Policy & Compliance
-
June 11, 2024
WilmerHale Lands Latham Atty To Help Lead Life Sciences
WilmerHale has added a partner in Palo Alto, California, who is an expert in complex strategic collaboration and licensing transactions, to co-chair its life sciences practice group, the firm said Tuesday.
-
June 11, 2024
Rao Tracks His Journey From Stay-At-Home Dad To FTC
Rahul Rao said that every role he's taken on — from BigLaw attorney to stay-at-home dad to overseeing healthcare mergers at the Federal Trade Commission — has helped shape him into the lawyer he is today.
-
June 11, 2024
FDA Urges 11th Circ. To Back E-Cig Ban Over High Nicotine
The U.S. Food and Drug Administration is urging the Eleventh Circuit to not let Bidi Vapor market an e-cigarette product that the agency claimed would expose users to nearly twice as much nicotine as a typical combustible cigarette.
-
June 11, 2024
Next Wave Of Opioid Suits Targets Drug Biz 'Middlemen'
Communities ravaged by opioid addiction have secured billions of dollars in settlements with companies that make, market and dispense the drugs. A new target is now emerging in the next wave of litigation — pharmacy benefit managers.
-
June 11, 2024
Beveridge & Diamond Hires DOJ Jan. 6 Litigator In DC
Beveridge & Diamond PC's new white collar principal, Louis Manzo, has worked on some of the highest-profile cases in the nation for the Justice Department, helping secure convictions for several January 6 insurrectionists charged with seditious conspiracy.
-
June 10, 2024
Rehab Clinics Add To MultiPlan Insurance Fixing Pile-On
Addiction treatment providers sued MultiPlan, Aetna, Cigna, UnitedHealth and Elevance Friday and Saturday in 14 separate New York federal court complaints that appear to be the first to add substance abuse disorder-specific allegations to the cases pegging MultiPlan at the center of a scheme to suppress insurer payouts.
-
June 10, 2024
IHS Urges Budget Shift After High Court Healthcare Ruling
The Indian Health Service, following a divided U.S. Supreme Court decision affirming that the federal government is liable for the reimbursement of millions in administrative healthcare costs for two Native American tribes, is urging Congress to shift its budget appropriations for fiscal year 2026 to protect the agency's overall health.
-
June 10, 2024
SoCal Workers Want Class Cert. In Union Healthcare Fee Suit
A group of union-represented Southern California hospitality workers who say they're getting charged much higher health insurance rates than their counterparts in Las Vegas are seeking class certification in their lawsuit challenging the rates, according to a filing in Illinois federal court.
-
June 10, 2024
Baltimore Lands $45M Deal With Allergan In Opioid Litigation
Baltimore has put to rest its claims that Allergan played a part in the opioid crisis, reaching a $45 million settlement with the pharmaceutical company, an amount the city called "unprecedented" in an announcement on Monday.
-
June 10, 2024
Colo. Justices Say Doc-Patient Privilege Mirrors Atty-Client
The Colorado Supreme Court held Monday that doctor-patient privilege does persist after a patient dies but that a "testamentary exception" exists for when a late patient's medical records become necessary information to execute their estate, similar to how attorney-client privilege works.
-
June 10, 2024
Drugmakers Look To Nix Non-Insulin Claims From AG Suit
Novo Nordisk, Eli Lilly and Sanofi-Aventis asked the federal judge overseeing a diabetes drug price-fixing multidistrict litigation to rule for drugmakers on Mississippi's claims the pricing for GLP-1s is illegal, saying in a brief that the drugs are under patent and too new to be included in the insulin-pricing suit.
-
June 10, 2024
'Four Tops' Singer Sues ER Staff Who Ordered Psych Test
The lead singer of Motown group The Four Tops has sued a hospital in Michigan federal court, claiming in a complaint filed Monday that hospital staff treated him as if he was mentally ill when he said he was a famous singer.
-
June 10, 2024
3 Takeaways From Cigna's Win In 9th Circ. Rehab Claim Fight
The Ninth Circuit's recent decision finding Cigna is off the hook for $8.6 million in out-of-network mental health and substance use disorder treatment claims against employee benefit plans administered by the insurer could discourage similar litigation, benefits attorneys say. Here are three key takeaways from the decision.
