Policy & Compliance
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February 07, 2025
Wash. AG Sues To Block 'Hateful' Trump Transgender Edict
Washington, Minnesota and Oregon, along with three unnamed doctors, seek to block President Donald Trump's order targeting transgender youth and their medical providers, arguing in a complaint filed Friday in Seattle federal court that the Trump edict is unconstitutional, discriminates against transgender people and interferes with lifesaving healthcare.
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February 06, 2025
Doctors Org. Wants Health Agency Website Info Restored
An advocacy organization representing physicians asked a Washington, D.C., federal judge Thursday to require federal agencies to restore public-health related web pages and data that were taken down after the Office of Personnel Management directed the agencies to root out references to "gender ideology" on their websites.
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February 06, 2025
6th Circ. Uncertain If Health Plan Administrator Is A Fiduciary
A yacht-maker urged the Sixth Circuit on Thursday to revive its lawsuit accusing Blue Cross Blue Shield of Michigan of overpaying employee health plan claims so it could profit off of savings recovered later, but faced tough questions about whether plan administrator BCBSM was a fiduciary under federal benefits law.
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February 06, 2025
ERISA Preempts Banker's $5.5M Deferred Comp, Judge Rules
The Employee Retirement Income Security Act preempts a former Leerink Partners employee's claims that she was cheated out of about $5.5 million in deferred compensation after the bank hired her under allegedly false pretenses from Goldman Sachs, a Massachusetts federal judge ruled Thursday.
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February 06, 2025
UnitedHealth Drops Bid To Toss Home Health Deal Challenge
UnitedHealth Group and home health and hospice giant Amedisys Inc. dropped their bid to toss a case challenging their $3.3 billion merger after enforcers detailed the home health and hospice markets they allege will be hurt by the deal.
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February 05, 2025
Trump Signs Order Restricting Transgender Women In Sports
President Donald Trump signed an executive order banning transgender women from competing in women's sports during a Wednesday afternoon press conference at the White House, continuing his trend of targeting transgender rights.
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February 05, 2025
Trade Groups Urge PBM Crackdown By Trump, Congress
A coalition of industry trade groups sent letters Wednesday urging President Donald Trump and leaders in Congress to advance legislation reining in pharmacy benefit managers — which intermediate between drugmakers, insurers and pharmacies — in the next piece of federal government funding legislation.
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February 05, 2025
Penn Hospital Says $200M Judgment Imperils Local Care
The Hospital of the University of Pennsylvania implored the Pennsylvania Superior Court on Wednesday to upend a purportedly historic $200 million medical malpractice judgment, arguing that the jury's award in the birth injury case was greater than the economic output of some nations and could seriously impact the hospital's operations.
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February 05, 2025
6th Circ. Urged To Revive Allergy Co.'s Antitrust Claims
An allergy company tried Wednesday to persuade a noncommittal Sixth Circuit panel to revive an antitrust suit it brought against health insurance companies it says worked together to push it out of the market.
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February 05, 2025
Sheppard Mullin Adds Healthcare Reg Partner From Troutman
Sheppard Mullin Richter & Hampton LLP on Wednesday announced the arrival of a healthcare partner joining from Troutman Pepper Locke LLP, continuing a streak of recent additions to its healthcare practice.
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February 04, 2025
9th Circ. Revives FCA Suit Over Military Meds Deliveries
The Ninth Circuit on Tuesday revived a whistleblower lawsuit accusing Express Scripts Inc. of defrauding the U.S. Department of Defense out of billions of dollars in unnecessary medications for military personnel, saying the lawsuit wasn't barred by any public disclosures of the alleged fraud.
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February 04, 2025
Meet The Attys Taking On Merck In The Gardasil Trial
An attorney at a personal injury firm with ties to Robert F. Kennedy Jr., President Donald Trump's pick for the nation's top healthcare position, is on the plaintiff team leading the first jury trial against Merck & Co. over claims the company wrongfully marketed its HPV vaccine Gardasil.
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February 04, 2025
Calif. AG Gets $25M To Fund Legal Fights Against Trump
The California Legislature greenlighted a $25 million cash infusion Monday for the state attorney general's office in a strategic effort to bolster the state's legal defenses against President Donald Trump's policy agenda, including anticipated challenges to immigration and environmental regulations.
