Policy & Compliance
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October 02, 2024
Abortion Clinic To Get Early Discovery In Patient Spying Case
A Massachusetts federal judge said Wednesday that an abortion clinic should get expedited discovery into its claims that a neighboring "pregnancy resource center" illegally infiltrated its patient communications in an attempt to derail appointments.
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October 01, 2024
CFPB Warns On Collecting 'Invalid,' Unverified Medical Debt
The Consumer Financial Protection Bureau on Tuesday cautioned debt collectors about significant potential compliance risks when working in the medical debt market, issuing guidance that identified a number of practices as illegal and capable of triggering "strict liability" under federal law.
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October 01, 2024
Judge Backs Louisiana 340B Law In Loss For Pharma Lobby
A Louisiana federal court has issued a sweeping loss to Big Pharma's top lobbying group and two pharmaceutical companies that argued a state law improperly expands the scope of the federal drug discount program.
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October 01, 2024
Ga. County Urges Full 11th Circ. To Nix Trans Deputy's Win
A Georgia county told the Eleventh Circuit on Monday that a health plan coverage exclusion for gender-affirming surgery is comparable to other exclusions in coverage and does not violate federal anti-discrimination laws.
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October 01, 2024
9th Circ. Revives FCA Claims Against Dermatology Practice
A Ninth Circuit panel on Monday revived the claims of a former employee who accused a Nevada dermatology practice of retaliation under the False Claims Act and other wrongdoing, reversing the practice's early win and sending the case back for trial.
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October 01, 2024
Novel FCA Decision Amplifies Voices Of Whistleblower Critics
A Florida federal judge's characterization of whistleblowers as self-appointed "special prosecutors" when they file lawsuits on the federal government's behalf amplifies the voices of critics questioning the constitutionality of a key enforcement tool for fighting fraud, while threatening to create a circuit split.
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October 01, 2024
11th Circ. Hearsay Ruling May Open Door To Top Court Review
An Eleventh Circuit decision to allow co-conspirator statements under a hearsay rule exclusion in a $400 million health insurance fraud case could stretch the scope of federal fraud law and might draw the attention of the U.S. Supreme Court.
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October 01, 2024
Biotech Investors Reach $32.5M Deal Over Failed COVID Test
A class of Talis Biomedical Corp. investors accusing the company of inflating their stock price in the run-up to its IPO and then failing to launch a COVID-19 diagnostic test asked a California federal judge on Monday to preliminarily approve their $32.5 million settlement, citing Talis' shrinking cash reserves and imminent plans to file for bankruptcy.
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October 01, 2024
Gov't Looks To High Court To Preserve Free Preventive Care
The federal government has taken a fight over the Affordable Care Act's requirements for cost-free preventive care to the U.S. Supreme Court.
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October 01, 2024
Doctors Were 'Bamboozled' By $160M Health Fraud, Jury Told
A Houston man accused of defrauding the government out of $160 million by submitting false claims for diabetes medication is only guilty of creating a competitive business model, his attorney said Tuesday, telling a Texas federal jury it was "ridiculous" to say doctors across the country were "bamboozled" by an alleged scheme.
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October 01, 2024
FDA Chief Talks Shortages, Food Labels, Reorganization
Pharmaceutical supply chain challenges. A major agency reorganization. Rare disease research. These issues were top of mind for U.S. Food and Drug Administration Commissioner Robert Califf in a recent "fireside chat" with the Alliance for a Stronger FDA, a group of trade associations, pharmaceutical companies, health-focused nonprofits and other stakeholders.
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October 01, 2024
Nostrum Labs Hits Ch. 11 A Year After Medicaid Settlement
Nostrum Laboratories, a New Jersey drugmaker that paid millions to settle allegations that it underpaid Medicaid drug rebates for its bladder infection drug after it hiked the price more than 400%, filed for Chapter 11 protection with nearly $68.3 million in debt.
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October 01, 2024
'Unsworn' Actors Sink Qui Tam Provision, Fla. Judge Rules
A Florida federal judge on Monday ruled that the provision of the False Claims Act allowing whistleblowers to bring suits on behalf of the federal government is unconstitutional, dismissing a closely watched Medicare Advantage fraud case and potentially upending a key federal enforcement tool.
