Policy & Compliance
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March 25, 2025
UBH Patients On Remand, CMS Audits And J&J Investor Suit
Patients challenging United Behavioral Health coverage guidelines for mental health treatment filed their first brief in the case since the Ninth Circuit clarified the scope of the remanded proceedings.
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March 25, 2025
Anthem Can't Escape Family's Mental Health Parity Claims
Anthem Blue Cross Blue Shield must face a Virginia family's claim that the company violated a federal benefits law by refusing to cover an adolescent girl's stay in a residential mental health facility, with a Virginia federal judge deeming the suit strong enough to survive a dismissal motion Tuesday.
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March 25, 2025
Trans Military Ban Rests On 'Unconvincing' Proof, Judge Says
A Washington federal judge hinted Tuesday he might block the Trump administration's ban on transgender troops later this week, expressing doubt that the U.S. Department of Defense has evidence to back its stance that gender dysphoria alone makes people unfit for military service.
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March 25, 2025
ND Justices Weigh Liberty Rights In Abortion Ban Challenge
North Dakota's top court on Tuesday wrestled with whether a recently passed anti-abortion law violates personal liberty rights and questioned both sides about the meaning of exceptions to the ban written into the law.
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March 25, 2025
Amid Abortion Fight, Idaho Bolsters Moral Objection Rights
A new law in Idaho — already the epicenter of a national clash over emergency abortion care — expands the conscientious objection rights of doctors and health professionals.
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March 25, 2025
Antitrust In Healthcare: 3 Cases To Watch
Amid a Congressional probe into a long-standing antitrust exemption for a national medical resident matching system, a handful of healthcare groups are in court with allegations that trade organizations have violated antitrust laws.
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March 25, 2025
Experts Warn Of 'Slippery Slope' In Judge Shopping Sanctions
A federal judge's judge shopping sanctions on lawyers challenging an Alabama transgender care ban were unusually harsh, legal experts said, and raise concerns about a chilling effect on advocates litigating similar cases in other jurisdictions.
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March 25, 2025
BU Law Prof On The Evolution Of Med Mal Standard Of Care
Boston University law professor Christopher Robertson talks about the American Law Institute's first update on medical malpractice law in 60 years and the state law evolution towards a “reasonable” care standard.
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March 25, 2025
Hartford HealthCare Fights Disclosure Of Antitrust Settlement
Hartford HealthCare Corp. says it cannot be forced to reveal a confidential January antitrust settlement with another Connecticut hospital at the behest of a Teamsters health plan and a public transit agency separately accusing the consortium of creating a monopoly.
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March 25, 2025
Unnecessary Surgeries Drive Rare Va. Hospital Criminal Case
An unusual indictment in Virginia details grave allegations against a former doctor, including unnecessary surgeries and bogus cancer diagnoses. With former OB-GYN Javaid Perwaiz already in federal prison, the hospital where many of the procedures occurred is now facing criminal charges.
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March 24, 2025
Trump Picks Acting CDC Head After Weldon Nomination Fails
President Donald Trump on Monday nominated acting Centers for Disease Control and Prevention head Susan Monarez to take over as the agency's director, a move that comes after Trump pulled his nomination of Dr. Dave Weldon for the position when it became clear Weldon lacked needed support.
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March 24, 2025
Wells Fargo Prescription Cost Suit Axed Over Standing
Wells Fargo has beaten back allegations that it violated federal benefits law by letting workers on its healthcare plan overpay for prescription drugs, with a Minnesota federal judge ruling Monday that the ex-workers behind the proposed class action lacked standing to sue.
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March 24, 2025
Investors Blame Electrotherapy Co.'s Practices For Stock Drop
Electrotherapy device maker Zynex Inc. faces a proposed investor class action claiming it harmed shareholders after it was booted from at least one insurer network for U.S. military members, allegedly due to oversupplying its customers.
