Policy & Compliance
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May 06, 2025
What's Ahead For FDA Enforcement: 3 Things To Watch
Companies regulated by the FDA should remain vigilant and expect scrutiny under the new Trump administration, not just from the agency itself but also from DOJ officials, the plaintiffs bar and others, attorneys at a boutique firm say.
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May 06, 2025
Battle Brewing In Michigan Over Nurse Practice Expansion Bill
Facing a doctor shortage, Michigan lawmakers are considering a bill that would allow nurse practitioners to treat patients without oversight from a licensed doctor. The effort is already receiving pushback from the state's medical board.
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May 06, 2025
UBH Can't Escape Residential Treatment Coverage Suit
United Behavioral Health can't dodge a proposed class action claiming it used restrictive guidelines and bundled reimbursement requests to deny claims for residential mental health treatment, with a California federal judge saying plan participants' allegations were detailed enough to stay in court.
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May 06, 2025
How A Small Pa. Firm Defended A Huge Fraud Case
When attorneys at Grail Law took on representation of one of three defendants facing trial for their purported roles in a $22 million healthcare fraud, the team knew it was up against the federal government's robust resources, and in a case that had already netted a string of guilty pleas.
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May 06, 2025
Buchanan Adds Senate Health Policy Vet To Gov't Practice
Buchanan Ingersoll & Rooney PC has hired the majority staff director of the U.S. Senate's Health, Education, Labor and Pensions Committee who aided Republican lawmakers, including its chair, Sen. Bill Cassidy, in advancing health policy legislation.
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May 06, 2025
Trump Orders FDA To Speed Up Drug Plant Approvals
President Donald Trump directed the U.S. Food and Drug Administration to cut the approval timelines for new manufacturing facilities by domestic drugmakers and also to pressure foreign drugmakers to comply with quality control inspections, according to a recent executive order.
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May 06, 2025
Ind. Hospital Merger Hits 'Public Advantage' Law Roadblock
Opposition from Indiana's top law enforcement official to the combination of Terre Haute's only two hospitals could spell the end to the hotly contested deal.
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May 06, 2025
New AG, Same DOJ Stance On Whistleblower Law
The Trump administration's forceful defense of the qui tam provisions of the False Claims Act is significant but not surprising, given the government's increasing reliance on whistleblowers to thwart fraud and abuse.
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May 05, 2025
Columbia Inks $750M Settlement Over OB-GYN Sex Abuse
A New York state court on Monday signed off on a $750 million settlement secured by hundreds of patients who say they were sexually abused by a former Columbia University obstetrician-gynecologist, according to an announcement by the patients' attorneys.
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May 05, 2025
DC Circ. Has Doubts About Narcolepsy Drug Appeal
The D.C. Circuit is now set to decide whether the U.S. Food and Drug Administration was wrong to declare a rival narcolepsy treatment not the "same drug" as another produced by Jazz Pharmaceuticals Inc., after appearing highly skeptical of the drug company's arguments that it was.
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May 05, 2025
High Court Urged To Back HHS Authority On Preventive Care
The federal government urged the U.S. Supreme Court on Monday to overturn a Fifth Circuit ruling that found the U.S. Department of Health and Human Services' secretary lacked authority over a preventive healthcare services task force, arguing the HHS secretary's oversight stemmed from multiple laws and precedent.
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May 05, 2025
UnitedHealth Tells Court Not To Review Special Master Report
A special master rightly determined that no reasonable jury could render a verdict for the U.S. Department of Justice in a massive False Claims Act case targeting Medicare Advantage plans operated by UnitedHealth, the health insurance company told a D.C. federal judge.
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May 05, 2025
Trump Admin Urges Dismissal Of States' Abortion Pill Suit
The Trump administration on Monday asked a Texas federal judge to dismiss a lawsuit seeking to roll back access to the abortion medication mifepristone, contending the three states pursuing the case waited too long to file and are suing in the wrong jurisdiction.
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May 05, 2025
Wash. Panel Quizzes State In Biologist's Vax Mandate Case
Washington appellate judges hinted on Monday they might revive an ex-state biologist's suit claiming she was wrongfully denied a religious accommodation to keep her position without getting the COVID-19 vaccination, citing factual questions as to whether her job duties were essential and whether she was technically fired.
