Policy & Compliance
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January 30, 2025
DOJ Calls UnitedHealth Dismissal Bid A Discovery 'End Run'
The U.S. Department of Justice assailed UnitedHealth Group on Wednesday for "masquerading" a "premature" discovery bid as a motion to dismiss the government's Maryland federal court lawsuit challenging the $3.3 billion purchase of home health and hospice giant Amedisys Inc.
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January 30, 2025
RFK Blasts Industry 'Puppets' Amid HHS Nomination Fight
Robert F. Kennedy Jr. said Thursday that federal scientific panels are rife with conflicts of interest that have turned them into "sock puppets" for industry, as he faced a second day of intense questioning on Capitol Hill and sought support for his nomination as secretary of health and human services.
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January 29, 2025
Albertsons Must Face County's Opioid Nuisance Claims
Albertsons Cos. Inc. can't escape a Texas county's public nuisance claims stemming from opioid sales at the grocery giant's in-store pharmacies, an Ohio federal judge ruled Tuesday, saying there's a "common law duty of care" for pharmacies not to expose the county to a "reasonably foreseeable" risk of harm.
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January 29, 2025
Lab Co-Owner Gets 9 Years For $369M COVID Testing Scheme
The co-owner of a California medical laboratory was sentenced to nine years in prison after being accused of conspiring to defraud Medicare and private insurers out of $369 million by submitting claims for medically unnecessary tests during the COVID-19 pandemic emergency.
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January 29, 2025
White House Rescinds Trump's Spending Freeze
The White House on Wednesday rescinded a directive freezing federal funding, saying it wants to end litigation and confusion, but said the move will not end a review of spending to ensure compliance with a series of executive orders by the president.
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January 29, 2025
RFK Jr. Disputes Anti-Vax Label In HHS Confirmation Hearing
Robert F. Kennedy Jr. attempted Wednesday morning to convince Republican and Democratic lawmakers that he is not anti-vaccine, despite many of his past comments to the contrary, as he hopes to convince them to confirm his appointment as head of the U.S. Department of Health and Human Services.
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January 28, 2025
Trump Targets Gender-Affirming Care For Minors In New Order
President Donald Trump ordered federal agencies late Tuesday to take steps to halt gender-affirming care for minors, including by cutting off Medicaid and military health coverage for what he called a "stain on our nation's history."
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January 28, 2025
Minn. AG Settles Novo Nordisk Insulin Claims With Price Cap
Minnesota's attorney general has reached a settlement resolving a long-running lawsuit accusing Novo Nordisk of inflating insulin prices, with the company agreeing to a $35 per month cap on out-of-pocket costs for state residents.
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January 28, 2025
Wash. Judge Asks If Dr.'s Ivermectin Discipline Was Political
A Washington appellate judge asked Tuesday if a doctor who was disciplined by a medical board for prescribing the controversial drug ivermectin to COVID-19 patients was targeted for his political views, while another judge asked if "all lies" about medical information are protected speech.
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January 28, 2025
Questions To Watch For In RFK Jr.'s Confirmation Hearing
Robert F. Kennedy Jr. is set to appear on Capitol Hill as he tries to secure the top position at the U.S. Department of Health and Human Services. Here are some of the questions healthcare lawyers and others want to see addressed about his "Make America Healthy Again" pledge.
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January 28, 2025
Feds Say Health System Can't Ditch Fraud Suit Over Surgeries
The federal government and state of Washington urged a judge on Monday to allow their suit against a hospital operator to move forward, saying they have provided more than enough detail to support allegations that the health system knew a doctor was performing unnecessary surgeries.
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January 28, 2025
Trump's CMS Suit U-Turn, Sacklers Settle, And Trans Suit Stay
Law360 Healthcare Authority recaps the significant cases and decisions that shaped the healthcare industry over the past week, including the Trump administration’s reversal on a case challenging the Medicare Advantage star rating system, a freeze on a lawsuit over a Biden-era gender dysphoria rule, and the Sackler family’s $7.4 billion opioid settlement.
