Policy & Compliance
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April 02, 2025
BakerHostetler Adds Ex-Federal Prosecutor As Partner
A former assistant U.S. attorney for the Northern District of Illinois has joined BakerHostetler in its Chicago office as a partner in the firm's litigation practice group, where he will focus on white collar matters, internal investigations and civil litigation.
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April 01, 2025
Unregulated Health Cost 'Ministries' Attract State Scrutiny
Offering a cheap alternative to traditional health insurance and a faith-based approach, health cost "sharing ministries" operate across the country with little oversight. But consumer complaints have prompted regulators in California and a number of other states to take action.
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April 01, 2025
Ala. Ruling Won't End Interstate Fights Over Abortion Travel
A federal court order blocking Alabama from prosecuting doctors for helping women seek out-of-state abortions won't end legal conflicts between states with abortion bans and those without.
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April 01, 2025
Takeda Antitrust Trial Over Actos Generics Set For July
A New York federal court refused a bid from Takeda Pharmaceuticals Co. to escape a long-running case accusing it of unlawfully delaying generic versions of its diabetes treatment Actos and scheduled a trial to start in July.
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April 01, 2025
Fla. Defends Sandoz Price-Fixing Settlement Terms
Florida defended its deal with Sandoz Inc. on Monday, saying the other states suing the generic-drug maker over price-fixing have no right to object to the settlement, which does not require court approval and does not affect the states objecting to it.
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April 01, 2025
Tenn. PBM Statute Conflicts With ERISA, Judge Says
Tennessee law requiring pharmacy benefits managers to accept "any willing pharmacies" into their network clashes with the Employee Retirement Income Security Act, a federal judge ruled, saying the state can't enforce its statute against McKee Foods Corp. or other plans governed by the federal benefits law.
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April 01, 2025
Ex-Biotech CEO Wrongly Sentenced To 7 Years, DC Circ. Told
A former biotech executive who pled guilty to misleading investors about a blood-based COVID-19 test urged the D.C. Circuit to order a redo of his seven-year prison sentence on Tuesday, telling an appeals panel that the trial court miscalculated the sentencing guidelines.
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April 01, 2025
Top Court Abortion Case Sets High Stakes For Medicaid
The U.S. Supreme Court is set to hear arguments Wednesday in a case over South Carolina's attempt to exclude a Planned Parenthood chapter from Medicaid, weighing whether patients can take state officials to court over the Medicaid Act's "free choice of provider" provision. Experts say the outcome could have a broad impact on state authority to say which providers can or cannot treat low-income patients, and how.
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April 01, 2025
Medicaid Changes May Intensify State AG FCA Enforcement
After decades of increasing False Claims Act enforcement in the healthcare industry, relators and defense counsel alike are now bracing for even more activity by state attorneys general as a federal push to cut spending could leave state taxpayers bearing more Medicaid costs.
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April 01, 2025
23 States Sue HHS To Stop $11B In Health Grant Funding Cuts
Twenty-three states and the District of Columbia on Tuesday accused the Trump administration of illegally terminating about $11 billion in public health funding, causing layoffs and "chaos" in public health agencies across the country.
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March 31, 2025
Doc Loses Redo On Claims Hospital Lies Fueled Murder Case
A Michigan federal judge has dismissed a former Ohio physician's second attempt at suing the parent company of his ex-employer on allegations it fed prosecutors lies about his opioid prescribing practices that led to him being charged with 25 counts of murder, saying the lawsuit didn't fix the gaps left in the first case.
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March 31, 2025
Despite 'Admirable' Effort, Vertex Kickback Challenge Fails
A D.C. federal judge dealt a loss on Monday to gene therapy drugmaker Vertex Pharmaceuticals, ruling in favor of a U.S. Department of Health and Human Services advisory opinion that found the company's fertility preservation program could potentially violate the Anti-Kickback Statute.
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March 31, 2025
DocGo Can't Nix Investor Suit Over 'Indisputably False' Claims
A New York federal judge has trimmed a proposed class action alleging that mobile medical provider DocGo and its top brass misled stockholders before its $432 million migrant-services contract with New York City faced public scrutiny, but the judge found that claims stemming from the former CEO's "indisputably false" statements can proceed.
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March 31, 2025
Cuomo Defeats Suit Over NY Nursing Home COVID-19 Deaths
A New York federal judge threw out on Monday a proposed class action blaming former Gov. Andrew Cuomo and other Empire State officials for COVID-19 deaths in nursing homes, saying the claims are legally deficient and "the court's sympathy for plaintiffs and their loved ones simply cannot supplant governing law."
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March 29, 2025
Up Next At High Court: Terror Liability, Health Provider Choice
The U.S. Supreme Court will return to the bench this week to consider whether a federal law subjecting Palestinian government organizations to federal jurisdiction violates due process principles and if the Medicaid Act's provider choice provision allows individual benefit recipients to sue states over the disqualification of healthcare providers.
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March 28, 2025
Colo. Beats Amgen's Drug Price Cap Challenge, For Now
A Colorado federal judge Friday threw out Amgen's challenge to the Centennial State's drug price cap system, finding that Amgen is not subject to "direct regulation" under the law it's challenging and therefore doesn't have standing to sue.
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March 28, 2025
Janssen Owes Additional $1.5B In HIV Prescription Trial
A New Jersey federal judge on Friday added nearly $1.3 billion in penalties and $240 million in damages to a whistleblower False Claims Act verdict against Janssen over the off-label marketing of two HIV medicines, saying trial evidence laid out "a deliberate and calculated scheme."
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March 28, 2025
Plan Administrator Wins Electric Co.'s Union Healthcare Fight
An electric company can't use the Employee Retirement Income Security Act to claw back contributions to a union healthcare plan that weren't put toward benefits, a New York federal judge said Friday, tossing the company's suit against the plan's administrator.
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March 28, 2025
PE Firm Hits Back Against Medical Device Coating Challenge
Private equity firm GTCR BC Holdings LLC told a Federal Trade Commission in-house judge Friday the commission has a warped view of the medical device coatings market, as the firm fights a bid to block its $627 million acquisition of Surmodics Inc.
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March 28, 2025
Ex-Chicago Firefighter's Vaccine Bias Suit Fails, For Now
The city of Chicago dodged a former firefighter's lawsuit claiming he was fired for not complying with the city's COVID-19 vaccination policy after being given a religious exemption, with an Illinois federal judge ruling Friday he failed to show he was also exempt from the policy's testing requirement.
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March 28, 2025
Feds Settle NC Insurer's Medicare Reimbursement Suit
The U.S. Department of Health and Human Services has settled a North Carolina state-created insurance association's suit arguing it did not need to pay back the federal Medicare program for claims that should otherwise be covered by private insurance, and the parties jointly dismissed the matter Thursday.
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March 28, 2025
NC Biz Court Bulletin: TikTok Duel Heats Up, NIL Suit Plays On
In March, the North Carolina Business Court readied for trial in an insurance coverage dispute involving Smithfield Foods, heard why TikTok is subject to the state's jurisdiction, and allowed the Cardiac Pack's NIL suit against the NCAA to proceed while a parallel case plays out.
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March 27, 2025
Diopsys Inks $14M Deal Resolving Vision Testing FCA Claims
Medical device maker Diopsys Inc. has agreed to pay up to $14.25 million to put to rest allegations it violated the False Claims Act by submitting false Medicare and Medicaid claims for certain vision testing services, according to a U.S. Department of Justice announcement Thursday.
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March 27, 2025
DC Judge Seems Open To Fired Inspectors' Reinstatement Bid
A D.C. federal judge on Thursday questioned whether it would make practical sense to reinstate eight inspectors general fired by President Donald Trump while signaling openness to the federal watchdogs' argument that the president must follow the legally mandated process before they can be terminated.
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March 27, 2025
Fertility Co. Wants To Pull Device Maker Into Negligence Suit
A fertility products company wants two other companies to share potential liability from a Connecticut state lawsuit alleging that a recalled culture medium was responsible for the loss of embryos a couple were planning to use for in vitro fertilization.