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February 04, 2025
Trump Trans Care Order Usurps Congress' Power, Suit Says
The Trump administration overstepped when it issued an executive order cutting off gender-affirming care for people under 19, a group of transgender adolescents, young adults and their families told a Maryland federal court Tuesday, arguing the president is trying to usurp Congressional authority by forcing federally funded hospitals to discriminate.
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February 04, 2025
NY Exoneree Lands Rare 'Indifference' Win In Prison Doc Case
Antonio Mallet spent nearly 20 years in a New York prison after he was convicted of a fatal shooting. After his release, he learned he had deadly prostate cancer that he claims was exacerbated by the "deliberate indifference" of prison doctors. A Second Circuit panel recently awarded him a rare appellate court victory.
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February 04, 2025
Docs, Lawmakers Cut Away At Prior Authorization Red Tape
As physicians sounded the alarms, states have passed a patchwork of laws reining in prior authorization requirements. Health insurers say they're a necessary safeguard against unnecessary treatments and higher premiums. Healthcare professionals and legal experts argue more reforms are needed.
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February 04, 2025
4th Circ. Revives FCA Suit Alleging Faked Therapy Notes
The Fourth Circuit on Monday sided with a whistleblower who accused her former employer of creating fake notes about addiction therapy sessions that never happened, finding that she had sufficiently detailed the allegations and connected the dots to defeat a motion to dismiss.
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February 04, 2025
Doctors Org. Sues Over Health Agency Website Purges
An advocacy organization representing physicians sued the U.S. Office of Personnel Management in D.C. federal court Tuesday after it directed federal agencies to root out references to "gender ideology" on their websites — a move the physicians claim deprives doctors and researchers of needed information.
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February 04, 2025
Trump Trans Care Order Raises New Legal Risks For Providers
President Donald Trump's executive order restricting gender-affirming care for minors is likely to ignite lasting legal conflicts over the limits of presidential power and whether the policy is discriminatory. In the meantime, hospitals are wrestling with what care they can offer families right now and what comes next for those already undergoing treatment.
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February 04, 2025
Party-Line Vote Sends Kennedy's HHS Nomination To Senate
Robert F. Kennedy Jr.'s nomination to be the nation's top healthcare official cleared a key confirmation hurdle on Tuesday, setting the stage for the anti-vaccine lawyer and activist to take the helm of the U.S. Department of Health and Human Services.
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February 03, 2025
Crowell & Moring Lands Former DOJ Assistant Chief For FCPA
A former assistant chief in the U.S. Department of Justice's Foreign Corrupt Practices Act unit has joined Crowell & Moring LLP as a partner in the firm's white collar and regulatory enforcement group, according to an announcement made Tuesday.
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February 03, 2025
5th Circ. Won't Revisit HHS Win On Scope Of ACA
The Fifth Circuit has declined to conduct an en banc rehearing after an appellate panel upheld a U.S. Department of Health and Human Services rule that said the Affordable Care Act forbids against transgender bias in healthcare, but one judge argued the court got its analysis wrong.
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February 03, 2025
Allergan Tells 4th Circ. Medicaid Pricing Suit Rightly Tossed
Allergan told the Fourth Circuit that a district court judge was right to dismiss a whistleblower's claims that its predecessor overcharged Medicaid by not aggregating discounts, saying the Medicaid Rebate Statute doesn't require it to do so.
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February 03, 2025
DC Judge Joins RI In Blocking Trump Funding Freeze
A D.C. federal judge on Monday temporarily blocked the Trump administration from implementing a freeze on federal spending while a group of nonprofits sue over the move, ruling the pause appears to "suffer from infirmities of a constitutional magnitude."
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January 31, 2025
New York Scores Win In Reproductive Rights Labor Law Suit
A New York federal judge Friday tossed an anti-abortion group's lawsuit challenging a New York state law that bars employers from penalizing workers for making certain reproductive health decisions, saying on the five-year anniversary of the case that the group lacked standing to assert its last remaining claim.
