Policy & Compliance

  • December 19, 2024

    Generic-Drug Cos. Get State AGs' Trial Order Flipped

    A Connecticut federal court has sided with the generic-drug makers accused of price-fixing by state-level enforcers and will allow a narrower case involving 15 drugs to move ahead prior to a much broader case involving more than 100 medications.

  • December 19, 2024

    FDA Declaration May Restart Compounders' Shortage Suit

    Federal regulators pulled Eli Lilly's lucrative weight-loss and diabetes drug off the national shortage list Thursday and gave compounding pharmacists two months to stop making copycat versions of the injectable medication, a move with the potential to reignite a Texas legal clash.

  • December 19, 2024

    Addiction Group Pays $2M In Mass. AG False Billing Probe

    An addiction treatment physician group with offices across western Massachusetts will pay $2 million to settle allegations that it overcharged for visits and billed for tests that were not medically necessary, the state's attorney general said Thursday.

  • December 19, 2024

    NYU Langone Wrongly Exempts IT Workers From OT, Suit Says

    New York University's academic medical center improperly classifies information technology workers as overtime-exempt despite their duties not falling under an exemption, causing them to lose out on extra wages, a proposed class and collective action filed in New York federal court said.

  • December 18, 2024

    Patent Limits For Biosimilar Litigation Lands In Spending Bill

    Congress' spending package to keep the government open through March would also limit how many patents a biologics maker can assert when trying to prevent a competitor from getting on the market.

  • December 18, 2024

    FDA's Gastro Drug Fast-Track Denial Survives DC Circ.

    A D.C. Circuit panel upheld federal regulators' refusal to streamline approval of a drug to treat nausea in patients with a chronic gastric condition, ruling that the U.S. Food and Drug Administration was right to consider the drug's development plan when deciding whether it qualified for fast tracking.

  • December 18, 2024

    Destroyed Docs Merit Harsher Sanctions, Mich. Panel Says

    A Michigan appellate panel on Tuesday said fees awarded to the estate of a man who died after choking in an adult foster care facility were likely too low, finding a lower court erred by limiting the scope of available sanctions over the destruction of "copious amounts" of digital evidence.

  • December 18, 2024

    Philip Morris Sues FDA Over New Cigarette Warning Labels

    Tobacco giant Philip Morris and a group of Georgia convenience store interests have sued the U.S. Food and Drug Administration over a rule that would add graphic warnings to cigarette labels, alleging the agency is exceeding its statutory authority in a move that would mark a "sea change" for the industry.

  • December 18, 2024

    CVS Fueled Opioid Epidemic In Rush For Profits, Feds Say

    The U.S. Department of Justice unveiled a suit Wednesday accusing CVS, the nation's largest pharmacy chain, of knowingly filling invalid prescriptions for powerful opioids and ignoring internal pleas from its pharmacists as it allegedly put profits over safety. 

  • December 18, 2024

    FTC Wants Express Scripts' Defamation Suit Tossed

    The Federal Trade Commission told a Missouri federal court that Express Scripts Inc. has no basis to challenge an interim agency report that only offered "qualified conclusions" from an ongoing study about how pharmacy benefit managers affect prescription drug prices.

  • December 18, 2024

    Senate Sends $895B Defense Bill To Biden's Desk

    The U.S. Senate on Wednesday easily passed an $895.2 billion defense policy and budget bill for 2025, despite criticism over a contentious clause effectively barring gender-affirming healthcare coverage for service members' transgender children.

  • December 18, 2024

    Top Conn. Cases Of 2024: Kickbacks, Paybacks And Bribes

    Judges and juries in Connecticut awarded several multimillion-dollar verdicts against companies big and small in 2024, socking Johnson & Johnson in a talc case in which the already substantial damages could multiply and ordering a pharmacy that paid kickbacks to cough up nearly four times the money it cost the state.

  • December 18, 2024

    Justices Will Decide If Medicaid Recipients Can Pick Providers

    The U.S. Supreme Court on Wednesday partially granted the state of South Carolina's petition to review a Fourth Circuit decision blocking its Medicaid program from ending its provider agreement with Planned Parenthood, agreeing to determine if the Medicaid Act allows a beneficiary to choose a specific provider. 