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May 05, 2025
Fla. Judge Wants Briefs In ACA Trans Health Fight
A Florida federal judge Monday requested briefing from the U.S. Department of Health and Human Services and the state of Florida on how to handle a suit challenging the Biden administration's regulations clarifying gender identity-based discrimination under the Affordable Care Act.
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May 05, 2025
20 AGs Sue To Stop 'Illegal Dismantling' Of HHS
Twenty attorneys general sued the Trump administration Monday in Rhode Island federal court alleging that massive cuts to the U.S. Department of Health and Human Services violate the Constitution and usurp congressional authority.
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May 05, 2025
Fed. Circ. Affirms Coverage Denial Over Pre-Service Surgery
A lower court did not err when it upheld the denial of a Navy veteran's shoulder disability claim based on a surgery that he had before entering the service, a Federal Circuit panel ruled.
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May 05, 2025
Kaiser Permanente Escapes 401(k) Forfeiture Suit, For Now
A California federal judge tossed a proposed class action alleging Kaiser Permanente misspent forfeitures from an employee 401(k) plan, concluding the allegations failed to state a claim for a violation of federal benefits law.
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May 05, 2025
Novartis, Incyte Settle Drug Royalty Fight On Eve Of Trial
A Manhattan federal judge put off trial on Monday in a five-year quest by Novartis to recover what it says are $500 million in missing royalties from its agreement to commercialize an Incyte compound used to treat blood cancers, with the sides announcing they reached a settlement.
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May 02, 2025
Fla. Lawmakers Vote To Repeal Law That Limits Death Suits
Florida lawmakers have voted to do away with a statute that plaintiffs attorneys say unfairly and arbitrarily limits pain-and-suffering damages in fatal medical malpractice cases, but an attorney representing healthcare providers says that repealing the law will cause a flood of new lawsuits.
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May 02, 2025
Ill. Judge Questions Legal Theory In Multiplan Pricing MDL
An Illinois federal judge handling multidistrict litigation accusing Multiplan of conspiring with insurers to fix out-of-network reimbursement rates seemed unsure Friday that a viable antitrust theory is at play, saying the plaintiffs' alleged market dynamic seems similar to various individuals independently deciding to hire the same "really good painter."
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May 02, 2025
Boston Scientific, FDA Sued Over 'Unsafe' Spinal Implant
Boston Scientific evaded safety regulations to market a defective spinal cord stimulator and the U.S. Food and Drug Administration rubber-stamped those alterations in an instance of "agency capture," according to a California federal lawsuit filed by a patient suffering from ongoing pain after the device was implanted.
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May 01, 2025
Planned Parenthood Slams HHS 'Attacks' On Teen Program
Planned Parenthood on Thursday pressed a D.C. federal court to block the U.S. Department of Health and Human Services' "attacks" on a long-running, successful public health initiative aimed at preventing teen pregnancy, claiming that HHS has implemented new, "deeply inconsistent" requirements threatening the program's funding.
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May 01, 2025
Aetna And Humana Accused Of Medicare Kickbacks And Bias
The federal government brought a bombshell False Claims Act suit Thursday against Aetna, Elevance and Humana, claiming the insurers paid hundreds of millions of dollars in illegal kickbacks to brokers in exchange for enrollments into their Medicare Advantage plans, with Humana and Aetna also accused of discriminating against disabled beneficiaries.
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May 01, 2025
HHS Report Finds 'Serious Concerns' On Trans Care For Youth
The U.S. Department of Health and Human Services on Thursday released a report it says raises "serious concerns" about medical interventions used to aid young people in gender transition.
Expert Analysis
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What To Expect From 'Make America Healthy Again' Actions
The Make America Healthy Again Commission recently established by President Donald Trump and chaired by Robert F. Kennedy Jr. will potentially bring energy and attention to important public health topics, and stakeholders should be aware of pathways for sharing their input and proactively informing proceedings, says Nicholas Manetto at Faegre Drinker.
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How Citizen Petitions Have Affected Drug Competition
In light of recent citizen petitions and proposed legislation regulating such petitions, Omar Robles at Managing Health analyzes the statistics of the extent to which citizen petitions have been filed, and to what extent they have delayed competition in prescription pharmaceuticals.
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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.