Policy & Compliance

  • October 05, 2026

    5th Circ. Hints CMS Medicare Advantage Rule May Violate APA

    A Fifth Circuit panel seemed hesitant to buy an argument that a rule from the Centers for Medicare & Medicaid Services dealing with Medicare Advantage plan overpayments went through proper rulemaking steps, asking Monday if the agency's argument that it can change its rationale "upends" rulemaking procedures.

  • October 05, 2026

    Securities Roundup: 7 Rulings You May Have Missed

    Federal judges from California to New York and several states in between issued a slew of decisions last week that determined the fates of shareholder lawsuits against a major health insurer, a New York bank that nearly failed in 2024 and a diagnostic company accused of hiding its challenges as COVID testing demand ebbed. 

  • October 05, 2026

    Catholic Org. Funding Cut Wasn't About Faith, Mich. Says

    A Catholic charity is improperly attempting to insert a prior religious liberty case over Michigan's foster care policies into current litigation challenging the charity's de-designation as a provider of treatment for substance use disorder, state officials have argued in a brief seeking dismissal.

  • October 05, 2026

    High Court Won't Review Medical Tape Antitrust Case

    The U.S. Supreme Court refused Monday to review a case accusing medical supplies group purchasing giant Vizient Inc. of locking in hospital customers, after the lower courts found a medical tape supplier failed to define a market that Vizient allegedly monopolized.

  • October 05, 2026

    1st Circ. Doubts Harvard Grant Fight Belongs In Claims Court

    The First Circuit Monday appeared skeptical that a lower court erred in backing Harvard University in a suit over the Trump administration's bid to freeze more than $2 billion in grant funding, suggesting that the case had been decided in the proper venue.

  • October 05, 2026

    Justices Won't Review Pregnancy Center Vandalism Case

    The U.S. Supreme Court on Monday said it will not review the conviction of a Florida woman for conspiring to violate a federal statute that prohibits intimidation and obstruction of people trying to access reproductive health facilities.

  • October 05, 2026

    Justices Won't Hear Minn. Indian Child Welfare Act Case

    The U.S. Supreme Court declined Monday to hear two foster parents' challenge to the Indian Child Welfare Act after the Minnesota Supreme Court determined they don't have standing to take on the bedrock law on claims of constitutional equal protection rights.

  • October 02, 2026

    Teva Ruling Creates Medicare Drug 'Chaos,' Full DC Circ. Told

    The federal government asked the full D.C. Circuit on Friday to reconsider a panel ruling allowing Teva to challenge Medicare's rules for deciding which drugs qualify for price negotiations, arguing the decision invites litigation that could create drug-pricing "chaos" and cause drug prices to quickly leap by more than 550%.

  • October 02, 2026

    Pa. Justices Reject Federal Limits On Agency Deference

    Pennsylvania courts do not have to follow federal precedents that limit deference to a state agency's interpretation of unclear regulations, with a majority of the state's highest court finding Thursday that an agency interpretation can be one of multiple factors for analyzing an ambiguous regulation.

  • October 02, 2026

    Judge OKs Provider Not Telling Clients Of Deal End, For Now

    A Colorado state judge granted Friday a home personal care services company's bid to delay notifying clients of a state regulatory agency's decision to terminate its provider agreement amid an upcoming administrative appeal hearing, citing a potential care gap for the providers' clients — all of them insured by Medicaid.

  • October 02, 2026

    NY-Presbyterian Can't Nix Union Funds' Antitrust Suit

    A New York federal judge ruled three union benefit funds can pursue an antitrust suit against New York Presbyterian Hospital without first proving it holds a large market share in the city, rejecting the hospital's motion to toss the suit on Friday.

  • October 02, 2026

    Pa. Hospital Workers Sue Over Biased Time Rounding

    A patient registration worker sued the University of Pittsburgh Medical Center in federal court Friday, alleging the hospital system's timekeeping software rounds time in the company's favor, while requiring patient services staff to work off the clock before and after their shifts and during meal breaks without compensation.

  • October 02, 2026

    DOJ Envisions 'Full-Fledged Law Firm' To Combat Gov't Fraud

    The National Fraud Enforcement Division was created less than six months ago, but it is rapidly reshaping the U.S. Department of Justice and spurring an uptick in internal corporate investigations, white collar experts say.

