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Policy & Compliance

  • April 28, 2025

    NC Dentist Acquitted Of $3M Fraud, Tax Evasion Charges

    A North Carolina dentist was acquitted of wire fraud and tax evasion charges on the fourth day of a federal jury trial in which prosecutors had alleged the dentist submitted false loan applications to the Small Business Administration and failed to pay income taxes.

  • April 28, 2025

    Mich. Nurses Quit Claims Of Pay Withheld For Breaks Untaken

    Two registered nurses agreed to drop their claims of unpaid wages against the two locations of a Michigan healthcare system they had accused in federal court of requiring them to work through meal breaks without pay, ending the case Monday in federal court.

  • April 28, 2025

    2nd Circ. Upholds Clinic Manager's Repeat Charges For Fraud

    A decision that allowed the federal government to reindict a health clinic manager for a Medicare and tax fraud scheme can stand, a Second Circuit panel found Monday, agreeing with the lower court that his offenses were serious enough to permit it.

  • April 28, 2025

    Red States Want ACA Trans Health Rule Permanently Off Books

    A group of 15 red states that successfully got a Biden-era rule frozen that protected gender-affirming care under the Affordable Care Act have urged a Mississippi federal judge to rule the U.S. Department of Health and Human Services overstepped its authority and cannot require states to allow gender-affirming care for transgender people.

  • April 25, 2025

    HHS Sued Over Withholding Of $65.8M In Title X Funding

    The U.S. Department of Health and Human Services unlawfully withheld $65.8 million in federal grants for critically needed family planning services, a nonprofit alleged in a suit filed Thursday in D.C. federal court, saying the withholding seemed to be based, in part, on grantees' support for diversity, equity and inclusion.

  • April 25, 2025

    Justices Want More Info On HHS Authority In Task Force Row

    The U.S. Supreme Court on Friday ordered the federal government and a group of Texas businesses and individuals to compile more information as to whether the U.S. Department of Health and Human Services secretary has the authority to appoint members of a task force under the Affordable Care Act.

  • April 25, 2025

    Sutter Health To Pay $228M In Years-Old Antitrust Suit

    A class of millions of health insurance premium payors asked a California federal judge Friday to greenlight an eleventh-hour $228.5 million settlement resolving their long-running claims that hospital chain Sutter Health drives up costs by pushing all-or-nothing network deals on insurers.

  • April 25, 2025

    Refusing Mental Healthcare Means Liability, Pa. Justices Rule

    Physicians in Pennsylvania can be held liable for turning away a mental health patient who goes on to harm someone if that patient came to the hospital asking for help, the state Supreme Court ruled Friday.

  • April 25, 2025

    HHS Says Cuts Target Excess After Judge Seeks More Info

    The U.S. Department of Health and Human Services told a Rhode Island federal judge that a group of states has no basis to challenge the cancellation of billions in grants supporting public health programs because they already received the funds appropriated to them by Congress.

  • April 25, 2025

    Trans Prisoners Fight For Care Over New White House Hurdles

    After staff at a New Jersey federal prison told Alishea Sophia Kingdom that, due to an executive order by President Donald Trump, she would no longer be receiving hormone therapy to treat gender dysphoria, Kingdom lodged the latest in a series of suits against the Federal Bureau of Prisons that contend following the executive order violates the Eighth Amendment's prohibition of cruel and unusual punishment.

  • April 25, 2025

    Organ Donor Network Wants Veteran's Waitlist Bias Suit Axed

    The United Network for Organ Sharing asked a Georgia federal court to toss a lawsuit filed against it and several university medical schools over allegations that they delayed a Black military veteran's ability to receive a kidney transplant by artificially inflating his kidney function scores.

  • April 25, 2025

    DOD To Assess Tricare Program Competition In Ga. And Fla.

    The U.S. Department of Defense has awarded contracts to CareSource Military and Veterans to compete with managed care support contractors in delivering health, medical and administrative support services to eligible Tricare beneficiaries in the Atlanta and Tampa markets. 

