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Health
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March 04, 2025
Health Providers Fight To Keep MultiPlan Pricing MDL Alive
Healthcare providers targeting MultiPlan and several major insurers with horizontal price-fixing claims argued Monday an Illinois federal judge should let their multidistrict litigation proceed because the defendants simply constructed a "strawman" to convince him to toss it.
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March 04, 2025
Trump To Drop Biden-Era Suit Against Idaho Abortion Ban
The Trump administration has said it plans to drop a federal lawsuit alleging that Idaho's strict abortion ban conflicts with a federal emergency stabilization law, a reversal from the Biden administration's legal efforts that fought the ban up to the U.S. Supreme Court.
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March 04, 2025
Insurer Says Claims Of Illegally Tracked Info Erase Coverage
An insurer for a fertility treatment provider told an Illinois federal court that an exclusion on the disclosure of personal information precludes commercial general liability coverage for a lawsuit accusing the provider of unlawfully installing tracking technologies to collect website users' private information.
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March 04, 2025
Calif. PBM Opioid Suit Belongs In Federal Court, 9th Circ. Told
Pharmacy benefit managers Express Scripts Inc. and OptumRx Inc. urged the Ninth Circuit on Tuesday to require California to litigate its public nuisance claims over their opioid dispensing practices in federal court, arguing that allowing the state to litigate in state court would create a circuit split.
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March 04, 2025
Special Master Recommends Win For UnitedHealth In FCA Suit
A massive False Claims Act case targeting Medicare Advantage plans operated by UnitedHealth relies on "speculation and assumptions," according to a special master's report that recommends ruling in the company's favor and ending the lawsuit.
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March 04, 2025
Colo. Justices Won't Review Hospital Tax Classification Suit
The Colorado Supreme Court declined to review an appeals court ruling finding that a rehabilitation hospital should be classified as a commercial property for tax purposes because it was predominantly designed for its services and not for residency.
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March 04, 2025
PBMs Ask 8th Circ. To Pause FTC's Insulin Pricing Case
Caremark Rx, Express Scripts and OptumRx have asked the Eighth Circuit to pause the Federal Trade Commission's in-house case accusing the pharmacy benefit managers of artificially inflating insulin prices as they push their constitutional claims against the agency.
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March 04, 2025
Petersen Health Care Opposes Vendor's Ch. 11 Fee Demand
Bankrupt skilled nursing facility operator Petersen Health Care told a Delaware bankruptcy judge Tuesday that a vendor seeking payment of its legal costs in pursuing a $163,000 administrative expense claim against the debtor should have the request slashed because the fees exceed the amount of the claim.
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March 04, 2025
NC Judge Wants 1st Look At Info In Hospital Sale Suit
A North Carolina judge has ruled that she needs to be the first one to review potentially privileged information sought in Attorney General Jeff Jackson's suit alleging that a hospital sale agreement was breached, reasoning that it's too early to determine if they're public record or shielded attorney-client communications.
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March 04, 2025
Conn. Hospital Network Seeks Sanctions From Antitrust Class
Hartford HealthCare Corp. moved to sanction a proposed class of antitrust plaintiffs for asking a Connecticut judge to formally recognize a document exchange schedule privately agreed to by both sides, arguing that it should get attorney fees and costs for opposing the request.
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March 04, 2025
In Rare Move, Texas Judge Shuns Out-Of-State BigLaw Attys
Two out-of-state BakerHostetler attorneys' "frequent" work in the Lone Star State has sunk their bids to be admitted pro hac vice in a lawsuit accusing the U.S. Food and Drug Administration of catering to Big Pharma by nixing cheaper versions of the miracle weight loss drug Ozempic.
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March 04, 2025
Anthem, Cancer Patient End Lawsuit Over Treatment Denials
A proposed class action accusing Anthem Health Plans Inc. of wrongly denying coverage for proton beam radiation therapy — a form of cancer treatment used to target and destroy tumor cells — has been withdrawn by the patient who first brought the matter to Connecticut state court.
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March 04, 2025
HHS Cuts Hit Attys Tackling Medicare Appeals Backlog
The Department of Health and Human Services is terminating more than a dozen attorneys charged with reducing a massive backlog of Medicare appeals at an internal administrative board. The cuts may slow an already cumbersome administrative process.
