Policy & Compliance
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March 28, 2025
NC Biz Court Bulletin: TikTok Duel Heats Up, NIL Suit Plays On
In March, the North Carolina Business Court readied for trial in an insurance coverage dispute involving Smithfield Foods, heard why TikTok is subject to the state's jurisdiction, and allowed the Cardiac Pack's NIL suit against the NCAA to proceed while a parallel case plays out.
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March 27, 2025
Diopsys Inks $14M Deal Resolving Vision Testing FCA Claims
Medical device maker Diopsys Inc. has agreed to pay up to $14.25 million to put to rest allegations it violated the False Claims Act by submitting false Medicare and Medicaid claims for certain vision testing services, according to a U.S. Department of Justice announcement Thursday.
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March 27, 2025
DC Judge Seems Open To Fired Inspectors' Reinstatement Bid
A D.C. federal judge on Thursday questioned whether it would make practical sense to reinstate eight inspectors general fired by President Donald Trump while signaling openness to the federal watchdogs' argument that the president must follow the legally mandated process before they can be terminated.
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March 27, 2025
Fertility Co. Wants To Pull Device Maker Into Negligence SuitÂ
A fertility products company wants two other companies to share potential liability from a Connecticut state lawsuit alleging that a recalled culture medium was responsible for the loss of embryos a couple were planning to use for in vitro fertilization.
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March 27, 2025
Feds Allowed To Weigh In On MultiPlan Pricing MDL
The federal government will be allowed to appear in multidistrict antitrust litigation targeting MultiPlan's out-of-network reimbursement rates to offer input on the legal framework for analyzing claims involving the joint use of algorithms, a practice it says poses "a growing threat" to free market competition.
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March 27, 2025
FCA Suit Alleging Unnecessary Spinal Surgeries Avoids Dismissal
A Washington federal judge declined Wednesday to toss the state and federal government's suit alleging a hospital operator made millions of dollars by submitting false claims to Medicaid and Medicare for medically unnecessary surgical procedures.
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March 27, 2025
Walgreens To Pay $2.8M For Alleged Medicaid Overcharges
Walgreens will pay $2.8 million under an agreement with federal prosecutors to settle allegations that it submitted inflated prices for some generic medications to Medicaid programs in Massachusetts and Georgia.
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March 27, 2025
DOJ's Antitrust Unit Targeting Anticompetitive Regulations
The U.S. Department of Justice launched a task force on Thursday aimed at eliminating state and federal laws and regulations that are hindering competition, with an initial focus on key sectors including housing, food and transportation.
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March 27, 2025
EMS Co. Accused Of Failing To Pay Proper Overtime
A private ambulance company has been hit with a proposed class action in Georgia federal court over allegations that it failed to pay workers overtime wages as required by the Fair Labor Standards Act.
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March 27, 2025
HHS To Cut 10,000 Jobs As RFK Jr. Reorganizes Agency
The U.S. Department of Health and Human Services said Thursday that it would lay off 10,000 employees as part of a "dramatic" plan to restructure the agency and downsize its workforce by about 24%.
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March 26, 2025
Sotomayor Urges Caution On Nondelegation Doctrine Revamp
U.S. Supreme Court Justice Sonia Sotomayor cautioned her colleagues during oral arguments Wednesday against using a challenge to the Federal Communications Commission's administration of a broadband subsidy program as a way to resurrect the long-dormant nondelegation doctrine. Several conservative justices, however, seemed willing to disregard that admonition.
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March 26, 2025
Healthcare Providers To Pay $63M Over False Spinal Diagnoses
California-based Seoul Medical Group, its healthcare management service unit and a radiology center will pay $62.85 million to settle allegations they submitted bogus spinal condition diagnoses to the Centers for Medicare and Medicaid Services to maximize their revenue, federal prosecutors announced Wednesday.
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March 26, 2025
Feds Seek 2 Years For Device-Maker's $2.4M Tax Evasion
A Floridian who made millions of dollars on medical devices and pled guilty to evading $2.4 million in taxes should be sentenced to between 24 and 30 months in prison for tax evasion based on the severity of his offense, the U.S. told a federal court Wednesday.
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March 26, 2025
AGs Seek 1st OK For $39M Apotex Deal In Price-Fixing Case
A coalition of 50 state attorneys general on Wednesday asked a Connecticut federal judge to accept a $39.1 million deal settling claims that pharmaceutical company Apotex Corp. schemed with others to fix generic-drug prices, with 70% earmarked for a restitution fund and 30% for consumer notices and attorney fees.
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March 26, 2025
False COVID Cure Claims No Longer Feds' 'Current Priority'
The Trump administration has abandoned another case targeting allegedly false claims that an over-the-counter product could treat, or even cure, COVID-19 by dropping its case against a one-man herbal tea operation.
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March 26, 2025
Hospital To Face Doctor's Libel Claim Over Suspension Report
A North Carolina federal judge has dismissed claims for breach of good faith and emotional distress from a gynecological oncologist's defamation suit against the hospital where he used to work, but let libel and loss of job opportunity claims continue in line with a magistrate judge's recommendation.