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January 28, 2025
Hospitals Brace For Immigration Agents, Legal Clashes
The Trump administration’s move to allow immigration enforcement at "sensitive" locations is pushing hospitals to scrutinize their legal obligations under HIPAA and other state and federal laws.
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January 28, 2025
CFPB's Medical Debt Rule In Peril Under Trump
A last-minute effort by the Biden administration to ease the burden of medical debt could face a perfect storm of regulatory and legal challenges under President Donald Trump, potentially quashing momentum to achieve relief for those saddled with unpaid healthcare bills.
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January 27, 2025
VA To Nix $6.1M In Contracts Under Trump's DEI Order
The U.S. Department of Veterans Affairs announced Monday that it has placed dozens of employees on paid leave and will cancel $6.1 million worth of contracts as part of efforts to root out diversity, equity and inclusion activities.
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January 25, 2025
Trump Revives Federal Anti-Abortion Policies
President Donald Trump issued two executive orders Friday targeting abortion inside and outside the United States, reinstating a ban on federal funding for certain international family planning groups and revoking a pair of Biden-era directives supporting abortion access.
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January 24, 2025
Anti-Abortion Group Seeks High Court Review Of NJ Probe
An anti-abortion pregnancy center operator wants the U.S. Supreme Court to revive its federal court challenge to a subpoena from the New Jersey attorney general that seeks information about its donors, urging the court in a petition for certiorari to resolve a legal "Catch-22."
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January 24, 2025
J&J Escapes Part Of Worker's Drug Benefits Suit, For Now
A suit alleging Johnson & Johnson overcharged employees through a prescription drug benefits program was partially tossed Friday, with a New Jersey federal judge ruling the suing worker failed to show the court could provide any remedies on her claims that plan members overpaid for medicine.
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January 24, 2025
Feds Drop HIPAA Charges Against Houston Surgeon
The federal government has dropped criminal charges against a Texas surgeon accused of improperly accessing patient information and sharing information about the hospital's gender-affirming care practices with the press.
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January 24, 2025
Employer Groups Back Tossing Pension Annuity Suit In NY
Three employer trade groups are backing Bristol-Myers Squibb and investment manager State Street as they fight claims brought by retirees of the pharmaceutical giant that the companies violated federal benefits law by converting workers' pension benefits into annuity insurance contracts.
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January 24, 2025
5th Circ. Upholds Tossing Medicare Rate Policy Challenge
A Fifth Circuit panel said it agrees with a Texas federal judge that a lawsuit brought by four anesthesia practices claiming a Centers for Medicare and Medicaid Services policy will cost them $4 million in reduced reimbursements is statutorily barred.
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January 24, 2025
Greenberg Traurig Health Ace Joins Polsinelli In LA
Polsinelli PC is expanding its California team, bringing in a Greenberg Traurig LLP healthcare corporate attorney as a principal in its Los Angeles office.
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January 24, 2025
Dentons Adds 2 Healthcare Attys From Katten In NY
Dentons announced that it has added two attorneys with extensive experience in Medicare and Medicaid reimbursement, regulatory compliance and False Claims Act defense as New York-based partners in its healthcare practice.
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January 23, 2025
Marlboro Smoker Was Target Of Deception, Jury Hears
Philip Morris targeted a Massachusetts preteen as a "replacement" customer for others who were dying of lung disease, a Springfield jury heard Thursday, though the company's lawyer said the woman had free will and knew enough to stop smoking.
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January 23, 2025
4th Circ. Reads Kickback Law Broadly In Loss For Big Pharma
The Fourth Circuit on Thursday affirmed a Virginia federal judge's ruling against a pharmaceuticals industry-backed charity looking to weaken the Anti-Kickback Statute, holding that a proposed program for helping patients cover the cost of drugs could indeed constitute a quid pro quo.
Expert Analysis
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FDA Warning Letter Tightens Reins On 'Research Only' Labels
A recent warning letter from the U.S. Food and Drug Administration to Agena Bioscience alleged the company’s diagnostic devices were labeled for research use only, but improperly promoted for human clinical purposes, signifying a reinforcement — and a potential narrowing — of the agency's policy on products labeled “research only,” say attorneys at Sheppard Mullin.
