Policy & Compliance

  • March 04, 2025

    Hospitals Risk Penalties As Trump Pushes Price Transparency

    President Donald Trump's executive order to sharpen enforcement of healthcare price transparency regulations is a "warning bell" that hospitals and health plans may face stiffer fines and tighter deadlines as they evaluate how to disclose complex data.

  • 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.

  • 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.

  • 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.

  • 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.

  • 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.

  • 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.

  • March 03, 2025

    Sutter Settles Years-Old Antitrust Suit On Courthouse Steps

    Attorneys for a class of millions of health insurance premium payors announced an eleventh hour deal staving off a new antitrust trial Monday in California federal court over claims that hospital chain Sutter Health drives up costs by pushing all-or-nothing network deals on insurers.

  • March 03, 2025

    2nd Circ. Denies Amish Schools' Vaccine Rule Challenge

    The Second Circuit on Monday denied a religious challenge to New York's immunization law from three Amish schools and two Amish parents, saying both the appellate court and the U.S. Supreme Court have a history of upholding school immunization requirements implemented by states.

  • February 28, 2025

    Group Blasts Judge's Call For Women In Contraception MDL

    A judicial organization dedicated to fighting "leftist lawfare" filed a complaint Thursday against the Florida federal judge overseeing multidistrict litigation over the hormonal contraceptive drug Depo-Provera, claiming that her comments about women needing to be represented in the MDL leadership show an impermissible bias.

  • February 28, 2025

    Wash. Judge Picks Apart Parents' Hospital Data Privacy Suit

    A Washington appellate judge on Friday grilled parents seeking to revive their proposed privacy class action against a Seattle hospital, expressing frustration with their argument that state wiretapping law could apply to an individual's queries to a public-facing website.

  • February 28, 2025

    Ex-Conn. Official Hit With New Corruption Charges

    A federal grand jury has indicted former Connecticut budget official Konstantinos Diamantis and Christopher Ziogas, a suspended attorney and former lawmaker, for allegedly accepting bribes to end a state audit targeting Ziogas' fiancée, an optometrist who separately admitted to healthcare fraud, prosecutors said Friday.

  • February 28, 2025

    SuperValu Complains About Falsity Question In FCA Case

    Whistleblowers claiming SuperValu overcharged the government by $123 million for prescriptions can ask witnesses a single question alluding to a bitterly contested legal finding in the False Claims Act case in Illinois federal court, the grocer revealed in a motion objecting to the judge allowing that question.

  • February 28, 2025

    Aetna, Optum To Pay $8.3M To End ERISA Fee Suit

    Aetna Inc. and OptumHealth Care Solutions LLC will pay $8.3 million to settle 88,000 patients' claims that they were overcharged in a scheme to hide administrative fees as medical expenses, nearly three months after OptumHealth said it was pulling out of the deal.

  • February 27, 2025

    FTC Asks To Delay In-House PBM Insulin Case

    Arguing that pharmacy benefit managers accused of artificially inflating insulin prices have already "unreasonably delayed" discovery, the Federal Trade Commission is asking an in-house judge to push back an evidentiary trial in the case, saying it would allow the administrative court more time to accommodate up to 17 expert witnesses.

  • February 27, 2025

    Unions Can Depose DOGE In Agency Access Suit, Judge Says

    The Department of Government Efficiency must tell a group of unions whom it's sent into the Department of Labor, the Department of Health & Human Services and the Consumer Financial Protection Bureau and what computer systems they've accessed, a D.C. federal judge ruled Thursday.

  • February 27, 2025

    CooperSurgical Says Unique IVF Claims Require Separate Trials

    Fertility company CooperSurgical Inc. is pushing back against the suggestion that four lawsuits accusing the company of negligently destroying embryos with its recalled culture media could be consolidated into one trial, saying the couples' varied location and unique IVF situations preclude joining them.

  • February 27, 2025

    CVS Freed From Hospital's Suit Over Drug Pricing Program

    A Pennsylvania hospital's antitrust lawsuit claiming CVS forced healthcare providers participating in a federal discount drug program to go through the pharmacy chain's administrator has been tossed, with a federal judge ruling the hospital fell short in its allegations of anticompetitive behavior.

  • February 27, 2025

    Cedars-Sinai Strikes Deal To End Retirement Plan Suit

    Cedars-Sinai Medical Center Inc. and a group of retirement plan participants agreed to settle a proposed class action alleging the healthcare system loaded the plan with excessive recordkeeping fees and underperforming investment options, according to a California federal court filing.

  • February 27, 2025

    Polsinelli Blocked From Repping BCBS Settlement Opt-Outs

    An Alabama federal judge has disqualified Polsinelli PC from representing hospitals that opt out of a landmark $2.8 billion Blue Cross Blue Shield antitrust settlement, even as other firms are licking their lips at the prospect of a multibillion-dollar bonanza of opt-out litigation.