  • December 17, 2024

    NC Panel Revives Negligence Suit Against State Health Dept.

    An adult care center's constitutional claims accusing the North Carolina Department of Health and Human Services of negligently asserting bogus penalties and unfairly suspending admissions at the facility are timely, a North Carolina state appellate panel ruled Tuesday, reviving a case that previously landed before the North Carolina Supreme Court.

  • December 17, 2024

    3 Healthcare Decisions This Week You Don't Want To Miss

    The Third Circuit issued a precedential ruling allowing Pennsylvania to dip into the $300 million budget surplus of an insurance fund for doctors facing medical malpractice claims. Meanwhile in Texas, a split appellate panel found that a member of a national hospital chain can enforce an arbitration agreement with an employee. 

  • December 17, 2024

    Express Scripts, OptumRx Can't Ditch LA County Opioid Suit

    A California judge ruled Tuesday that Los Angeles County can keep pursuing a lawsuit claiming pharmacy benefit managers Express Scripts and OptumRx colluded with drugmakers to fuel the opioid epidemic, though the county must rework its complaint to specify how regulators were allegedly deceived.

  • December 17, 2024

    House GOP Asks CVS How Its PBM Treats Smaller Pharmacies

    Lawmakers on Capitol Hill are demanding documents from CVS on its pharmacy benefit manager's treatment of independent pharmacies, continuing to press the healthcare giant over potentially anticompetitive conduct.

  • December 17, 2024

    Feds Intervene In $200M FCA Case Against CVS

    The federal government has intervened in a whistleblower case accusing CVS and its subsidiaries of pocketing more than $200 million in overpayments, in order to defend the constitutionality of the False Claims Act's whistleblower provisions.

  • December 17, 2024

    5th Circ. Preserves Feds' ACA Trans Health Policy

    The Fifth Circuit upended a Texas court decision that invalidated a federal agency interpretation of the Affordable Care Act's provision on nondiscrimination in healthcare, keeping intact federal policy that prohibits insurers from discriminating against individuals seeking treatment for gender dysphoria.

  • December 17, 2024

    Nurse Survey Rule Case Sheds Light On Loper At 2nd Circ.

    A legal challenge over a federal rule saying registered nurses aren’t required at Medicaid compliance inspections is at the center of a Second Circuit case that promises to shed light on how courts could use the Loper Bright decision.

  • December 16, 2024

    Pa. Malpractice Fund Belongs To State, 3rd Circ. Rules

    The Third Circuit said Monday in a precedential ruling that Pennsylvania's medical malpractice insurance fund is an agency of the state and that it can dip into the fund's $300 million budget surplus.

  • December 16, 2024

    11th Circ. Appears Wary Of Doc's New Trial Bid In $27.5M Case

    The Eleventh Circuit on Monday questioned whether a Georgia doctor and his medical practice should get a new trial in a $27.5 million False Claims Act case on the basis that he and an expert who wasn't allowed to testify at trial believed the thousands of treatments he billed for were medically necessary and could be covered by Medicare, saying that contention seems to contradict the doctor's prior statements. 

  • December 13, 2024

    UnitedHealthcare Owes $900K For Services, Provider Says

    A national healthcare provider and two affiliated entities told a Minnesota federal court that UnitedHealthcare owes over $900,000 in independent dispute resolution awards entered against the carrier, accusing it of devising a scheme of denying, delaying and underpaying out-of-network providers.

  • December 13, 2024

    Texas AG Sues NY Doctor Over Telehealth Abortion Script

    Texas Attorney General Ken Paxton sued a New York doctor who founded the Abortion Coalition for Telemedicine in the Lone Star State Friday, accusing the physician of violating Texas state abortion laws by providing abortion-inducing prescription drugs to a Texas resident via telehealth.

  • December 13, 2024

    McKinsey To Pay $650M For Work With Opioid Maker Purdue

    Consulting giant McKinsey & Co. will pay $650 million to resolve charges related to its work helping Purdue Pharma market and boost sales of OxyContin, federal prosecutors announced Friday.