-
June 10, 2024
FTC To Fight Go-Ahead Order On Novant $320M Hospital Deal
Just days after a district court loss, the Federal Trade Commission said Monday it will ask the Fourth Circuit to step in and block Novant Health from buying two North Carolina hospitals in a $320 million deal the agency contends would harm competition.
-
June 10, 2024
Mass. Nursing Home To Pay Record $4M Over Neglect Claims
A Massachusetts nursing home operator has agreed to pay a total of $4 million and hire an independent monitor to settle allegations that understaffing at its 16 facilities led to substandard care and patients being harmed, the attorney general’s office announced Monday. Next Step Healthcare LLC has agreed pay $750,000 directly to the state and dedicate the remaining $3.25 million toward increasing staffing levels.
-
June 10, 2024
High Court To Review HHS Hospital Pay Formula
The U.S. Supreme Court on Monday agreed to review a D.C. Circuit decision siding with the Department of Health and Human Services over how the agency applies a formula for calculating disproportionate share hospital payments for Supplemental Security Income benefits.
-
June 07, 2024
Conn. Judge Pushes State For Proof In $11M Kickback Case
The Connecticut state judge presiding over an $11 million false claims and kickbacks case against a compounding pharmacy appeared unconvinced Friday that the defendants submitted false claims for payment, peppering the government's counsel with requests to support assertions with case law and evidence that was put on at trial.
-
June 07, 2024
Chicago-Area Man Charged With $60M COVID Test Fraud
A suburban Chicago man is facing healthcare fraud and money laundering charges over more than $60 million in Medicare reimbursement claims for over-the-counter COVID-19 test kits that were allegedly never provided, including thousands of tests for dead people.
-
June 07, 2024
7 Health Insurers Eye Rate Hikes In Connecticut
Seven health insurers have asked Connecticut state regulators to approve rate hikes of 7.4% to 12.5% for individual market plans and 5.1% to 13.6% for small groups, averaging out to a lesser increase than last year's, according to an announcement Friday.
-
June 06, 2024
Chronic Care Co. To Pay $14.9M To End DOJ False Claims Suit
A provider of chronic disease management services across several states has reached a $14.9 million settlement with the U.S. Department of Justice, resolving a False Claims Act suit alleging it defrauded Medicare and Medicaid by "upcoding" healthcare claims.
-
June 06, 2024
Justices Say Feds Liable For Tribes' Healthcare Admin Costs
A split U.S. Supreme Court on Thursday held that the federal government is required to reimburse two Native American tribes millions of dollars in administrative healthcare costs, saying the spending is necessary for the communities to operate programs assumed from the Indian Health Service.
-
June 05, 2024
House Votes To Block Vets' Access To Gender-Affirming Care
The U.S. House of Representatives on Wednesday passed a $147.5 billion spending bill along mostly party lines funding military construction and the U.S. Department of Veterans Affairs, which would block veterans' access to gender-affirming care and which the White House has already threatened to veto.
-
June 05, 2024
Calif. Wage Hike To Cover Nearly All Healthcare Workplaces
Nearly all workers at healthcare facilities in California will be entitled to a higher minimum wage beginning July 1 regardless of whether they're involved in patient care. One expert called the increase a sweeping change, partly due to broad definitions of what employees and facilities are covered.
-
June 04, 2024
Divided 9th Circ. Reverses Sutter Health Antitrust Trial Victory
A split Ninth Circuit panel on Tuesday overturned Sutter Health's win in insurance plan purchasers' $400 million antitrust suit, ruling that the lower court wrongly excluded "highly relevant" evidence — including admissions by Sutter executives — that would've helped the purchasers potentially prove claims they overpaid thanks to Sutter's anticompetitive conduct.
-
June 04, 2024
Texas Justices Fuel Confusion Over Abortion Ban Exceptions
The Texas Supreme Court recently ruled that doctors may perform abortions only when "reasonable medical judgment" says a patient's life is in danger — a decision attorneys say puts doctors in the position of weighing the lives of their patients against the risk of criminal prosecution.