  • October 02, 2026

    6th Circ. Blocks 100s Of Opioid MDL Cases Targeting PBMs

    The Sixth Circuit on Friday overturned a pivotal decision in multidistrict opioid litigation that had dramatically expanded claims against the nation's largest pharmacy benefit managers, saying the MDL's presiding judge "clearly abused" his authority by belatedly allowing hundreds of new cases in one fell swoop.

  • October 02, 2026

    5 Supreme Court Cases To Watch This Fall

    The U.S. Supreme Court will convene Monday to begin its 2026 October term, which includes several cases that could determine the future of climate change tort litigation, expand religious freedoms and parental rights, and grant states authority to require proof of citizenship when individuals register for presidential elections using state forms. 

  • October 02, 2026

    4 Argument Sessions Benefits Attys Should Watch In October

    Former Intel workers' bid to convince the U.S. Supreme Court to revive their suit alleging shoddy retirement plan investments tops the list of oral arguments slated for October that benefits attorneys may want to keep an eye on. Here's a look at that case and three others teed up for argument this month.

  • October 01, 2026

    Home Health Co. Seeks Pause Of Colo. Agency's Backout

    A Colorado home personal care services company exclusively serving those insured by Medicaid urged a state judge Thursday to pause a Colorado regulatory agency's decision to terminate its provider agreement, contending any transition of clients to other providers should come after an administrative court hearing later this month.

  • October 01, 2026

    AbbVie Gets Humira Antitrust Suit Trimmed, But Not Tossed

    An Illinois federal judge tossed all but one claim in a sheet metal worker health plan's putative class action against AbbVie for allegedly causing artificially inflated prices for the rheumatoid arthritis drug Humira, saying the plan sufficiently alleged AbbVie unlawfully stifled competition in the adalimumab market.

  • October 01, 2026

    NH Families Seek To Block Medicaid Ban On Youth Trans Care

    Transgender adolescents and their parents urged a New Hampshire federal court Thursday to block the Trump administration's plan to cut off Medicaid funding for minors' gender-affirming care, arguing it's unconstitutional, motivated by discriminatory animus and violates the Administrative Procedure Act.

  • October 01, 2026

    Judge Bars HHS Medicaid Cuts For Wash. Noncitizens On SSI

    A federal judge has temporarily halted the U.S. Department of Health and Human Services' attempts to cancel Medicaid benefits to noncitizens in Washington state receiving supplemental security income, finding the loss of benefits could lead to permanent disability or death.

  • October 01, 2026

    Fla. Doc Says He Opposed Cruise Co.'s Billing, Got Fired

    A doctor has brought a federal whistleblower lawsuit against Norwegian Cruise Lines Holdings Ltd. in Florida federal court, alleging he lost his job after speaking out against what he believed were fraudulent practices to overcharge passengers for medical services that weren't necessary. 

  • October 01, 2026

    Fla. AG Says Pfizer Hid COVID Vax Risks From Consumers

    Florida's attorney general sued Pfizer and its CEO on Thursday, claiming they deceptively marketed the pharmaceutical company's COVID-19 vaccines as safe despite knowing of reports of adverse events.

  • October 01, 2026

    Calif. Co. Will Pay $20M To Settle COVID Payment Claims

    Los Angeles-based medical lab Signal Diagnostics LLC agreed to pay $20.5 million to settle allegations that it unlawfully retained overpayments for COVID tests for people who had health insurance, according to federal prosecutors.

  • September 30, 2026

    Aetna Escapes Zelis Repricing Tool Antitrust Case

    A Massachusetts federal judge granted Aetna's bid Wednesday to dismiss claims against it in consolidated antitrust litigation accusing insurance companies of using Zelis Healthcare's repricing tools to reduce reimbursements paid to healthcare providers, finding an amended complaint failed to plausibly allege that Aetna used the tools.

  • September 30, 2026

    Ex-NFL Players Object To Proposed Race-Norming Settlement

    More than 100 former NFL players spoke against a proposed class action settlement over allegedly discriminatory cognitive disability assessments, telling a federal judge it threatens to release the league's benefit plans from claims raised in other litigation and deliver largely empty rescoring promises.

Expert Analysis

  • 2nd Circ. Tylenol MDL Ruling Clarifies Court Gatekeeper Role

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    The Second Circuit’s recent decision in multidistrict litigation over alleged links between Tylenol and developmental disorders, holding that the trial court improperly excluded expert witnesses, preserves meaningful judicial gatekeeping while making clear that judges may not resolve legitimate scientific disputes themselves, say attorneys at Lowenstein Sandler.