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September 30, 2024
Calif. Sues Eureka Hospital For Denying Emergency Abortion
California on Monday sued Providence of St. Joseph Hospital in Eureka for denying an emergency abortion to a woman it diagnosed with a serious pregnancy complication and sending her off to a small community hospital with a bucket and towels.
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September 30, 2024
Takeda End Payors, Direct Buyers Win Antitrust Class Cert.
A New York federal judge Monday adopted a magistrate judge's recommendation to certify two classes of direct purchasers and end payors in consolidated antitrust actions accusing Takeda Pharmaceuticals Co. of unlawfully inflating the price of its diabetes treatment Actos by delaying entry of generic alternatives.
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September 30, 2024
Ga.'s 'Heartbeat' Abortion Ban Struck Down Once Again
Georgia residents had their legal access to abortion temporarily restored Monday as the state's so-called heartbeat abortion ban was again struck down by a judge whose previous move to block the 2019 law had been reversed by the state's highest court.
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September 30, 2024
J&J Backs Off 340B Rebate Plan Following Feds' Objections
Johnson & Johnson abandoned its plan Monday to offer rebates rather than upfront discounts for two medications under the 340B drug pricing law, contending it had no choice after a federal agency threatened to impose excessive penalties.
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September 30, 2024
Physician Assistant Seeks Lenient Term In $10M Fraud Case
A North Carolina physician assistant is looking to spend just one year behind bars after a federal jury in Charlotte found him guilty of rubber-stamping bogus prescriptions for genetic testing, marking a far cry from prosecutors' requested nine-year prison sentence.
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September 27, 2024
Texas AG Wants Austin's Abortion Travel Fund Shut Down
Texas Attorney General Ken Paxton on Friday accused the city of Austin of illegally using taxpayer funds to cover travel costs for people traveling out of the Lone Star State to get abortions, claiming that the city is misappropriating the funds in violation of the state constitution.
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September 27, 2024
Kappos' Bayh-Dole Warning To Clients Draws Debate
An advocate for lowering drug prices squared off Friday against a former U.S. Patent and Trademark Office director about the potential risk of accepting government funds to develop drugs, as part of a discussion at New York University School of Law.
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September 27, 2024
Acadia To Pay $19.9M For Alleged Inpatient Billing Scheme
Acadia Healthcare will pay $19.85 million to settle allegations it billed false claims to the federal government for medically unnecessary behavioral health services provided to patients who weren't even eligible for treatment, the U.S. Department of Justice announced.
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September 27, 2024
Why Many Drugs Remain Pricey 40 Years After Hatch-Waxman
In the four decades since Congress passed the Hatch-Waxman Act in an effort to make generic drugs more available, the pharmaceutical industry has used patent thickets, "evergreening" and pay-for-delay tactics to block competition and keep prices of life-saving specialty drugs astronomical, several legal experts told Law360, while the industry argues other parties shoulder more of the blame.
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September 27, 2024
MetLife's 3rd Circ. Win Won't Stop ERISA Health Fee Suits
The Third Circuit's recent decision upholding MetLife's escape from a lawsuit accusing the company of pocketing $65 million in pharmacy rebates instead of using the funds to lower employee healthcare costs hands additional authority over to employers facing a new wave of class action litigation over excessive health fees, attorneys say.
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September 27, 2024
Medical Equipment Co., Founder Settle FCA Suit For $20M
A Florida-based medical equipment company and its founder will pay $20 million to settle claims under the federal False Claims Act that they improperly billed government healthcare plans for duplicated and unnecessary sales of devices meant to offer pain relief through electrical stimulation, Pennsylvania prosecutors said Friday.
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September 26, 2024
Virtua Discriminates Against Pregnant Patients, NJ Alleges
Virtua Health discriminates against pregnant patients by forcing them to undergo drug testing for inpatient admission to its hospitals — a policy that does not apply universally to other patients, New Jersey Attorney General Matthew J. Platkin alleged in a lawsuit filed Thursday in New Jersey state court.
