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Policy & Compliance

  • April 09, 2025

    Mass. Justices Asked To Raise Bar For Pension, Benefit Loss

    Massachusetts' highest court was asked on Wednesday to adopt a more expansive interpretation of what constitutes cruel or unusual punishment or an excessive fine in the case of a former state trooper whose $1 million public pension and healthcare benefits were forfeited after his conviction in an overtime fraud case.

  • April 09, 2025

    2nd Circ. Allows Takeda To Appeal Actos Antitrust Class Cert.

    A split Second Circuit will allow Takeda Pharmaceuticals Co. to immediately appeal a New York federal judge's ruling certifying two classes of direct purchasers and end payors in consolidated antitrust actions accusing the company of unlawfully inflating the price of its diabetes treatment Actos by delaying the entry of generic alternatives.

  • April 09, 2025

    Fertility Care Concerns Linger As PWFA Regs Face Revision

    Efforts to pare down the U.S. Equal Employment Opportunity Commission's regulations requiring workplace accommodations for pregnancy-related conditions have centered largely on abortion, but experts warn that access to fertility treatment — which workers seek more frequently — may also become harder to get.

  • April 09, 2025

    Data Co. Can't Make DOL Accept Health Plan, Judge Says

    A data-mining company can't force the U.S. Department of Labor to acknowledge that a health insurance plan offered in exchange for participants' user data is covered by federal benefits law, a Texas federal judge ruled, saying the case's thin record prevented the court from deciding issues the Fifth Circuit told it to consider.

  • April 09, 2025

    Religious Mission Justifies Philly Injection Site, 3rd Circ. Told

    Counsel for a nonprofit seeking to open a safe injection site in Philadelphia told the Third Circuit Wednesday that it qualified as a religious organization immune from prosecution, despite not having any spiritual language in its incorporation documents.

  • April 08, 2025

    NJ Hospital Can Face Claims In Life Support Malpractice Suit

    A New Jersey appeals court won't let a hospital escape claims that it wrongfully took a patient off life support, saying Tuesday the trial court was too hasty in tossing the suit under the New Jersey Declaration of Death Act.

  • April 08, 2025

    Calif. Bill Aims To Limit Insurer Control Over Addiction Care

    A number of U.S. states have made it illegal for insurance providers to override a physician's judgment concerning the addiction treatments necessary for their patient, be it for inpatient care or other kinds of therapies. A recently introduced bill could make California the latest to join the trend.

  • April 08, 2025

    5th Circ. Orders New Trial In $140M Healthcare Fraud Case

    A Fifth Circuit panel shot down a bid from a suspect in a $140 million healthcare fraud scheme to forestall a second trial after alleged prosecutorial misconduct sank the first, finding the government hadn't intentionally withheld evidence.

  • April 08, 2025

    OIG Finds $1.8M Of Potential 'Overbillings' In VA Contract

    The Department of Veterans Affairs Office of Inspector General said Tuesday that a transportation services contractor may have overbilled the department by about $1.8 million over two years and recommended that VA contracting officials consider whether they could or should try to recover any money.

  • April 08, 2025

    Expert And 'Worthlessness Theory' Ejected In Valsartan MDL

    Patients and insurers who claim they were ripped off when purchasing the contaminated blood pressure medication Valsartan won't be able to argue that the drug was worthless as a matter of law, a New Jersey federal judge overseeing the multidistrict litigation has ruled, casting doubt that the plaintiffs will secure a full refund for their purchase.

  • April 08, 2025

    Medicare Drug Price Plan Tramples Constitution, 3rd Circ. Told

    New Jersey federal court rulings preserving the Centers for Medicare & Medicaid Services' ability to negotiate prices with drug companies should be overturned on constitutional grounds, pharmaceutical giants Novo Nordisk and Novartis told the Third Circuit during oral arguments Tuesday.

  • April 08, 2025

    UnitedHealth Puts Anesthesiologists' Antitrust Suit To Sleep

    A New York federal judge tossed an antitrust lawsuit accusing a United Healthcare unit of using its market power in the New York metropolitan area to cut reimbursement rates to anesthesia providers by 80% in its public-sector employee health plan, while enlisting MultiPlan to pressure providers into accepting the rates.

  • April 08, 2025

    Md. Board Enacts Expungement Rule For Physician Records

    Maryland doctors who have faced administrative action for failing to pay taxes or attend continuing education classes can have their public records wiped clean under a new rule from the state Board of Physicians.

  • April 08, 2025

    2nd Circ. Rejects Biden Diary Thief's Appeal Over Medical Info

    The Second Circuit denied an appeal on Tuesday from a woman who pled guilty to stealing a diary belonging to former President Joe Biden's daughter, rejecting her arguments that a judge was wrong to allow a probation officer to disclose her presentencing report and prior medical records to mental health providers without first obtaining consent.

  • April 07, 2025

    CMS' Nursing Home Staffing Requirements Struck Down

    A Texas federal judge on Monday struck down new staffing standards for nursing homes participating in Medicare or Medicaid, ruling that federal health officials overstepped their authority by establishing a one-size-fits-all requirement.

  • April 07, 2025

    Policy Group Tells 4th Circ. Drug Discount Law Needs Reform

    The Fourth Circuit on Monday allowed a Boston-based think tank to file an amicus brief supporting a district court's injunction against a West Virginia law that pharmaceutical companies and lobbyists claim unconstitutionally expands a federal drug discount program.