Expert Analysis

  • A Look At Healthcare Timelines Set By Biden's AI Order

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    President Joe Biden's artificial intelligence executive order establishes standards for using AI in the healthcare industry, including a number of staggered deadlines that should help coordinate a more unified federal approach to AI governance, say attorneys at Holland & Knight.

  • A Look At Successful Bid Protests In FY 2023

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    Attorneys at Sheppard Mullin look beyond the statistics in the U.S. Government Accountability Office’s recent annual report on bid protests, sharing their insights about nine categories of sustained protests, gained from reading every fiscal year 2023 decision in which the protester had a positive result.

  • Navigating Discovery Of Generative AI Information

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    As generative artificial intelligence tools become increasingly ubiquitous, companies must make sure to preserve generative AI data when there is reasonable expectation of litigation, and to include transcripts in litigation hold notices, as they may be relevant to discovery requests, say Nick Peterson and Corey Hauser at Wiley.

  • FDA's Lab-Developed Test Rule May Bring Historic Challenges

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    If finalized, the U.S. Food and Drug Administration's proposed rule for regulating laboratory-developed tests will provoke some of the most interesting legal challenges that the agency has faced in decades, with outcomes that will likely reverberate across the agency's product centers, says Stacy Amin at MoFo.

  • Finding Focus: Strategies For Attorneys With ADHD

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    Given the prevalence of ADHD among attorneys, it is imperative that the legal community gain a better understanding of how ADHD affects well-being, and that resources and strategies exist for attorneys with this disability to manage their symptoms and achieve success, say Casey Dixon at Dixon Life Coaching and Krista Larson at Stinson.

  • AI Use May Trigger False Claims Act's Public Disclosure Bar

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    The likely use of publicly available artificial intelligence tools to detect government fraud by combing through large data sets will raise complex questions about a False Claims Act provision that prohibits the filing of claims based on previously disclosed information, say Nick Peterson and Spencer Brooks at Wiley Rein.

  • Beware Privacy Risks In Training AI Models With Health Data

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    Because data used to train artificial intelligence models may be protected by the Health Insurance Portability and Accountability Act or other regulations, users of these models should conduct proper diligence to avoid costly compliance failures, say Neha Matta and Barbara Bennett at Frost Brown.

  • Unpacking GAO's FY 2023 Bid Protest Report

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    The U.S. Government Accountability Office's recent bid protest report reflects an increase in sustained protests, illustrating that disappointed offerors may see little reason to refrain from seeking corrective action — but there is more to the story, say Aron Beezley and Patrick Quigley at Bradley Arant.

  • White House AI Order Balances Innovation And Regulation

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    President Joe Biden’s recently issued executive order on artificial intelligence lays out a sprawling list of directives aimed at establishing standards for safety, security and privacy protection, and may help strike the balance between the freedom to innovate and the need to impose regulation in this rapidly evolving space, say Kristen Logan and Martin Zoltick at Rothwell Figg.

  • Reading Between The Lines Of HHS' National Lab Opinion

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    The U.S. Department of Health and Human Services' Office of Inspector General recently rejected a national laboratory's request to pay a referring lab to process specimens, but the request might have been an attempt to exploit the OIG's advisory opinion process for a competitive advantage, says Mary Kohler at Kohler Health Law.

  • A Closer Look At Proposed HHS Research Misconduct Rule

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    The U.S. Department of Health and Human Services' proposed updates to its policies on research misconduct codify many well-known best practices, but also contain some potential surprises for the research community and counsel, say attorneys at Hogan Lovells.

  • Handling Religious Objections To Abortion-Related Job Duties

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    While health care and pharmacy employee religious exemption requests concerning abortion-related procedures or drugs are not new, recent cases demonstrate why employer accommodation considerations should factor in the Title VII standard set forth by the U.S. Supreme Court’s 2023 Groff v. DeJoy ruling, as well as applicable federal, state and local laws, say attorneys at Epstein Becker.

  • Why Hemp-Synthesized Intoxicants Need Uniform Regs

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    State laws regulating hemp-synthesized intoxicants are a patchwork with little consistency between any given state, and without the adoption of a uniform regulatory framework, producers and consumers alike will need to be very cautious, say Dylan Anderson and Seth Goldberg at Duane Morris.