  • CMS Rule, DOJ Probes Deepen Gender Care Compliance Risk

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    The Centers for Medicare & Medicaid Services' final rule restricting Medicaid funding for hospitals that provide gender-affirming care is likely to face immediate litigation, but the CMS rulemaking is already working alongside U.S. Department of Justice's enforcement campaign to create operational risk for providers, say attorneys at Arnall Golden.

  • 5th Circ. Ruling Hints At Loper Bright's Effect On OSHA Suits

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    The Fifth Circuit's recent decision in Exxon Mobil v. Occupational Safety and Health Review Commission relied on Loper Bright to narrow the scope of illnesses that employers must record, signaling that courts may continue to scrutinize agency assertions that deference is due, say attorneys at Ogletree.

  • 2 Cases Shed Light On Invoking The 5th Before Congress

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    Given the anticipated increase in congressional investigations following the midterm elections, those who anticipate being in Congress' spotlight can draw valuable Fifth Amendment lessons from the ongoing case involving Dr. Anthony Fauci's testimony and the D.C. Circuit’s recent ruling in de la Torre v. Cassidy, say attorneys at King & Spalding.

  • Vanda Ruling Offers New Guide To Generic Labeling Disputes

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    The D.C. Circuit's recent decision in Vanda Pharmaceuticals v. U.S. Food and Drug Administration is significant for its guidance on when generic-drug labeling remains sufficiently similar to brand labeling and when a difference requires a statutory exception, says Shashank Upadhye at Upadhye Tang.

  • Cannabis, Psychedelics Boom Raises IP Hurdles

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    Recent data regarding patent filing activity and litigation in the cannabis and psychedelics markets indicates that as commercial interest accelerates, the scope of publicly accessible prior art is also expanding, setting a higher bar for novelty and nonobviousness in patent applications, say attorneys at Sterne Kessler.

  • 5 Practice Tips After DOJ's Healthcare Fraud Declination

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    In light of the U.S. Department of Justice's decision to not prosecute Campus Eye Management under the agency's new corporate enforcement and voluntary self-disclosure policy, healthcare companies should keep several considerations in mind when weighing their risk and self-disclosure strategy, including the distinctions between reporting to the DOJ versus other government agencies, say attorneys at Haynes Boone.

  • FDA Closeout Letter Suggests Relaxing Stance On Wearables

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    The U.S. Food and Drug Administration's recent decision not to pursue enforcement action against Whoop's wearable blood pressure tracker, read together with guidance released earlier this year, suggests a softer shift in the FDA's approach to regulating wearables, say attorneys at Arnold & Porter.

  • Teva MDL Loss Shows DPAs Can Return To Haunt Civil Suits

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    Teva’s recent partial summary judgment loss in antitrust multidistrict litigation reinforces the importance of carefully scrutinizing any statement of facts a company admits to in a deferred prosecution agreement, and illustrates the potential costs of resolving a criminal investigation this way, say attorneys at Sheppard.

  • 11th Circ. FCA Qui Tam Revival Queues Up Next Challenges

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    Though the Eleventh Circuit on Sept. 1 upheld the constitutionality of the False Claims Act's qui tam provision, it will probably face continued litigation since the appellate court declined to rule on other constitutional challenges and the decision will likely be petitioned to the U.S. Supreme Court, say attorneys at Sheppard.

  • Prepping Health Businesses For Sale In A Data-Driven Market

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    In a thinner market for healthcare transactions, with both regulators and buyers using artificial intelligence to inspect data in great detail, the margin for error in sellers' financials and legal diligence has narrowed, requiring more proactive compliance efforts, says Cody Dumas at FBFK Law.

  • NY Ethics Opinion Warns Attys On Qui Tam Deception

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    A recent New York State Bar Association ethics opinion cautions that counsel representing whistleblowers may not induce, supervise or facilitate a client's deceptive prefiling investigations, creating a potential vulnerability for qui tam complaints built on questionable evidence-gathering methods, say attorneys at Sidley.

  • DOJ Fraud Declination Highlights Self-Disclosure Tradeoffs

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    As exemplified by the U.S. Department of Justice's declination of charges against Campus Eye Management under its new corporate enforcement policy, self-disclosure can be an attractive option for healthcare companies navigating criminal exposure, but should be weighed against potential costs, say attorneys at Morgan Lewis.