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March 04, 2025
Lead Testing Operations Chief To Admit Misbranding Charge
The former chief operating officer of Magellan Diagnostics will admit to defrauding the public by hiding flaws in the company's lead testing devices for years, according to a filing in Massachusetts federal court.
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March 04, 2025
Ore. House OKs Extending Medical Provider Taxes
Oregon would extend the sunset on medical provider and insurance assessments, worth more than $5 billion over four years and used to help fund state healthcare programs, under legislation approved by the state House of Representatives.
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March 04, 2025
Former Fried Frank Antitrust Partner Joins Davis Polk
Davis Polk & Wardwell LLP announced it has hired a former Fried Frank Harris Shriver & Jacobson LLP antitrust attorney as a partner in its antitrust and competition practice in New York.
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March 03, 2025
USAID Leader Details Toll On 'Critical' Aid Under Trump
The U.S. Agency for International Development has been "wholly prevented" from delivering "critical" lifesaving services around the world, and that will lead to preventable death, destabilization and threats to national security "on a massive scale," according to memos from an agency leader made public Monday.
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March 03, 2025
Calif. Court OKs Slash Of $30M Med Mal Verdict To $250K
A California appeals court has agreed with the decimation of a $29.5 million wrongful death verdict against a chiropractor who cleared a teen with a heart condition for strenuous physical activity, saying the state's damages cap applies.
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March 03, 2025
Ultragenyx Loses Bid To Toss Suit Over Henrietta Lacks' Cells
A Maryland federal judge on Monday refused to toss a lawsuit lodged by the family of the late Henrietta Lacks against biotechnology company Ultragenyx for allegedly profiting off her stolen "immortal" cells, saying proof Ultragenyx engaged in intrastate business in Maryland would thwart its contention the lawsuit was filed too late.
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March 03, 2025
Credit Bureaus Look To Duck Renewed Medical Debt Claims
Equifax, Experian and TransUnion asked a California federal judge Monday to toss an updated case accusing the credit reporting agencies of violating antitrust law by agreeing to exclude medical debt under $500 from consumer credit reports.
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March 03, 2025
Sandoz Settles Florida's Generic Drug Price-Fixing Claims
Sandoz AG reached a settlement with Florida that ends federal antitrust claims the Sunshine State lodged against the drugmaker within wider litigation claiming numerous pharmaceutical companies and individuals participated in a conspiracy to fix generic drug prices, according to a Friday court filing.
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March 03, 2025
Teva Should Face Key Copaxone Antitrust Claims, Court Told
Mylan and pharmaceutical wholesalers should be allowed to proceed with some, but not all, parallel claims accusing Teva of using regulatory deception, false advertising, improper rebates and more to delay generic competition to its Copaxone multiple sclerosis treatment, a special master has recommended in New Jersey federal court.
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March 03, 2025
Insurer Doesn't Owe Spine Surgery Suit Defense, Judge Says
An insurer has no duty to defend or indemnify an orthopedic treatment center or one of its surgeons in a suit over a botched spine surgery, a Georgia federal court ruled Monday, saying the policy bars coverage for claims reported to another insurer before its effective date.
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March 03, 2025
Adult Day Care Owner Must Pay $1.5M For Medicare Fraud
The former owner of a Michigan adult day care facility was sentenced Monday to spend one year in prison and pay about $1.5 million in restitution for submitting $3.4 million in fraudulent bills to Medicare for psychotherapy services that were either unnecessary or not provided by qualified professionals.
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March 03, 2025
Trump Admin Defends Right To Send DOGE Into Agencies
A group of unions is trying to limit the president's right to oversee the executive branch by claiming that Elon Musk's Department of Government Efficiency can't access agencies' computer systems, the Trump administration told a D.C. federal judge, asking him to nix the unions' injunction bid.
Expert Analysis
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Why Now Is The Time For Law Firms To Hire Lateral Partners
Partner and associate mobility data from the second quarter of this year suggest that there's never been a better time in recent years for law firms to hire lateral candidates, particularly experienced partners — though this necessitates an understanding of potential red flags, say Julie Henson and Greg Hamman at Decipher Investigative Intelligence.
