Policy & Compliance
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October 10, 2025
Ex-Casino CEO's ERISA Fight Against ND Tribe Gets Trimmed
A North Dakota federal judge trimmed a suit by the ex-CEO of a tribe-owned casino who alleged his healthcare benefits were cut off following a period of leave, finding the court lacked jurisdiction over common law claims, but claims under federal benefits law were sufficiently backed up to reach discovery.
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October 09, 2025
Aetna Inks ERISA Deal Over Nixed Spinal Surgery Claims
Aetna has agreed to pay a class of health plan members up to $55,000 each to resolve their suit alleging their coverage claims for lumbar disk replacement surgeries were wrongfully denied, amounting to a deal worth millions of dollars, according to a California federal court filing.
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October 09, 2025
ADA Doesn't Stop At Prison Gates, 3rd Circ. Says In Reversal
The Third Circuit ordered a lower court to accept an incarcerated man's amended Americans with Disabilities Act lawsuit against a Pennsylvania prison that he says denied him proper medical treatment when a spinal cord injury left him paralyzed in his cell.
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October 09, 2025
San Antonio Abandons Out-Of-State Abortion Travel Appeal
The city of San Antonio on Thursday conceded defeat in its request for court approval to go forward with a program that included funding for out-of-state travel for abortions, handing a victory to the state's attorney general.
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October 08, 2025
Chancery Extends Pause On Hospital Board Law Challenge
The pause on ChristianaCare's lawsuit in Delaware Chancery Court against state officials in which it's challenging legislation that created a state-appointed board to review and approve hospital budgets was extended four months Wednesday to allow more time for the sides to reach a settlement.
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October 08, 2025
$20M Deal Over Wash. Hospital Wage Claims Gets Final OK
A Washington state judge has given the final sign-off on a $20 million deal resolving a class action alleging that the state of Washington, doing business as the University of Washington Medical Center, shortchanged healthcare workers by rounding their hours worked and denying them second meal breaks on longer shifts.
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October 08, 2025
Arnall Golden Sanctioned For Giving Feds ERISA Suit Docs
A California federal judge has ordered Arnall Golden Gregory LLP to pay a $50,000 penalty for giving the U.S. Department of Labor confidential documents United Behavioral Health turned over in a class action accusing the insurer of overcharging workers for out-of-network substance use disorder treatments.
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October 08, 2025
Trump Admin Challenges Denial Of Trans Care Subpoena
The Trump administration told a Massachusetts federal judge that he got it wrong in quashing a subpoena for records of gender-affirming care at Boston Children's Hospital last month, urging the court to reconsider.
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October 07, 2025
Aetna COVID-19 Test Provider Sues Insurer For 'Unpaid' $53M
A Nebraska company that provided COVID-19 testing for Aetna has filed suit in California federal court, alleging that the insurer owes it more than $53 million for testing services but has refused to pay up.
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October 07, 2025
Bausch And Teva Blocked Cheaper IBS Drug, Retailers Say
A slew of retailers on Tuesday accused Bausch Health Cos. Inc. and Teva Pharmaceuticals of working together to keep the generic version of an irritable bowel syndrome drug off the market until 2028, forcing the retailers and other purchasers of the drug to pay monopoly prices.
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October 07, 2025
As Shutdown Continues, Hospital Attys Face Tired Clients
As the government shutdown passes the one-week mark, hospital administrators facing potential financial hits and other heartache from the battle on Capitol Hill are getting tired.
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October 07, 2025
4th Circ. Urged To Reverse $10M Medicare Fraud Conviction
A former physician's assistant on Tuesday requested that the Fourth Circuit reverse a six-year prison sentence for his involvement in a $10 million Medicaid fraud scheme, claiming evidence that could exonerate him was suppressed by a federal district court.
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October 07, 2025
DOJ Deal In Medicare Fraud Case A 'Slap On The Wrist'
Healthcare startup Troy Medicare had big ambitions to revolutionize senior care in the Medicare Advantage market before justice officials learned that thousands of people were being fraudulently enrolled. A former Troy board member calls the company’s nonprosecution agreement a “slap on the wrist.”
