Policy & Compliance

  • May 07, 2024

    MultiPlan, Insurance Cos. Accused Of Algorithmic Collusion

    A medical provider has lodged a proposed class action in Illinois federal court accusing MultiPlan and major insurance companies, including UnitedHealth, Aetna, Kaiser Permanente and Cigna, of using pricing tools to systematically underpay out-of-network providers.

  • May 07, 2024

    Why Midwives Are Fighting Practice Limits Across The US

    Heather Swanson has long hoped to use her training to help pregnant people in Nebraska give birth safely in their homes but is blocked by state law. Today, she’s among a number of midwives battling laws they say unduly restrict skilled healthcare providers while maternity care "deserts” proliferate across the U.S.

  • May 07, 2024

    Rare Texas Discovery Rule Deployed In Abortion Travel Case

    A Lone Star State lawyer pursuing documents and depositions about an out-of-state abortion is relying on a quirk of Texas civil procedure allowing for pre-litigation discovery. The Arnold & Porter attorney representing the targets calls the move "a shot across the bow" meant to discourage women from exercising their rights.

  • May 07, 2024

    Wary Of 'Pharmacy Deserts,' Oregon Agency Eyes Grocer Deal

    A new Oregon board focused on healthcare consolidation has the power to shape a divisive mega-deal between the Kroger and Albertsons grocery chains some fear would create "pharmacy deserts." Some experts think it could further entangle an agreement between chains that together fill a third of all prescriptions in the state.

  • May 07, 2024

    20 Years Ago, One Case Opened Up Billions In FCA Liability

    On the 20-year anniversary of a landmark whistleblower case, attorneys look back on how Franklin v. Parke-Davis shaped the healthcare landscape, put Boston on the map as a hotbed of False Claims Act litigation and changed the drug industry's off-label marketing practices.

  • May 07, 2024

    DOJ Inks FCA, Opioid-Branding Enforcement Settlements

    The U.S. Department of Justice has been busy over the past week settling a variety of False Claims Act claims as well as a case against a pharmaceutical company for allegedly violating the Food, Drug and Cosmetic Act with deceptive opioid marketing.

  • May 07, 2024

    9th Circ. Asks Idaho To Define 'Recruit' In Abortion Travel Ban

    A Ninth Circuit panel grappled Tuesday with an Idaho law that makes it a criminal offense to help minors travel out of state to receive abortions without parental permission, with one judge struggling to understand what it means to "recruit" a pregnant teen to get an abortion under the law.

  • May 07, 2024

    Gov't Seeks Early Win In Ga. Medicaid Expansion Suit

    The Biden administration is urging a federal judge to take its side in a lawsuit in which Georgia is attempting to keep its Medicaid program for low-income residents running until 2028, arguing that the state never properly asked for a program extension and that the court lacks jurisdiction to extend its end date.

  • May 06, 2024

    Judge Trims ESOP Valuation Suit Against Healthcare Co.

    A California federal judge has trimmed a lawsuit against KPC Healthcare Inc., its employee stock ownership plan committee and its investment manager Alerus Financial alleging that a sale of company stock was mismanaged.

  • May 06, 2024

    UChicago Can't Ditch Data Sharing Privacy Claim

    A University of Chicago Medical Center patient accusing the hospital of illegally sharing her and other patients' identifying information with Meta can pursue her claims that the info sharing constitutes a federal wiretap violation, an Illinois federal judge said.

  • May 06, 2024

    Hooper Lundy Adds Government Relations Director

    An attorney who worked in-house for healthcare industry trade and advocacy associations has joined healthcare boutique Hooper Lundy & Bookman PC as director of government relations and public policy.

  • May 03, 2024

    Ala. High Court Won't Rethink Decision On Frozen Embryos

    The Alabama Supreme Court on Friday refused to revisit its February decision finding that frozen embryos count as children, a first-of-its-kind decision that has been received as potentially ruinous for in vitro fertilization services in the Yellowhammer State.

  • May 03, 2024

    Aetna To Pay $2M To End LGBTQ Fertility Coverage Suit

    A group of Aetna policyholders said Friday that the insurance giant has agreed to pay $2 million and revise certain health insurance guidelines to settle a proposed class action alleging its definition of infertility made it difficult and expensive for LGBTQ couples to obtain coverage for fertility treatments.