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March 24, 2025
Patients Say UBH Limits On Mental Health Violated ERISA
Employee health benefit plan participants who sought coverage for mental health and substance use disorder treatments from United Behavioral Health urged a California federal court to rule that the company violated federal benefits law by implementing overly restrictive guidelines, arguing the insurer's interest in narrowing coverage wrongly limited patients' access.
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March 24, 2025
Residents Rip Hospital Co.'s 'Scorched-Earth' Sanctions Bid
A proposed class of Connecticut residents pursuing antitrust claims against Hartford HealthCare Corp. slammed the company's bid to sanction them for seeking judicial enforcement of a document exchange deal the parties had reached, arguing that sanctions would only complicate discovery rather than help it along.
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March 21, 2025
Judge Says Anti-Abortion Group's Clinic Blockades Are Illegal
A New York federal judge ruled Thursday that an anti-abortion group violated federal and New York state laws prohibiting interference with reproductive health services, saying evidence made clear group members physically obstructed access to three reproductive health care clinics in New York City.
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March 21, 2025
Novartis Urges Court To Make FDA Block Entresto Generic
Novartis says the U.S. Food & Drug Administration has made a drug marketing exclusivity window "meaningless" and wants a D.C. federal judge to block a rival from selling a generic drug that would compete with its blockbuster heart medication Entresto.
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March 21, 2025
NC Top Court Revives Constitutional Claim In Forced Vax Suit
The North Carolina Supreme Court Friday partially revived a family's lawsuit alleging a 14-year-old was given a COVID-19 vaccine without his parents' consent, saying a federal law that shields certain activity aimed at resolving the spread of disease during a public health emergency covers tort injuries, not state constitutional violations.
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March 21, 2025
New Mexico Lawmakers Approve Medical Psilocybin Bill
New Mexico lawmakers have given final approval to legislation to create a regulated medical psilocybin program, sending the proposal to the governor's desk.
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March 21, 2025
Idaho Hospital Wins Reprieve From State Abortion Ban
Idaho's near-total abortion ban "must yield" to a federal requirement that doctors provide emergency abortions for pregnant women facing severe injuries, an Idaho federal judge ruled.
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March 20, 2025
Texas Says Planned Parenthood Can't Get Atty Immunity
Texas has urged the full Fifth Circuit to reconsider a panel's decision concluding that Planned Parenthood is entitled to attorney immunity in a whistleblower suit accusing the organization of improperly billing Medicaid programs, saying state-law attorney immunity doesn't apply.
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March 20, 2025
8th Circ. Won't Pause FTC's Insulin Pricing Case
The Eighth Circuit refused Thursday to pause the Federal Trade Commission's in-house case accusing Caremark Rx, Express Scripts and OptumRx of artificially inflating insulin prices while the pharmacy benefit managers challenge the constitutionality of the proceedings.
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March 20, 2025
MiMedx Challenges FDA Classification Of Wound Care Powder
Biomedical company MiMedx Group urged a Georgia federal judge on Thursday to overturn the U.S. Food and Drug Administration's classification of a wound care treatment as a biological product, arguing the agency misapplied its own regulations.
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March 20, 2025
4th Circ. Seems Open To Reviving Pregnant Worker's Bias Suit
The Fourth Circuit seemed receptive Thursday to a former hospital worker's argument that she was unlawfully fired for a pregnancy-related disability, pondering whether the lower court had relied on an outdated interpretation of disability bias law when it tossed her case.
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March 20, 2025
6th Circ. Judge Skeptical Of Mich. Newborn Screening Ruling
A Sixth Circuit panel questioned Thursday if Michigan's practice of holding onto blood samples collected through a newborn health screening program violates parents' rights to make medical decisions for their children, with one judge saying he didn't see evidence for that proposition.