Expert Analysis
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FDA Warning Letter Tightens Reins On 'Research Only' Labels
A recent warning letter from the U.S. Food and Drug Administration to Agena Bioscience alleged the company’s diagnostic devices were labeled for research use only, but improperly promoted for human clinical purposes, signifying a reinforcement — and a potential narrowing — of the agency's policy on products labeled “research only,” say attorneys at Sheppard Mullin.
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First 10b5-1 Insider Trading Case Raises Compliance Issues
The ongoing case against former Ontrak CEO Terren Peizer is the U.S. Department of Justice's first insider trading prosecution based primarily on the filing of 10b5-1 plans, and has important takeaways for attorneys reviewing corporate policies on the possession of material nonpublic information, say attorneys at Cadwalader.
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Policy Misrepresentations Carry Insurance Rescission Risks
The Second Circuit's recent decision in Medical Mutual v. Gnik, finding that material misrepresentation in a clinic's insurance applications warranted policy rescission, is a clear example of the far-reaching effects that misrepresentations can have and provides a reminder that policyholders should employ relatively straightforward steps to decrease risks, say attorneys at Hunton.
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The Pros And Cons Of NIST's Proposed March-In Framework
Recent comments for and against the National Institute of Standards and Technology’s proposed guidance on march-in rights — which permit the government to seize federally funded patents — highlight how the framework may promote competition, but could also pose a risk to contractors and universities, say Nick Lee and Paul Ragusa at Baker Botts.
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2 Recent Suits Show Resiliency Of Medicare Drug Price Law
Though pharmaceutical companies continue to file lawsuits challenging the Inflation Reduction Act, which enables the federal government to negotiate for lower prescription drug prices, recent decisions suggest that the reduced drug prices are likely here to stay, says Jose Vela Jr. at Clark Hill.
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Defense Attys Must Prep For Imminent AI Crime Enforcement
Given recent statements by U.S. Department of Justice officials, white collar practitioners should expect to encounter artificial intelligence in federal criminal enforcement in the near term, even in pending cases, say Jarrod Schaeffer and Scott Glicksman at Abell Eskew.
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Lessons For Nursing Facilities From DOJ Fraud Settlement
The U.S. Department of Justice's recent settlement with the owner of skilled nursing and assisted living facilities in Florida provides a cautionary tale of potential fraud risks, and lessons on how facilities can mitigate government enforcement actions, say Callan Stein and Rebecca Younker at Troutman Pepper.
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HHS' Updated Tracking Tech Guidance Offers Little Clarity
The U.S. Department of Health and Human Services' Office for Civil Rights' updated guidance on the use of online tracking technologies appears more focused on legal issues raised in ongoing litigation with the American Hospital Association and less on practical guidance for covered entities, say attorneys at Sheppard Mullin.
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Takeaways From The 2023 DOJ Fraud Section Report
Attorneys at Wiley discuss notable trends from the U.S. Department of Justice's recently reported Fraud Section activity last year and highlight areas of enforcement to watch for in the future, including healthcare fraud and Foreign Corrupt Practices Act violations.
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NIST March-In Framework Is As Problematic As 2021 Proposal
While the National Institute of Standards and Technology's proposed march-in framework on when the government can seize patents has been regarded as a radical departure that will support lowering prescription drug costs, the language at the heart of it is identical to a failed 2021 notice of proposed rulemaking, says attorney Kelly Morron.
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Spartan Arbitration Tactics Against Well-Funded Opponents
Like the ancient Spartans who held off a numerically superior Persian army at the Battle of Thermopylae, trial attorneys and clients faced with arbitration against an opponent with a bigger war chest can take a strategic approach to create a pass to victory, say Kostas Katsiris and Benjamin Argyle at Venable.
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The Road Ahead For Florida's Drug Importation Program
Though the U.S. Food and Drug Administration approved Florida's drug importation program in January, a series of hurdles — including requisite buy-in from Canada — and potential legal challenges must be addressed before importation can begin, say attorneys at Ropes & Gray.
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Assessing CDC's Revised Guideline On Opioid Prescriptions
Kenneth Weinstein, Nicholas Van Niel and Kate Uthe at Analysis Group look at newly available data to evaluate the impact that the Centers for Disease Control and Prevention's revised opioid monitoring guideline have had on prescription trends in recent years, highlighting both specific and overall decreases.