Expert Analysis
-
ESG Around The World: European Union
As the EU makes ESG regulation a priority, companies — both those based in the EU and others just doing business there — need to keep abreast of myriad new legislation that has either already taken effect or will in the near future, as noncompliance could result in fines, damages and director liability, say attorneys at Steptoe & Johnson.
-
Avoiding The Ethical Pitfalls Of Crowdfunded Legal Fees
The crowdfunding of legal fees has become increasingly common, providing a new way for people to afford legal services, but attorneys who accept crowdsourced funds must remember several key ethical obligations to mitigate their risks, say Hilary Gerzhoy and Julienne Pasichow at HWG.
-
4 Pharma Industry Arguments Against CMS Drug Pricing Plan
The Centers for Medicare & Medicaid Services is facing significant pushback regarding its plans for implementing the Inflation Reduction Act's Medicare drug price negotiation program, due to a number of potential repercussions for manufacturers, say attorneys at Mintz Levin.
-
Issues Ahead As Psychedelic Medicine Faces Pivotal Moment
Recent regulatory changes and decriminalization efforts have opened doors for research and development in psychedelic medicine, but challenges like stigma, access and funding persist, meaning companies will need to address these issues to support the industry’s credibility, say consultants at FTI Consulting.
-
An Overview Of 6 PBM Bills Moving Through Congress
As legislators turn to pharmacy benefit manager reform as a potential next step in addressing the cost of prescription drugs, six congressional committees have recently advanced PBM-related legislation with generally high bipartisan support, suggesting that a final package is likely to advance through Congress, say Rachel Stauffer and Katie Waldo at McDermott+Consulting.
-
10th Circ. ERISA Ruling Is Promising For Self-Funded Plans
Though some recent appellate decisions have seemingly narrowed application of Employee Retirement Income Security Act preemption, which generally helps protect self-funded health plans from state regulation, the Tenth Circuit's decision in PCMA v. Mulready takes a big step toward reaffirming preemption, say attorneys at Bass Berry.
-
What Large Language Models Mean For Document Review
Courts often subject parties using technology assisted review to greater scrutiny than parties conducting linear, manual document review, so parties using large language models for document review should expect even more attention, along with a corresponding need for quality control and validation, say attorneys at Sidley.
-
Checking In On How SuperValu Has Altered FCA Litigation
Four months after the U.S. Supreme Court's ruling in U.S. ex rel. Chutte v. SuperValu, the decision's reach may be more limited than initially anticipated, with the expansion of the scienter standard counterbalanced by some potential defense tools for defendants, say Elena Quattrone and Olivia Plinio at Epstein Becker.
-
Participating In Living History Makes Me A Better Lawyer
My role as a baron in a living history group, and my work as volunteer corporate counsel for a book series fan association, has provided me several opportunities to practice in unexpected areas of law — opening doors to experiences that have nurtured invaluable personal and professional skills, says Matthew Parker at the Nebraska Department of Health and Human Services.
-
Private Equity Owners Can Remedy Law Firms' Agency Issues
Nonlawyer, private-equity ownership of law firms can benefit shareholders and others vulnerable to governance issues such as disparate interests, and can in turn help resolve agency problems, says Michael Di Gennaro at The Law Practice Exchange.
-
Cos. Must Overhaul Data Privacy Approach To Avoid Lawsuits
With the proliferation of third-party trackers and the increasing complexity of privacy laws, companies need to significantly change their approach to online privacy to avoid litigation by focusing on responsible data collection practices and ongoing monitoring of ad tech tools, says Ian Cohen at LOKKER.
-
Biden Admin's Mental Health Proposal May Not Be Enough
The Biden administration's recent proposed updates to federal mental health care rules acknowledge the difficulty that Americans face in finding and affording care, but may have limited impact due to enforcement challenges, a lack of providers and other issues, say Khaled Klele and Jessica Osterlof at Riker Danzig.
-
How To Protect Atty-Client Privilege While Using Generative AI
When using generative artificial intelligence tools, attorneys should consider several safeguards to avoid breaches or complications in attorney-client privilege, say Antonious Sadek and Christopher Campbell at DLA Piper.