Policy & Compliance

  • March 25, 2026

    Insurers, Brokers Can't Exit Medicare Advantage Steering Suit

    A Massachusetts federal judge on Wednesday largely rejected a bid by insurers and brokers to toss claims that they colluded in a kickback scheme to steer Medicare Advantage customers to certain companies and to push away disabled individuals.

  • March 25, 2026

    PBMs Say Mich. Price-Fixing Suit Lacks Specifics

    For the second time, pharmacy benefit managers Express Scripts Inc. and Prime Therapeutics LLC asked a Michigan federal judge on Monday to toss a price-fixing suit filed by Michigan Attorney General Dana Nessel, arguing that the state has no standing to file the suit.

  • March 25, 2026

    Judge Trims SEC Fraud Case Over Cancer Drug Claims

    A Massachusetts federal judge greenlighted U.S. Securities and Exchange Commission claims against two of three former pharmaceutical executives accused of concealing from investors the U.S. Food and Drug Administration's "harsh critiques" about a cancer drug.

  • March 25, 2026

    Foreign Aides' RICO Labor Suit Against PruittHealth Hits NC

    A Tennessee federal judge has agreed to transfer to North Carolina a year-old class action in which foreign workers say a healthcare system and recruiter trapped them in punitive contracts and buried them in grueling labor, after a judge said the action could have been filed in the Tar Heel State in the first place.

  • March 24, 2026

    Nicotine Pouch Maker To Refile FDA Suit In DC After Transfer

    The maker and seller of Zone nicotine pouches on Tuesday dismissed its own lawsuit accusing the U.S. Food and Drug Administration of unfairly holding up a market application for its product, promising to refile in D.C. federal court after a Texas federal court transferred it to South Carolina federal court.

  • March 24, 2026

    Biz Services Co. Faces ERISA Suit Over 'Tobacco Surcharge'

    Business services company Conduent unlawfully imposes health insurance surcharges on employees who use tobacco products, forcing them to pay more for coverage the company provides, a former employee and plan participant said in a proposed class action in New Jersey federal court.

  • March 24, 2026

    $5.7M Cigna Ghost Network Deal Receives Final Go-Ahead

    An Illinois federal judge gave his final sign-off Tuesday to a $5.7 million settlement in what he called an "interesting" case accusing Cigna of improperly advertising out-of-network providers as though they're in-network for certain benefit plans it administered.

  • March 24, 2026

    Health Co. Escapes Workers' 401(k) Forfeiture Suit In La.

    A Louisiana federal judge agreed to toss a federal benefits lawsuit against a health company from workers who alleged the company misspent forfeitures from their employee 401(k) plan, rejecting the workers' argument that funds should have gone toward defraying expenses instead of lowering employer-side contribution obligations.

  • March 24, 2026

    Utah Hospitals To Track Violence As States Step Up Reporting

    Under a new law, Utah hospitals will join a national effort to better understand the risks facing healthcare workers.

  • March 24, 2026

    Ohio Justices Likely Split On Trans Care Restrictions

    The Ohio Supreme Court appeared split Tuesday as to whether a new state law banning gender-affirming care for minors trumps a decade-old healthcare freedom provision passed by voters that says state laws can't block a patient from obtaining healthcare. 

  • March 24, 2026

    Fraud Task Force May Boost White Collar Defense Work

    A new federal anti-fraud task force involving at least a dozen federal agencies could soon expose more state and local governments, contractors, companies and others to compliance risks, particularly in healthcare fraud and False Claims Act cases, experts say.

  • March 24, 2026

    Justices Won't Review Class Cert. In Diabetes Drug Risk Case

    The U.S. Supreme Court has declined to review whether a federal court can certify a class of third-party payors who claim drugmakers hid the cancer risks of an anti-diabetes drug.

  • March 24, 2026

    Mass General Accused Of Shaving Time From Workers' Pay

    Boston-based healthcare system Mass General Brigham shaved as much as 14 minutes a day from employees' pay by rounding their clock-in and clock-out times, according to a proposed class and collective action filed in federal court.