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March 26, 2025
BCBS Settlement Opt-Outs Ordered To Disclose Funding Deals
Four law firms representing hospitals that opted out of the landmark $2.8 billion Blue Cross Blue Shield antitrust settlement must disclose whether their clients were motivated by a "quick payment" from litigation funders, an Alabama federal judge ordered Tuesday.
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March 26, 2025
Ex-CEO Says McGuireWoods Can't Rehash Immunity Appeal
McGuireWoods LLP and one of its former partners are rehashing immunity defenses in a last-ditch effort to dodge a long-running defamation case, the former CEO of a managed care organization told the North Carolina Court of Appeals in seeking to have the case kicked back down to the trial court.
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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.
Expert Analysis
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A Changing Regulatory Landscape For Weight Loss Drugs
As drugs originally approved to treat diabetes become increasingly popular for weight loss purposes, federal and state regulators and payors are increasing their focus on how these drugs are prescribed, and industry participants should pay close attention to rapidly evolving compliance requirements, say attorneys at Goodwin.
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Opioid Suits Offer Case Study In Abatement Expert Testimony
Settlements in the opioid multidistrict litigation provide useful insight into leveraging expert discovery on abatement in public nuisance cases, and would not have been successful without testimony on the costs necessary to lessen the harms of the opioid crisis, says David Burnett at DiCello Levitt.
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How HHS Discrimination Rule Affects Gender-Affirming Care
The U.S. Department of Health and Human Services' new final rule, which reinterprets the Affordable Care Act's anti-discrimination provision, greatly clarifies protections for gender-affirming care and will require compliance considerations from sponsors and administrators of most group health plans, say attorneys at McDermott.
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FTC Noncompete Rule's Impact On Healthcare Nonprofits
Healthcare entities that are nonprofit or tax-exempt and thus outside of the pending Federal Trade Commission noncompete rule's reach should evaluate a number of potential risk factors and impacts, starting by assessing their own status, say Ben Shook and Tania Archer at Moore & Van Allen.
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Key Takeaways From FDA Final Rule On Lab-Developed Tests
Michele Buenafe and Dennis Gucciardo at Morgan Lewis discuss potential consequences of the U.S. Food and Drug Administration's recently finalized rule regulating lab-developed tests as medical devices, and explain the rule's phaseout policy for enforcement discretion.
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Assessing HHS' Stance On Rare Disease Patient Assistance
The U.S. Department of Health and Human Services' recent advisory opinion, temporarily blessing manufacturer-supported copay funds for rare disease patients, carves a narrow path for single-donor funds, but charities and their donors may require additional assistance to navigate programs for such patients, says Mary Kohler at Kohler Health Âé¶¹´«Ã½.
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Are Concessions In FDA's Lab-Developed Tests Rule Enough?
Although the U.S. Food and Drug Administration's new policy for laboratory-developed tests included major strategic concessions to help balance patient safety, access and diagnostic innovation, the new rule may well face significant legal challenges in court, say Dominick DiSabatino and Audrey Mercer at Sheppard Mullin.
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8 Questions To Ask Before Final CISA Breach Reporting Rule
The Cybersecurity and Infrastructure Security Agency’s recently proposed cyber incident reporting requirements for critical infrastructure entities represent the overall approach CISA will take in its final rule, so companies should be asking key compliance questions now and preparing for a more complicated reporting regime, say Arianna Evers and Shannon Mercer at WilmerHale.
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Mid-2024 FCA Enforcement And Litigation Trends To Watch
Reviewing notable False Claims Act trends and enforcement efforts in the last year and a half reveals that healthcare is a key enforcement priority for the U.S. Department of Justice, and the road ahead may bring clarification on Anti-Kickback Statute causation and willfulness standards, along with increased focus on private equity, cybersecurity and self-disclosure, say attorneys at Epstein Becker.
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Online Portal Helps Fortify Feds' Unfair Health Practices Fight
The Federal Trade Commission, U.S. Justice Department and the U.S. Department of Health and Human Services recently launched an online portal where the public can report potentially unfair healthcare practices, effectively maximizing enforcers' abilities to police anti-competitive actions that can drive up healthcare costs and chill innovation, say attorneys at Seyfarth.
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McKesson May Change How AKS-Based FCA Claims Are Pled
The Second Circuit’s analysis in U.S. v. McKesson, an Anti-Kickback Statute-based False Claims Act case, provides guidance for both relators and defendants parsing scienter-related allegations, say Li Yu at Dicello Levitt, Ellen London at London & Stout, and Erica Hitchings at Whistleblower Âé¶¹´«Ã½.
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9th Circ. Ruling Puts Teeth Into Mental Health Parity Claims
In its recent finding that UnitedHealth applied an excessively strict review process for substance use disorder treatment claims, the Ninth Circuit provided guidance on how to plead a Mental Health Parity and Addiction Equity Act violation and took a step toward achieving mental health parity in healthcare, says Mark DeBofsky at DeBofsky Âé¶¹´«Ã½.
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Breaking Down DOJ's Individual Self-Disclosure Pilot Program
The U.S. Department of Justice’s recently announced pilot program aims to incentivize individuals to voluntarily self-disclose corporate misconduct they were personally involved in, complementing a new whistleblower pilot program for individuals not involved in misconduct as well as the government's broader corporate enforcement approach, say attorneys at Paul Weiss.