Expert Analysis
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FDA's Recent Litigation Records Are Strong, But Imperfect
The U.S. Food and Drug Administration has notched its share of litigation wins in recent years thanks to a number of key advantages, but the FDA has been less successful in certain highly visible arenas, Jonathan Berman and Colleen Heisey at Jones Day.
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5 Steps For Healthcare Companies After Biden's AI Order
Rather than simply monitoring for the issuance of agency guidelines on artificial intelligence in the wake of President Joe Biden's October executive order, health and life sciences companies should take action now and begin building internal operational and technical infrastructures designed to govern the use of AI, says Joy Sharp at Faegre Drinker.
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Giving The Gov't Drug Patent March-In Authority Is Bad Policy
The Biden administration's recent proposal to allow government seizure of certain taxpayer-funded drug patents is a terrible idea that would negate the benefits of government-funded research, to the detriment of patients and the wider economy, says Wayne Winegarden at Pacific Research Institute.
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How Clients May Use AI To Monitor Attorneys
Excerpt from Practical Guidance
Artificial intelligence tools will increasingly enable clients to monitor and evaluate their counsel’s activities, so attorneys must clearly define the terms of engagement and likewise take advantage of the efficiencies offered by AI, says Ronald Levine at Herrick Feinstein.
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When Patients Have Standing For Hospital Antitrust Suits
Brown v. Hartford Healthcare Corp., recently decided by a Connecticut state court, provides a useful examination of how antitrust standing issues may be analyzed when patients directly sue a healthcare system for anti-competitive conduct, says Charles Honart at Stevens & Lee.
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ESG Around The World: Singapore
Singapore is keen to establish itself as a leading international financial center and a key player in the sustainable finance ecosystem, and key initiatives led by its government and other regulatory bodies have helped the Asian nation progress from its initially guarded attitude toward ESG investment and reporting, say attorneys at Morgan Lewis.
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The Pop Culture Docket: Judge D'Emic On Moby Grape
The 1968 Moby Grape song "Murder in My Heart for the Judge" tells the tale of a fictional defendant treated with scorn by the judge, illustrating how much the legal system has evolved in the past 50 years, largely due to problem-solving courts and the principles of procedural justice, says Kings County Supreme Court Administrative Judge Matthew D'Emic.
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Performing Music Makes Me A Better Lawyer
The discipline of performing live music has directly and positively influenced my effectiveness as a litigator — serving as a reminder that practice, intuition and team building are all important elements of a successful law practice, says Jeff Wakolbinger at Bryan Cave.
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'Patient' Definition Ruling Raises Discount Drug Questions
A South Carolina federal court's recent decision in Genesis Health Care v. Becerra supports a broader definition of a "patient" eligible to receive discounted drugs under the Section 340B program, but raises a host of novel questions regarding how the decision will affect covered entities and enforcement actions, say attorneys at McDermott.
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Breaking Down High Court's New Code Of Conduct
The U.S. Supreme Court recently adopted its first-ever code of conduct, and counsel will need to work closely with clients in navigating its provisions, from gift-giving to recusal bids, say Phillip Gordon and Mateo Forero at Holtzman Vogel.
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Legal Profession Gender Parity Requires Equal Parental Leave
To truly foster equity in the legal profession and to promote attorney retention, workplaces need to better support all parents, regardless of gender — starting by offering equal and robust parental leave to both birthing and non-birthing parents, says Ali Spindler at Irwin Fritchie.
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Activist Short-Sellers Are The Dark Knights Of Wall Street
While so-called activist short-sellers have been subject to increased scrutiny in recent years, these investors work in the shadows like Batman to expose fraud on Wall Street, often generating leads that may move regulators to take action, say attorneys at Labaton Sucharow.
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Steps Toward A Unified Health Financing System For Calif.
A new law authorizes the secretary of the California Health and Human Services Agency to move forward with designing a unified healthcare financing system, though the notable absence of healthcare payers in the law's list of specified stakeholders raises questions about the state's position regarding private payer options, says Ima Nsien at Squire Patton.