  • May 03, 2024

    Ohio Statehouse Catch-Up: Trans, Abortion Laws Face Battles

    Ohio lawmakers have shepherded controversial bills impacting healthcare, social media and other matters into law in recent months, prompting lawsuits and even a veto from Gov. Mike DeWine.

  • May 03, 2024

    6 States Strike $270M Opioid Deal With Amneal

    The New York state attorney general on Friday said that a $270 million multistate deal had been reached with opioid manufacturer Amneal Pharmaceuticals for its role in the addiction epidemic over allegations that the company failed to report suspicious orders of the narcotics.

  • May 02, 2024

    7th Circ. Mostly Backs Ill. Home Health Kickbacks Judgment

    The Seventh Circuit on Thursday largely left intact an Illinois federal judge's $6 million ruling that a home health care company broke federal kickback laws, refusing to reverse the lower court's liability finding but directing it to ensure its damages award was calculated correctly.

  • May 02, 2024

    Endo Judge Hopes Criminal Sentence Warns Opioid Makers

    A Michigan federal judge said Thursday she hoped Endo's criminal sentence for falsely advertising a pain medication as "abuse deterrent" would itself be a deterrent for other opioid makers, as she accepted the company's recent $200 million settlement deal with federal prosecutors. 

  • May 02, 2024

    Feds Call Out Gilead's Efforts To Revise HIV Drug IP Judgment

    The U.S. Department of Justice has asked a Delaware federal judge to reject Gilead Sciences' motion to modify a judgment finding that two medications in its HIV prevention regimen directly infringe voided patents owned by the government, arguing that the pharmaceutical company's attempt to rewrite the judgment is "unnecessary as well as improper."

  • May 02, 2024

    Lawmaker Wants Antitrust Probe Of Health Insurance Data Co.

    Sen. Amy Klobuchar, D-Minn., is calling for antitrust enforcers to investigate concerns that MultiPlan and other healthcare data companies are hurting competition by helping health insurers effectively collude when making pricing decisions.

  • May 02, 2024

    Biden Announces $3B To Fund Lead Pipe Replacement

    The Biden administration is distributing $3 billion to states so they can replace lead water pipes that pose a health risk to those who rely on them for drinking water, as part of the larger goal to remove all lead service lines nationwide.

  • May 02, 2024

    State Legislators Urge Feds To Change Cannabis' Status

    A coalition of state lawmakers on Thursday urged the heads of the U.S. Department of Justice and its drug enforcement agency to prioritize changing cannabis' status as a highly restricted drug.

  • May 01, 2024

    Sens. Slam UnitedHealth's Security Lapses, Breach Response

    UnitedHealth's top executive faced heavy criticism during his first appearance before a U.S. Senate committee since a cyberattack rocked its Change Healthcare subsidiary, with lawmakers blasting the company for lacking basic security measures and for still not being able to confirm the scale and scope of the incident.

  • May 01, 2024

    Ariz. AG Warns Repeal Of 1864 Abortion Ban May Be Too Late

    Legislation narrowly adopted Wednesday to repeal Arizona's 1864 abortion law won't be enough on its own to keep the near-total ban from taking effect this summer, the state attorney general warned, because the bill lacks an emergency clause.

  • May 01, 2024

    J&J Unit Cuts Deal To End Cancer Drug Trade Secret Fight

    A New Jersey federal judge has signed off on a consent judgment that permanently bars Chinese drugmaker Jiangsu Hengrui Pharmaceuticals Co. from misappropriating Johnson and Johnson's pharmaceutical subsidiary Janssen's trade secrets for its popular chemotherapy drug Yondelis.

  • May 01, 2024

    5th Circ. Judge Skeptical Of Medicare Drug 'Price-Setting'

    A Fifth Circuit judge on Wednesday sharply criticized the Biden administration's Medicare drug pricing program, characterizing it as government "price-setting" and questioning "what possible procompetitive justification" there can be for penalizing companies that don't participate.