Expert Analysis
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Drug Kickback Ruling Will Make FCA Liability Harder To Prove
The First Circuit's ruling in U.S. v. Regeneron Pharmaceuticals, requiring the government to prove but-for causation to establish False Claims Act liability based on violations of the Anti-Kickback Statute, raises the bar for FCA enforcement and deepens a circuit split that the U.S. Supreme Court may need to resolve, say attorneys at Baker Donelson.
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Assessing PE Risk After Mass. False Claims Act Amendments
A law recently passed in Massachusetts amends the commonwealth's False Claims Act by dramatically expanding potential liability for private equity firms and investors, underscoring the importance of robust diligence and risk assessments for private equity firms conducting transactions in the commonwealth, say attorneys at Gibson Dunn.
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What Trump Actions Mean For Federal Research Funding
New guidance from the National Institutes of Health represents a massive policy shift regarding federal funding for researchers at institutions of higher education, contributing to a perfect storm of significant resource shortfalls in upcoming years, say attorneys at Arnold & Porter.
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A Look At Healthcare Transaction Oversight In Oregon
Understanding Oregon's enforcement authority and its impact on proposed transactions last year provides a road map to the state's plans to strengthen its processes this year, though enforcement could be challenged by ongoing litigation, say attorneys at Ropes & Gray.
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Rethinking 'No Comment' For Clients Facing Public Crises
“No comment” is no longer a cost-free or even a viable public communications strategy for companies in crisis, and counsel must tailor their guidance based on a variety of competing factors to help clients emerge successfully, says Robert Bowers at Moore & Van Allen.
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High Court Must Acknowledge US History Of Anti-Trans Laws
Despite Justice Amy Coney Barrett's claim to the contrary during oral arguments in U.S. v. Skrmetti, U.S. governments at every level have systematically discriminated against transgender people, and the U.S. Supreme Court must consider this historical context in upcoming cases about transgender issues, says Paisley Currah at the City University of New York.
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The Fate Of Biden-Era Clinical Study Guidance Under Trump
Draft guidance about the study of sex and gender differences in medical product development issued by the outgoing Biden administration currently faces significant uncertainty and litigation potential due to the Trump administration's executive orders and other actions, say attorneys at Arnold & Porter.
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10 Issues To Watch In Aerospace And Defense Contracting
This year, in addition to evergreen developments driven by national security priorities, disruptive new technologies and competition with rival powers, federal contractors will see significant disruptions driven by the new administration’s efforts to reduce government spending, regulation and the size of the federal workforce, say attorneys at Thompson Hine.
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Dispelling 10 Myths About Health Provider-Based Compliance
Congress appears intent on requiring hospitals to submit provider-based attestations for all off-campus outpatient hospital locations, so now is the time for hospitals to prepare for this change by understanding common misconceptions about provider-based status and proactively correct noncompliance, say attorneys at McDermott.
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A Look At HHS' New Opinion On Patient Assistance Programs
A recent advisory opinion from the U.S. Department of Health and Human Services' Office of Inspector General follows a recent trend of blessing patient assistance program arrangements that implicate the Anti-Kickback Statute, as long as they are structured with appropriate safeguards to minimize the risk of fraud and abuse, say attorneys at Sheppard Mullin.
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2 Anti-Kickback Developments Hold Lessons For Biopharma
The U.S. Department of Justice's Anti-Kickback Statute settlement with QOL Medical and a favorable advisory opinion from the U.S. Department of Health and Human Services provide a study in contrasts, but there are tips for biopharma manufacturers trying to navigate the vast compliance space between them, says Mary Kohler at Kohler Health Law.
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Tips For Pharma-Biotech Overlap Reporting In New HSR Form
While there’s no secret recipe for reporting overlaps to the Federal Trade Commission in the new Hart-Scott-Rodino Act form, there are several layers of considerations for all pharma-biotech companies and counsel to reflect on internally before reporting on any deal, say attorneys at A&O Shearman.
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A Look At Drug Price Negotiation Program's Ongoing Impact
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.