Enforcement Delays Ahead Amid HHS Regional Closures
The Trump administration's overhaul of the U.S. Department of Health and Human Services' in-house legal team is likely to slow enforcement proceedings and other compliance activities involving Medicare providers.

Unnecessary Surgeries Drive Rare Va. Hospital Criminal Case
An unusual indictment in Virginia details grave allegations against a former doctor, including unnecessary surgeries and bogus cancer diagnoses. With former OB-GYN Javaid Perwaiz already in federal prison, the hospital where many of the procedures occurred is now facing criminal charges.

Ky. Abortion Ban Carveouts Stir Concerns Over Clarity
Kentucky lawmakers passed a bill spelling out medical exceptions to the state's strict post-Dobbs abortion ban. The bill, drafted by anti-abortion lawmakers, is stoking concerns that it could lead to more restrictions in emergency situations.
Expert Analysis
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Unpacking Trump Admin Plans For Value-Based Care
Recent developments from the Center for Medicare and Medicaid Innovation suggest the Trump administration intends to put its own stamp on value-based care, emphasizing cost savings assessment in particular, with its recent cancellation of several payment models that had supported primary care, says Miranda Franco at Holland & Knight.
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What To Expect For Stem Cell Regulation Under Trump Admin
The new administration's push for deregulation, plus the post-Chevron legal landscape, and momentum from key political and industry players to facilitate stem cell innovation may create an opportune backdrop for a significant reduction in the U.S. Food and Drug Administration's regulatory framework for stem cells, say attorneys at Sheppard Mullin.
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How Importers Can Minimize FCA Risks Of Tariff Mitigation
False Claims Act risks are inherent in many tariff mitigation strategies, making it important for importers to implement best practices to identify and report potential violations of import regulations before they escalate, says Samuel Finkelstein at LMD Trade Law.
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10 Practical Takeaways From FDA's Biopharma AI Guidance
Recent guidance from the U.S. Food and Drug Administration provides much-needed insight on the usage of artificial intelligence in producing information to support regulatory decision-making regarding drug safety, with implications ranging from life cycle maintenance to AI tool acquisition, say attorneys at Covington.
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Lawmakers Shouldn't Overlook Rare Disease Therapies' Value
As the ORPHAN Cures Act is pending in Congress, policymakers assessing the value of certain drugs for price regulation should consider data beyond what is collected in clinical trials, say Alice Chen at the University of Southern California, and Molly Frean and Yao Lu at Analysis Group.
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What Trump's Order Means For The Legal Status Of IVF
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.
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Mitigating Tariff Risks For Healthcare In US And Canada
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.
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What's At Stake In High Court Transgender Care Suit
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.
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6 Laws Transforming Calif.'s Health Regulatory Framework
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.
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Anticipating Calif. Oversight Of PE Participation In Healthcare
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.
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Considering The Future Of AI Regulation On Health Sector
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.
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What To Expect From 'Make America Healthy Again' Actions
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.
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How Citizen Petitions Have Affected Drug Competition
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.