  • April 25, 2025

    2nd Circ. Says Withdrawn Application Dooms Age Bias Suit

    The Second Circuit refused to reopen a sleep doctor's lawsuit claiming a hospital refused to consider him for a job because he was 66 years old, saying his decision to turn down an interview after receiving a misaddressed email doomed his case.

  • April 25, 2025

    5 Issues Benefits Attys Want The Gov't To Shed Light On

    The first three months of President Donald Trump's administration have left lawyers who represent employers and benefit plans hungry for clarity on issues like cryptocurrency as a 401(k) investment and coverage for gender-affirming care. Here, Âé¶¹´«Ã½360 looks at five areas where attorneys are hoping for guidance or regulations.

  • April 24, 2025

    Ex-Pain Clinic Owner Gets 3½ Years For Drug Test Scheme

    The former owner of a Pennsylvania pain management practice has been sentenced to three-and-a-half years in prison for conspiring with others to defraud Medicare by submitting unnecessary urine drug tests for chronic opioid patients at his medical clinics.

  • April 24, 2025

    'Egregious' Delays Wipe Out Ga. Health Fraud Case

    A Georgia federal judge on Thursday dismissed an eight-year-old case over alleged Medicaid fraud, calling the government's delays in bringing three healthcare executives to trial "egregious" and noting that the alleged criminal conduct took place between 12 and 25 years ago.

  • April 24, 2025

    No Greece Trip For Ex-Conn. Official Facing Corruption Cases

    A Connecticut federal judge on Thursday denied a former state official's request to take a trip to Greece amid two indictments, an order that came the day after the government opposed the plan.

  • April 24, 2025

    Polsinelli Gains 2 Healthcare Shareholders In Denver

    Polsinelli PC announced this week that it has brought two Denver-based attorneys from Husch Blackwell LLP and the U.S. Food and Drug Administration to its healthcare practice, which the firm says gained six new shareholders in the past 12 months, not including these most recent additions.

  • April 24, 2025

    Harvard Seeks To Move 'Swiftly' In $2B Fund Freeze Suit

    Harvard University is seeking to move as quickly as possible to get to the merits of its suit challenging the Trump administration's $2.2 billion funding freeze, asking a Massachusetts federal judge to expedite discovery and briefing.

  • April 24, 2025

    Workplace Screening Co. To Pay $8M For False Billing Claims

    Vault Medical Services will pay $8 million to resolve allegations that it knowingly submitted false reimbursement claims for providing COVID-19 testing and other pandemic-related services to a federal program designated for uninsured patients.

  • April 23, 2025

    11th Circ. Considers Timeliness Of J&J Pelvic Mesh Claims

    An Alabama couple urged the Eleventh Circuit on Wednesday to revive their lawsuit over injuries allegedly caused by pelvic mesh manufactured by Ethicon Inc. and its parent Johnson & Johnson, arguing that a district court wrongly found their claims were time-barred.

  • April 23, 2025

    Feds Oppose Ex-Conn. Official's 'Troubling' Greece Trip Plan

    Federal prosecutors on Wednesday opposed a twice-indicted ex-Connecticut budget official's request to spend six weeks in Greece visiting family as he awaits twin corruption trials, citing a skipped deadline to relinquish guns and the risk that he might use Greek citizenship to evade justice.

  • April 23, 2025

    Genetic Testing Co., Marketer Settle FCA Case For $6M

    A genetic testing company, marketing firm, and their top executives have agreed to pay $6 million to resolve the government's allegations that they billed Medicare for unnecessary medical tests, in violation of the False Claims Act.

  • April 23, 2025

    Eli Lilly Sues 4 Telehealth Cos. For Weight Loss Drug Copies

    Eli Lilly filed a new round of lawsuits Wednesday over the compounding of its popular weight loss drugs Mounjaro and Zepbound, accusing four telehealth companies of making copies of the medications while alleging that two companies violated laws requiring doctors to make medical decisions, not corporations. 

  • April 22, 2025

    Free Speech Experts Question DOJ Letter To Medical Journal

    A federal prosecutor's letter to a medical journal skeptically asking about its commitment to nonpartisan debate is an unusual intrusion into editorial decision-making and may interfere with the publication's First Amendment rights, free speech experts say.