Expert Analysis

  • When Calif. Health Shield Law Reaches Beyond State Borders

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    In light of California's newly signed shield law to increase protections for reproductive health and gender-affirming care, it's important to understand how the law's covered services and key legal protections could affect patients and providers nationwide, says Natalie Birnbaum at Nelson Hardiman.

  • FDA's Lab-Developed Test Rule Faces High Hurdles

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    The U.S. Food and Drug Administration's recently announced plans to explicitly regulate lab-developed tests will likely face resistance from industry stakeholders and congressional actions, and lead to significant litigation, say attorneys at Hogan Lovells.

  • FTC's Health Co. Suit Indicates Agency's Private Equity Focus

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    The Federal Trade Commission's latest lawsuit against an anesthesia company and its private equity investor highlights the agency's willingness to regulate the health care industry even when relevant acquisitions are relatively dated or when the controlling entity's economic interest is under 50%, say attorneys at Simpson Thacher.

  • What Marijuana Status Change Would Mean For Industry

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    If the Drug Enforcement Administration accepts the U.S. Department of Health and Human Services’ recent recommendation to change marijuana’s classification under federal law, it would be a significant regulatory shift that could foster many industry benefits — but questions, risks and uncertainties at both the state and federal levels would remain, say attorneys at Neal Gerber.

  • Top 4 Antitrust Enforcement Issues In Health Care Today

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    The Federal Trade Commission's recent lawsuit against U.S. Anesthesia Partners exemplifies antitrust enforcement authorities' efforts to aggressively reshape the health care industry, ranging from new proposed rules to withdrawals of previous guidance, say attorneys at Fried Frank.

  • Calif. Climate Disclosure Bills Promise Challenges For Cos.

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    Two novel climate disclosure bills recently passed by the California Legislature will pose challenges for many businesses — especially private companies that are less familiar with climate-related reporting obligations — and will require investments of significant time and effort in processes, procedures and personnel, say John Rousakis and Chris Bowman at O'Melveny.

  • Maximizing Law Firm Profitability In Uncertain Times

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    As threats of an economic downturn loom, firms can boost profits by embracing the power of bottom-line management and creating an ecosystem where strategic financial oversight and robust timekeeping practices meet evolved client relations, says Shireen Hilal at Maior Strategic Consulting.

  • 5th Circ. Ruling Reminds Attys That CBP Can Search Devices

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    The Fifth Circuit’s recent Malik v. Department of Homeland Security decision adds to the chorus of federal courts holding that border agents don’t need a warrant to search travelers’ electronic devices, so attorneys should consider certain special precautions to secure privileged information when reentering the U.S., says Jennifer Freel at Jackson Walker.

  • ESG Around The World: European Union

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    As the EU makes ESG regulation a priority, companies — both those based in the EU and others just doing business there — need to keep abreast of myriad new legislation that has either already taken effect or will in the near future, as noncompliance could result in fines, damages and director liability, say attorneys at Steptoe & Johnson.

  • Avoiding The Ethical Pitfalls Of Crowdfunded Legal Fees

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    The crowdfunding of legal fees has become increasingly common, providing a new way for people to afford legal services, but attorneys who accept crowdsourced funds must remember several key ethical obligations to mitigate their risks, say Hilary Gerzhoy and Julienne Pasichow at HWG.

  • 4 Pharma Industry Arguments Against CMS Drug Pricing Plan

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    The Centers for Medicare & Medicaid Services is facing significant pushback regarding its plans for implementing the Inflation Reduction Act's Medicare drug price negotiation program, due to a number of potential repercussions for manufacturers, say attorneys at Mintz Levin.

  • Issues Ahead As Psychedelic Medicine Faces Pivotal Moment

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    Recent regulatory changes and decriminalization efforts have opened doors for research and development in psychedelic medicine, but challenges like stigma, access and funding persist, meaning companies will need to address these issues to support the industry’s credibility, say consultants at FTI Consulting.

  • An Overview Of 6 PBM Bills Moving Through Congress

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    As legislators turn to pharmacy benefit manager reform as a potential next step in addressing the cost of prescription drugs, six congressional committees have recently advanced PBM-related legislation with generally high bipartisan support, suggesting that a final package is likely to advance through Congress, say Rachel Stauffer and Katie Waldo at McDermott+Consulting.