  • February 27, 2025

    NC Pharmacy Settles Feds' Suit Over Opioid Records

    A North Carolina pharmacy has agreed to pay $204,000 to resolve allegations that it violated federal recordkeeping requirements for controlled substances, the U.S. Attorney's Office for the Western District of North Carolina announced Thursday.

  • February 26, 2025

    Merck, Glenmark Trim United Healthcare's Zetia Antitrust Suit

    A Minnesota federal judge has trimmed a United Healthcare unit's antitrust suit claiming that Merck and Glenmark conspired to delay a generic version of the anti-cholesterol drug Zetia, throwing out non-Minnesota state-law claims he called a "bare and conclusory pleading."

  • February 26, 2025

    Planned Parenthood Immune From FCA Suit, 5th Circ. Says

    Planned Parenthood is entitled to attorney immunity, the Fifth Circuit said Wednesday in a case that had accused the organization of improperly billing Medicaid programs for millions after losing its Medicaid credentials.

  • February 26, 2025

    CVS Ordered To Comply With FTC's PBM Subpoena

    A D.C. federal judge is ordering CVS to turn over new materials in the Federal Trade Commission's investigation into its pharmacy benefit manager Caremark Rx, saying that just because producing updated documents would cost the company more doesn't mean it faces an "undue burden."

  • February 25, 2025

    DC Judge Blocks Trump's Federal Funding Freeze

    A D.C. federal judge on Tuesday issued a preliminary injunction blocking the Trump administration from implementing a federal spending freeze while a group of nonprofits challenge the freeze, calling the measure "ill-conceived from the beginning."

Expert Analysis

  • Proposed Legislation May Crack Down On Online Drug Ads

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    A bill recently proposed in Congress could serve as a sea change in how the U.S. Food and Drug Administration regulates drug-related speech, with significant trickle-down effects on various corners of not only the drug industry but also on consumers and providers themselves, say Dominick DiSabatino and Arushi Pandya at Sheppard Mullin.

  • What To Expect From Calif. Bill Regulating PE In Healthcare

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    A California bill currently awaiting Gov. Gavin Newsom's approval, intended to increase oversight over private equity and hedge fund investments in healthcare, is emblematic of recent increased scrutiny of investments in the space, and may affect transactions and operations in California in a number of ways, say attorneys at Ropes & Gray.

  • Vertex Suit Highlights Issues For Pharma Fertility Support

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    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.

  • CMS' New 'Breakthrough' Device Policy Shows Little Promise

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    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.

  • A Preview Of AI Priorities Under The Next President

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    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.

  • Managing Community Health Needs Assessments: A Checklist

    Excerpt from Practical Guidance
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    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.

  • Pa. Health Employers Must Prep For Noncompete Restrictions

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    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.

  • FTC Focus: What Access To Patent Settlements Would Mean

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    Settling parties should adopt a series of practice tips, including specifying rationales to support specific terms, as the Federal Trade Commission seeks to expand its access to settlements before the Patent Trial and Appeal Board, say Shannon McGowan and David Munkittrick at Proskauer.

  • Agencies Should Reward Corporate Cyber Victim Cooperation

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    The increased regulatory scrutiny on corporate victims of cyberattacks — exemplified by the U.S. Securities and Exchange Commission's case against SolarWinds — should be replaced with a new model that provides adequate incentives for companies to come forward proactively and collaborate with law enforcement, say attorneys at McDermott.

  • Strategies To Defend Against Healthcare Nuclear Verdicts

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    The healthcare industry is increasingly the target of megaclaims, particularly those alleging medical malpractice, but attorneys representing providers can use a few tools to push back on flimsy litigation and reduce the likelihood of a nuclear verdict, says LaMar Jost at Wheeler Trigg.

  • What Drug Cos. Must Know About NY Price Transparency Law

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    Drug manufacturers must understand the contours of New York's recently implemented law requiring self-reporting of drug price increases, as well as best practices for compliance and challenges against similar laws in other states, say Elizabeth Bierut and Angie Garcia at Friedman Kaplan.

  • Whistleblowers Must Note 5 Key Differences Of DOJ Program

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    The U.S. Department of Justice’s recently unveiled whistleblower awards program diverges in key ways from similar programs at other agencies, and individuals must weigh these differences and look first to programs with stronger, proven protections before blowing the whistle, say Stephen Kohn and Geoff Schweller at Kohn Kohn.

  • The Licensure Landscape For Psychedelics Manufacturers

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    As the need for bulk manufacturing of psychedelic substances grows, organizations aiming to support clinical trials or become commercial suppliers must navigate a rigorous and multifaceted journey to obtaining a license from the U.S. Drug Enforcement Administration, say Kimberly Chew at Husch Blackwell and Jaime Dwight at Promega Corp.