Expert Analysis

  • Incoming Admin May Shake Up Life Sciences Regulation

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    Though President-elect Donald Trump has not yet articulated policy priorities regarding the life sciences industry, the sector is positioned to see significant changes that could affect everything from drug exclusivity and generic drug approvals, to the availability of over-the-counter drugs, to laboratory-developed tests and digital health, say attorneys at Morgan Lewis.

  • Navigating DOJ's Patchwork Whistleblower Regime

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    In the past few months, the U.S. Department of Justice and several individual U.S. attorney’s offices have issued different pilot programs aimed at incentivizing individuals to blow the whistle on misconduct, but this piecemeal approach may create confusion and suboptimal outcomes, say attorneys at BakerHostetler.

  • What To Expect Next From Federal Health Tech Regulation

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    Healthcare organizations should pay close attention to federal health information technology regulators' recent guidance concerning barriers to accessing electronic health information, which signals that more enforcement in this area is likely forthcoming, say attorneys at Ropes & Gray.

  • 5 Areas Congress May Investigate After GOP Election Wins

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    With Republicans poised to take control of Congress in addition to the executive branch next year, private companies can expect an unprecedented uptick in congressional investigations focused on five key areas, including cryptocurrency and healthcare, say attorneys at Cahill Gordon.

  • Takeaways From State Votes On Abortion In The 2024 Election

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    Attorneys at Epstein Becker discuss how 10 states voted on ballot initiatives to either protect or restrict access to abortion in the 2024 general election, and analyze overarching trends.

  • Loper Bright Offers New Materiality Defense To FCA Liability

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    The U.S. Supreme Court's decision in Loper Bight Enterprises v. Raimondo, ending Chevron deference, may have created a new defense to False Claims Act liability by providing the opportunity to argue that a given regulation is not material to the government's payment decision, says Tanner Cook at Husch Blackwell.

  • How Expanded Birth Control Coverage May Affect Employers

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    Employers should consider the potential impact of recently proposed regulations that would expand group health plans' required coverage of preventive services and contraceptives, including questions about how the agencies would implement their plans to eliminate the prescription requirement and alter the exceptions process, says Jennifer Rigterink at Proskauer.

  • Legislation Most Likely To Pass In Lame Duck Session

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    As Congress begins its five-week post-election lame duck session, attorneys at Greenberg Traurig break down the legislative priorities and which proposals can be expected to pass.

  • Preserving The FCA Is Crucial In Trump's 2nd Term

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    While the Trump administration may pursue weaker False Claims Act enforcement, it remains an essential tool in safeguarding public funds and maintaining corporate accountability, so now is not the time to undermine ethical behavior, or reduce protections and incentives for whistleblowers, says Adam Pollock at Pollock Cohen.

  • PREVAIL Bill Is Another Misguided Attempt To Restrict PTAB

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    The decade-long campaign against the U.S. Patent and Trademark Office's Patent Trial and Appeal Board — currently focused on the PREVAIL Act that's slated for markup in the Senate — is not really about procedural issues, and it is not aimed at securing more accurate patentability decisions, says Clear IP's Joseph Matal, former acting director at the USPTO.

  • Justices Face Tough Question On HHS Hospital Pay Formula

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    In Advocate Christ Medical Center v. Becerra, the U.S. Supreme Court will determine whether the U.S. Department of Health and Human Services properly applied certain Medicare reimbursement adjustments to hospitals — a decision that could significantly affect hospitals' ability to seek higher Medicare reimbursement for low-income patients, say attorneys at Sheppard Mullin.

  • Key Healthcare Issues That Hinge On The Election Outcome

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    The 2024 presidential race, while not heavily dominated by healthcare issues compared to past elections, holds significant implications for the direction of healthcare policy in a potential Harris or Trump administration, encompassing issues ranging from Medicare to artificial intelligence, says Miranda Franco at Holland & Knight.

  • The Key To Solving High Drug Costs Is Understanding Causes

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    One-sided views on who or what contributes to the high cost of pharmaceuticals render possible solutions much harder to discover and implement, and a better approach would be to examine history and learn why costs have increased and what legislation has and hasn't helped, says Nancy Linck at NJ Linck Consulting.