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First 10b5-1 Insider Trading Case Raises Compliance Issues
The ongoing case against former Ontrak CEO Terren Peizer is the U.S. Department of Justice's first insider trading prosecution based primarily on the filing of 10b5-1 plans, and has important takeaways for attorneys reviewing corporate policies on the possession of material nonpublic information, say attorneys at Cadwalader.
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Policy Misrepresentations Carry Insurance Rescission Risks
The Second Circuit's recent decision in Medical Mutual v. Gnik, finding that material misrepresentation in a clinic's insurance applications warranted policy rescission, is a clear example of the far-reaching effects that misrepresentations can have and provides a reminder that policyholders should employ relatively straightforward steps to decrease risks, say attorneys at Hunton.
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The Pros And Cons Of NIST's Proposed March-In Framework
Recent comments for and against the National Institute of Standards and Technology’s proposed guidance on march-in rights — which permit the government to seize federally funded patents — highlight how the framework may promote competition, but could also pose a risk to contractors and universities, say Nick Lee and Paul Ragusa at Baker Botts.
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2 Recent Suits Show Resiliency Of Medicare Drug Price Law
Though pharmaceutical companies continue to file lawsuits challenging the Inflation Reduction Act, which enables the federal government to negotiate for lower prescription drug prices, recent decisions suggest that the reduced drug prices are likely here to stay, says Jose Vela Jr. at Clark Hill.
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Defense Attys Must Prep For Imminent AI Crime Enforcement
Given recent statements by U.S. Department of Justice officials, white collar practitioners should expect to encounter artificial intelligence in federal criminal enforcement in the near term, even in pending cases, say Jarrod Schaeffer and Scott Glicksman at Abell Eskew.
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Lessons For Nursing Facilities From DOJ Fraud Settlement
The U.S. Department of Justice's recent settlement with the owner of skilled nursing and assisted living facilities in Florida provides a cautionary tale of potential fraud risks, and lessons on how facilities can mitigate government enforcement actions, say Callan Stein and Rebecca Younker at Troutman Pepper.
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HHS' Updated Tracking Tech Guidance Offers Little Clarity
The U.S. Department of Health and Human Services' Office for Civil Rights' updated guidance on the use of online tracking technologies appears more focused on legal issues raised in ongoing litigation with the American Hospital Association and less on practical guidance for covered entities, say attorneys at Sheppard Mullin.
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Takeaways From The 2023 DOJ Fraud Section Report
Attorneys at Wiley discuss notable trends from the U.S. Department of Justice's recently reported Fraud Section activity last year and highlight areas of enforcement to watch for in the future, including healthcare fraud and Foreign Corrupt Practices Act violations.
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NIST March-In Framework Is As Problematic As 2021 Proposal
While the National Institute of Standards and Technology's proposed march-in framework on when the government can seize patents has been regarded as a radical departure that will support lowering prescription drug costs, the language at the heart of it is identical to a failed 2021 notice of proposed rulemaking, says attorney Kelly Morron.
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Spartan Arbitration Tactics Against Well-Funded Opponents
Like the ancient Spartans who held off a numerically superior Persian army at the Battle of Thermopylae, trial attorneys and clients faced with arbitration against an opponent with a bigger war chest can take a strategic approach to create a pass to victory, say Kostas Katsiris and Benjamin Argyle at Venable.
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The Road Ahead For Florida's Drug Importation Program
Though the U.S. Food and Drug Administration approved Florida's drug importation program in January, a series of hurdles — including requisite buy-in from Canada — and potential legal challenges must be addressed before importation can begin, say attorneys at Ropes & Gray.
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Assessing CDC's Revised Guideline On Opioid Prescriptions
Kenneth Weinstein, Nicholas Van Niel and Kate Uthe at Analysis Group look at newly available data to evaluate the impact that the Centers for Disease Control and Prevention's revised opioid monitoring guideline have had on prescription trends in recent years, highlighting both specific and overall decreases.