  • March 23, 2026

    J&J Amici Seek Clarity On Goldman Precedent For Class Cert.

    Four groups of amici have urged the U.S. Supreme Court to take up Johnson & Johnson's challenge to a Third Circuit decision allowing a securities class action over its talc products to proceed, warning the ruling could reshape how shareholder suits are litigated nationwide.

  • March 23, 2026

    FTC Stays Focused On Healthcare, Launches Task Force

    The Federal Trade Commission announced it is launching a new task force with staff from across the agency to coordinate healthcare policy approaches and initiate investigations meant to help protect patients, healthcare workers and American taxpayers.

  • March 23, 2026

    Progressive Escapes Workers' Tobacco, Vaccine Fee Suit

    Allegations that Progressive Corp. wrongly charged higher health premiums from workers who used tobacco or refused the COVID-19 vaccination failed to state a claim for violating federal benefits law, an Ohio federal judge ruled as he tossed a proposed class action against the insurance giant.

  • March 23, 2026

    Feds Approve Minnesota's Plan To Combat Medicaid Fraud

    Minnesota may soon receive the release of $243 million in deferred Medicaid funds after the Centers for Medicare & Medicaid Services approved the state's updated plan to combat Medicaid fraud, Minnesota state health officials told a federal court last week.

  • March 23, 2026

    Health Insurers Can't Force Conn. ERISA Row Into Arbitration

    Elevance Inc. can't compel arbitration of a union health plan's allegations the insurer caused it to pay excessive administrative fees and medical costs, a Connecticut federal judge ruled, finding the insurer and its subsidiaries waived that right by seeking to dismiss the proposed class action.

  • March 23, 2026

    High Court Won't Hear Mich. Newborn Blood Testing Case

    The U.S. Supreme Court on Monday declined to hear a petition from parents seeking to revive claims that the way newborn blood samples are collected and stored in a Michigan health screening program violates their rights to make medical decisions for their children.

  • March 23, 2026

    Justices Won't Review Lab Owner's Kickback Conviction

    The U.S. Supreme Court on Monday declined to review the conviction of a former California biotech president sentenced to eight years in prison for lying about the efficacy of his company's COVID-19 and allergy testing and conducting a $70 million Medicare fraud scheme. 

  • March 23, 2026

    High Court Won't Hear Calif. Border Hospital Medicaid Fight

    The U.S. Supreme Court said Monday it would not consider a case challenging California's exclusions of hospitals in neighboring states from supplemental federal payments going to providers that serve Medi-Cal beneficiaries.

  • March 20, 2026

    Feds Rip Ex-NFL Player's New Trial Bid Over Medicare Scheme

    The federal government opposed a new trial bid by Keith Gray, a former NFL player and Texas laboratory owner convicted in a $328 million scheme involving billing for unnecessary cardiovascular genetic testing for Medicare beneficiaries, arguing Thursday he lacks any valid basis to "disturb the jury's sound verdict."

  • March 20, 2026

    EPA's Ethylene Oxide Plan May Hinder Other Air Toxics Regs

    A new proposal from the U.S. Environmental Protection Agency to weaken emission standards for a medical sterilizer could have broader implications for the agency's power to tighten air pollution limits when new science becomes available.

  • March 20, 2026

    Pa. Hospital Must Pay $109M For Brain Injury During Birth

    Jefferson Health and its subsidiary Einstein Healthcare Network have been hit with a nearly $109 million verdict by a Philadelphia jury in a lawsuit accusing them of negligence leading to debilitating brain injuries sustained by a child delivered at one of their hospitals.

  • March 20, 2026

    Mich. BCBS Unit Gets Health Plans' Claims Fight Transferred

    A federal judge granted Blue Cross Blue Shield of Michigan's request to transfer a proposed class action alleging the insurance company violated federal benefits law by mismanaging claims in self-funded employee healthcare plans it administered, given that a similar, earlier-filed action was proceeding in an adjacent district.