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October 07, 2025
Drug Tax Outdoes Biblical Punishment, 5th Circ. Judge Says
A Fifth Circuit panel pressed the U.S. Department of Health and Human Services to justify the basis for the Medicare drug pricing program's steep excise tax, asking Tuesday whether the government had ever levied a higher tax in the nation's history.
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October 07, 2025
9th Circ. Rejects 'Kitchen Sink' Challenge To Vaccine Mandate
A Ninth Circuit panel on Monday upheld a lower court's rejection of a lawsuit brought by dozens of former employees of a nonprofit healthcare system who claimed Washington state's requirement that healthcare workers be vaccinated against COVID-19 violated their statutory and constitutional rights.
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October 07, 2025
Northwestern Wants ERISA Health Offering Suit Tossed
Northwestern University asked an Illinois federal judge on Monday to throw out a proposed class action alleging it breached fiduciary duties in offering a higher-cost health plan alongside a cheaper option, arguing the plaintiffs have failed to allege injury because they admit that they received all the benefits to which they were entitled under the more-expensive plan's terms.
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October 07, 2025
Arizona Ruling Delivers Trans Victory Amid Federal Scrutiny
A recent court order that bars Arizona from requiring proof of surgery before transgender people can change a birth certificate continues a trend of courts making it easier to amend vital records to match a person's gender identity.
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October 07, 2025
AGs Rip DOJ Bid To Pause Planned Parenthood Funding Suit
The U.S. Department of Justice wants to use the ongoing government shutdown as a "shield" to stop a group of states from seeking an injunction against a halt to Medicaid funding for Planned Parenthood, the states told a Massachusetts federal judge in opposing a possible pause on their lawsuit.
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October 07, 2025
Colo. Drug Board First To Cap Drug Price, Likely Not The Last
Colorado's drug price regulation board put a first-of-its-kind cap on a pricey autoimmune disease drug. Law360 Healthcare Authority breaks down the Colorado announcement and other moves by state regulators.
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October 07, 2025
Justices Probe Standard Of Care In 'Conversion Therapy' Case
The U.S. Supreme Court on Tuesday wrestled with whether gay "conversion" therapy banned by a Colorado law is a medical treatment that falls outside the accepted standard of care, or whether it's protected First Amendment speech.
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October 07, 2025
2nd Circ. Rules Inmates Not Entitled To Specific Gender Care
A Second Circuit panel has overturned a transgender inmate's partial win in a lawsuit against prison officials in Connecticut over allegedly inadequate gender dysphoria treatment, holding that the defendants are entitled to qualified immunity and that "inmates have no clearly established right to be treated by gender-dysphoria specialists" or receive specific treatments for the condition.
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October 07, 2025
3rd Circ. Won't Rehear J&J Investor Cert. Appeal
The U.S. Court of Appeals for the Third Circuit declined Tuesday to reconsider backing a New Jersey federal judge's class certification order in a Johnson & Johnson investor action alleging the company artificially inflated its stock price by failing to disclose cancer risks.
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October 07, 2025
Approach The Bench: Judge Kaplan On Suit Against The Gov't
U.S. Court of Federal Claims Judge Elaine Kaplan's docket doesn't always garner attention in the same way trial court cases do, but that may change as the executive branch makes sweeping budget and policy changes that could lend more political significance to monetary claims against the government.
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October 07, 2025
EMTs Appeal Losses Ahead Of False Death Declaration Trial
First responders facing trial for declaring a woman dead, only for a funeral home to discover she was alive, are urging a Michigan state appeals court to review what they say are "contradictory legal frameworks" imposed by a judge ahead of trial.
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October 07, 2025
La. Challenges Mail-Order Access To Abortion Medication
The state of Louisiana on Monday sued federal regulators for expanding access to the abortion medication mifepristone under the Biden administration, alleging the removal of an in-person dispensing requirement allows the drug to be mailed illegally into anti-abortion states.