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Considering Possible PR Risks Of Certain Legal Tactics
Disney and American Airlines recently abandoned certain litigation tactics in two lawsuits after fierce public backlash, illustrating why corporate counsel should consider the reputational implications of any legal strategy and partner with their communications teams to preempt public relations concerns, says Chris Gidez at G7 Reputation Advisory.
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It's No Longer Enough For Firms To Be Trusted Advisers
Amid fierce competition for business, the transactional “trusted adviser” paradigm from which most firms operate is no longer sufficient — they should instead aim to become trusted partners with their most valuable clients, says Stuart Maister at Strategic Narrative.
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Vertex Suit Highlights Issues For Pharma Fertility Support
Vertex Pharmaceuticals' recent lawsuit challenging the U.S. Department of Health and Human Services' interpretation of the Anti-Kickback Statute is influenced by a number of reproductive rights and health equity issues that the Office of Inspector General should address more concretely, including in vitro fertilization and fertility preservation programs, says Mary Kohler at Kohler Health Law.
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Opinion
CMS' New 'Breakthrough' Device Policy Shows Little Promise
The Centers for Medicare & Medicaid Services’ recent procedural notice outlining a new Medicare coverage pathway for breakthrough medical devices will, at best, be a failed experiment and, at worst, result in Medicare beneficiaries denied access to innovative treatments, say attorneys at King & Spalding.
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Assessing Algorithmic Versus Generative AI Pricing Tools
A comparison of traditional algorithmic pricing models and those powered by generative artificial intelligence can help regulators and practitioners weigh the pros and cons of relying on large language models to price products or services, say Maxime Cohen at McGill University, and Tim Spittle and Jimmy Royer at Analysis Group.
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SBA Proposal Materially Alters Contractor Recertification
The Small Business Administration's new proposed rule on recertification affects eligibility for set-aside contracts, significantly alters the landscape for mergers and acquisitions in the government contracts industry, and could have other unintended downstream consequences, says Sam Finnerty at PilieroMazza.
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A Preview Of AI Priorities Under The Next President
For the first time in a presidential election, both of the leading candidates and their parties have been vocal about artificial intelligence policy, offering clues on the future of regulation as AI continues to advance and congressional action continues to stall, say attorneys at Mintz.
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How Companies Are Approaching Insider Trading Policies
An analysis of insider trading policies recently disclosed by 49 S&P 500 companies under a new U.S. Securities and Exchange Commission rule reveals that while specific provisions vary from company to company, certain common themes are emerging, say attorneys at Gibson Dunn.
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11 Patent Cases To Watch At Fed. Circ. And High Court
As we head into fall, there are 11 patent cases to monitor, touching on a range of issues that could affect patent strategy, such as biotech innovation, administrative rulemaking and patent eligibility, say Edward Lanquist and Wesley Barbee at Baker Donelson.
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Managing Community Health Needs Assessments: A Checklist
Excerpt from Practical Guidance
To guide nonprofit hospitals and health systems through their required community health needs assessment every three years, this checklist outlines the steps for 12 phases of the process.
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How Methods Are Evolving In Textualist Interpretations
Textualists at the U.S. Supreme Court are increasingly considering new methods such as corpus linguistics and surveys to evaluate what a statute's text communicates to an ordinary reader, while lower courts even mull large language models like ChatGPT as supplements, says Kevin Tobia at Georgetown Law.
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7th Circ. Rulings Offer Employee Vaccine Exemption Guidance
Dawn Solowey and Samantha Brooks at Seyfarth explain how two recent Seventh Circuit rulings in Passarella v. Aspirus and Bube v. Aspirus could affect litigation involving employee vaccine exemptions, and discuss employer best practices for handling accommodation requests that include both religious and secular concerns.
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Pa. Health Employers Must Prep For Noncompete Restrictions
Newly enacted legislation in Pennsylvania prohibits certain noncompete covenants for healthcare practitioners in the state beginning next year, creating compliance challenges that both employers and employees should be aware of, say attorneys at Buchanan Ingersoll.
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Opinion
Congress Must Do More To Bolster ERISA Protections
As the Employee Retirement Income Security Act turns 50 this month, we applaud Congress for championing a statute that protects worker and retiree rights, but further action is needed to ban arbitration clauses in plan provisions and codify regulations imperiled by the U.S. Supreme Court’s Chevron ruling, say Michelle Yau and Eleanor Frisch at Cohen Milstein.