed Tests

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    Though the U.S. Food and Drug Administration's final rule regarding regulation of laboratory-developed tests outlines a four-year plan for ending enforcement discretion, and though this rule is currently being challenged in courts, manufacturers should heed compliance opportunities immediately as enforcement actions are already on the horizon, say attorneys at Kirkland & Ellis.

  • 3 High Court Rulings May Shape Health Org. Litigation Tactics

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    Three separate decisions from the U.S. Supreme Court's most recent term — Loper Bright, Corner Post and Jarkesy — will likely strengthen healthcare organizations' ability to affirmatively sue executive agencies to challenge regulations governing operations and enforcement actions, say attorneys at McDermott.

  • A New Way Forward For COVID Vaccine Lawsuit Immunity

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    As Public Readiness and Emergency Preparedness Act protections for COVID-19 vaccines wane, adding those vaccines to coverage by the National Vaccine Injury Compensation Program would bolster defenses for administrators and manufacturers while also providing stronger remedies for those injured by vaccines, says Altom Maglio at MCT Law.

  • Why DOJ's Whistleblower Program May Have Limited Impact

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    The U.S. Department of Justice’s new whistleblower pilot program aims to incentivize individuals to report corporate misconduct, but the program's effectiveness may be undercut by its differences from other federal agencies’ whistleblower programs and its interplay with other DOJ policies, say attorneys at Milbank.

  • How Cos. With Chinese Suppliers Should Prep For Biotech Bill

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    A proposed bill to prohibit government-affiliated life sciences companies from contracting with Chinese biotech companies of concern may necessitate switching to other sources for research and supplies, meaning they should begin evaluating supply chains now due to the long lead times of drug development, say John O'Loughlin and Christina Carone at Weil Gotshal.

  • FTC's Drug Middlemen Probe Highlights Ongoing Scrutiny

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    The Federal Trade Commission's interim staff report on its inquiry into pharmacy benefit managers suggests that the industry will remain under an enforcement microscope for the foreseeable future due to concerns about how PBMs affect drug costs and accessibility, say attorneys at Arnold & Porter.