Expert Analysis

  • A Look At Drug Price Negotiation Program's Ongoing Impact

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    More than two years after the passage of the Inflation Reduction Act and the rapid implementation of the drug price negotiation program, attorneys at Ropes & Gray discuss how the IRA has influenced licensing strategies, and how maximum fair prices under the law have economically affected certain drugs.

  • Preparing For A Possible End To The Subminimum Wage

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    The U.S. Department of Labor's proposed rule to end the subminimum wage for employees with disabilities may significantly affect the community-based rehabilitation and training programs that employ these workers, so certified programs should be especially vigilant about compliance during this period of evaluation and scrutiny, say attorneys at Jackson Lewis.

  • Drug Pricing Policy Trends To Expect In 2025 And Beyond

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    Though 2025 may bring more of the same in the realm of drug pricing policy, business as usual entails a sustained, high level of legal and policy developments across at least six major areas, say attorneys at Ropes & Gray.

  • Top 10 Healthcare And Life Sciences Issues To Watch In 2025

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    Under the new Trump administration, this coming year may benefit some healthcare and life sciences stakeholders, while creating new challenges for others amid an increasingly complex regulatory environment, say attorneys at Debevoise.

  • 4 Keys To Litigating In An Active Regulatory Environment

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    For companies facing litigation influenced by government regulatory action — a recent trend that a politically charged atmosphere will exacerbate — there are a few principles that can help to align litigation strategy with broader public positioning in the regulatory and oversight context, say attorneys at Jenner & Block.

  • How Views On Healthcare Price Transparency Are Changing

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    Regulators' attitudes toward price transparency regulation have shifted over the past several years in ways that may seem contradictory, and research into detailed rate information published by hospitals and health plans has yielded mixed results, says Matthew List at Charles River Associates.

  • EEOC Wearable Tech Guidance Highlights Monitoring Scrutiny

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    The U.S. Equal Employment Opportunity Commission's recent fact sheet on wearable technologies cautions against potential issues with federal anti-discrimination laws and demonstrates growing concern from regulators and legislators about intrusive technologies in the workplace, say attorneys at Littler.

  • Navigating The Potential End Of GLP-1 Drug Shortages

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    The U.S. Food and Drug Administration's determination of whether GLP-1 products are in shortage may affect how compounders provide these products and spur a range of litigation including patent disputes and unfair competition suits, say attorneys at Goodwin.

  • Politicized OIGs Could Target Federal Employees, Contractors

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    After President Donald Trump fired nearly 20 inspectors general last week, it’s worth exploring how the administration could use Offices of Inspectors General to target federal employees and contractors, why it would be difficult to fight this effort, and one possible bulwark against the politicization of these watchdogs, says Sara Kropf at Kropf Moseley.

  • Takeaways From DOJ Fraud Section's 2024 Year In Review

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    Attorneys at Paul Weiss highlight notable developments in the U.S. Department of Justice Fraud Section’s recently released annual report, and discuss what the second Trump administration could mean for enforcement in the year to come.

  • IVF Suits Highlight Need For Better Legal Frameworks

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    The high number of in vitro fertilization embryo losses underscores the need for more cohesive legal and regulatory guidance related to human errors, property versus personhood, and liability, says Jeff Korek at Gersowitz Libo.

  • Takeaways From FDA's Updated Confirmatory Trial Guidance

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    The U.S. Food and Drug Administration's latest draft guidance about accelerated drug approval indicates the FDA's intent to address the significant lag time between accelerated approval and full approval of drugs and may help motivate the industry to complete confirmatory trials, say attorneys at Sheppard Mullin.

  • A Look At FDA's Plans To Establish New OTC Drug Category

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    The U.S. Food and Drug Administration's recently finalized rule, creating a new over-the-counter pathway for drugs when patients satisfy certain conditions, may be useful for off-patent drugs with established safety records, though switching to OTC comes with additional costs and considerations, say attorneys at Skadden.