Expert Analysis
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Takeaways From DOJ's 1st Wage-Fixing Jury Conviction
U.S. v. Lopez marked the U.S. Department of Justice's first labor market conviction at trial as a Nevada federal jury found a home healthcare staffing executive guilty of wage-fixing and wire fraud, signaling that improper agreements risk facing successful criminal prosecution, say attorneys at McGuireWoods.
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Deregulation Memo Presents Risks, Opportunities For Cos.
A recent Trump administration memo providing direction to agencies tasked with rescinding regulations under an earlier executive order — without undergoing the typical notice-and-review process — will likely create much uncertainty for businesses, though they may be able to engage with agencies to shape the regulatory agenda, say attorneys at Blank Rome.
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The IRS Shouldn't Go To War Over Harvard's Tax Exemption
If the Internal Revenue Service revokes Harvard's tax-exempt status for violating established public policy — a position unsupported by currently available information — the precedent set by surviving the inevitable court challenge could undercut the autonomy and distinctiveness of the charitable sector, says Johnny Rex Buckles at Houston Law Center.
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New Hospice Regulations Should Enforce Core Principles
As the U.S. Department of Health and Human Services' Office of Inspector General prepares to research and expand on oversight of Medicare hospice care, the OIG should keep in mind certain core principles, such as an emphasis on preventing the entry of hospices that raise red flags, says Bill Dombi at Arnall Golden.
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7 Considerations For Conducting Drug Clinical Trials Abroad
With continuing cuts to U.S. Food and Drug Administration staffing motivating some pharmaceutical companies to consider developing drugs abroad, it's important to understand the additional risks and compliance requirements associated with conducting clinical studies in other countries, say attorneys at Morgan Lewis.
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Compliance Lessons From Warby Parker's HIPAA Fine
The U.S. Department of Health and Human Services' civil money penalty against Warby Parker highlights the emerging challenges that consumer-facing brands encounter when expanding into healthcare-adjacent sectors, with Health Insurance Portability and Accountability Act compliance being a potential focus of regulatory attention, say attorneys at Saul Ewing.
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5th Circ. Ruling Is Latest Signal Of Shaky Qui Tam Landscape
In his recent concurring opinion in U.S. v. Peripheral Vascular Associates, a Fifth Circuit judge joined a growing list of jurists suggesting that the False Claims Act's whistleblower provisions are unconstitutional, underscoring that acceptance of qui tam relators can no longer be taken for granted, say attorneys at Miller & Chevalier.
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Medicare Advantage Enforcement Strong Amid Agency Cuts
The second Trump administration's actions thus far suggest that Medicare Advantage enforcement remains a bipartisan focus despite challenges presented by evolving trends in federal agency staffing and resources, say attorneys at Ropes & Gray.
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A New Tool For Assessing Kickback Risks In Health Marketing
The Seventh Circuit's recent decision in U.S. v. Sorensen, reversing a conviction after trial of a durable medical equipment distributor, highlights two principle considerations for determining whether payments to marketers in healthcare are unlawful under the Anti-Kickback Statute, says Elisha Kobre at Sheppard Mullin.
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How Trump Orders Affect Health Orgs.' Care For Trans Minors
Two recent executive orders issued by President Donald Trump regarding gender-affirming care for minors have put healthcare organizations in a precarious situation, and these institutions should prepare for various implications and potential scenarios, say attorneys at ArentFox.
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Reproductive Health Under Trump So Far, And What's Next
Based on priorities stated so far, the Trump administration will likely continue to weaken Biden-era policies that protect reproductive health, with abortion, in vitro fertilization and contraception all being issues to watch closely amid a post-Dobbs shift, say attorneys at McDermott.
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What's Next For Lab Test Regulation Without FDA Authority
A recent Texas federal court decision vacating the U.S. Food and Drug Administration's final rule that would apply FDA regulations to laboratory-developed tests signals potential positive impacts in the diagnostic space, and could inspire more healthcare entities to litigate against the government, say attorneys at Hooper Lundy.
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6 Criteria Can Help Assess Executive Branch Actions
With new executive policy changes announced seemingly every day, several questions can help courts, policymakers and businesses determine whether such actions are proper, effective and in keeping with our democratic norms, say Marc Levin and Khalil Cumberbatch at the Council on Criminal Justice.