  • April 07, 2025

    Drug Buyers, Generics Cos. Fight Over Bellwether Litigation

    Generic drug buyers vied Friday with the pharmaceutical companies they've accused of price-fixing over how to shape the first rounds of long-gestating Pennsylvania federal court litigation that the plaintiffs want heard in separate consecutive trials and that the drugmakers want combined.

  • April 07, 2025

    AGs Announce $335M Opioid Deal With Mylan

    New York Attorney General Letitia James on Monday said her office and those of other states reached a $335 million deal with Mylan to help combat the opioid crisis.

  • April 07, 2025

    Ex-Conn. Budget Official Plans To Testify In Corruption Cases

    Twice-indicted former Connecticut budget official Konstantinos Diamantis plans to testify in two upcoming federal corruption trials, his attorney revealed Monday during a scheduling call that snapped into focus the timeline for both cases.

  • April 07, 2025

    Conn. Judge Pauses 'Staggering' Hospital Data Subpoena

    A Connecticut judge temporarily paused a subpoena seeking what a health nonprofit called "a staggering amount" of confidential patient data by a proposed class of Constitution State residents accusing Hartford HealthCare Corp. of monopolizing the state's healthcare industry, stating that the court must review the subpoena first.

  • April 07, 2025

    11 States Tell 6th Circ. To Ax Mich. Conversion Therapy Ban

    Eleven U.S. states led by Iowa and South Carolina urged the Sixth Circuit to strike down Michigan's ban on conversion therapy for minors, saying the law censors therapists' speech.

  • April 07, 2025

    Feds Say Fla. Doctor Fleeced Medicare With Bogus Charges

    A doctor and his Florida-based business, Vohra Wound Physicians Management LLC, deliberately overbilled Medicare for years, charging it for wound care procedures that were unnecessary or not performed, according to federal prosecutors.

  • April 04, 2025

    Split DC Circ. Denies Calif. Subsidies For Border Hospitals

    A split D.C. Circuit panel on Friday found it was not unconstitutional for California to exclude hospitals bordering the state from a program distributing supplemental payments to providers that serve Medi-Cal beneficiaries.

  • April 04, 2025

    HHS Drops 11th Circ. Fight Over ACA Trans Rule Freeze

    The U.S. Department of Health and Human Services agreed to drop its bid to overturn an order blocking it from enforcing regulations that extend the Affordable Care Act's anti-discrimination provisions to transgender individuals against Florida organizations, according to filings with the Eleventh Circuit.

  • April 04, 2025

    Ohio AG Takes Trans Care Limits Bid To State Justices

    Ohio Attorney General Dave Yost has taken his bid to reinstate limits on gender-affirming care for transgender youths to the state's highest court and wants the law's enforcement to continue throughout his appeal.

Expert Analysis

  • A Look At HHS' New Opinion On Patient Assistance Programs

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    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.

  • 2 Anti-Kickback Developments Hold Lessons For Biopharma

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    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.

  • Tips For Pharma-Biotech Overlap Reporting In New HSR Form

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    While there’s no secret recipe for reporting overlaps to the Federal Trade Commission in the new Hart-Scott-Rodino Act form, there are several layers of considerations for all pharma-biotech companies and counsel to reflect on internally before reporting on any deal, say attorneys at A&O Shearman.

  • A Look At Drug Price Negotiation Program's Ongoing Impact

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    More than two years after the passage of the Inflation Reduction Act and the rapid implementation of the drug price negotiation program, attorneys at Ropes & Gray discuss how the IRA has influenced licensing strategies, and how maximum fair prices under the law have economically affected certain drugs.

  • Preparing For A Possible End To The Subminimum Wage

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    The U.S. Department of Labor's proposed rule to end the subminimum wage for employees with disabilities may significantly affect the community-based rehabilitation and training programs that employ these workers, so certified programs should be especially vigilant about compliance during this period of evaluation and scrutiny, say attorneys at Jackson Lewis.

  • Drug Pricing Policy Trends To Expect In 2025 And Beyond

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    Though 2025 may bring more of the same in the realm of drug pricing policy, business as usual entails a sustained, high level of legal and policy developments across at least six major areas, say attorneys at Ropes & Gray.

  • Top 10 Healthcare And Life Sciences Issues To Watch In 2025

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    Under the new Trump administration, this coming year may benefit some healthcare and life sciences stakeholders, while creating new challenges for others amid an increasingly complex regulatory environment, say attorneys at Debevoise.

  • 4 Keys To Litigating In An Active Regulatory Environment

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    For companies facing litigation influenced by government regulatory action — a recent trend that a politically charged atmosphere will exacerbate — there are a few principles that can help to align litigation strategy with broader public positioning in the regulatory and oversight context, say attorneys at Jenner & Block.

  • How Views On Healthcare Price Transparency Are Changing

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    Regulators' attitudes toward price transparency regulation have shifted over the past several years in ways that may seem contradictory, and research into detailed rate information published by hospitals and health plans has yielded mixed results, says Matthew List at Charles River Associates.

  • EEOC Wearable Tech Guidance Highlights Monitoring Scrutiny

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    The U.S. Equal Employment Opportunity Commission's recent fact sheet on wearable technologies cautions against potential issues with federal anti-discrimination laws and demonstrates growing concern from regulators and legislators about intrusive technologies in the workplace, say attorneys at Littler.

  • Navigating The Potential End Of GLP-1 Drug Shortages

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    The U.S. Food and Drug Administration's determination of whether GLP-1 products are in shortage may affect how compounders provide these products and spur a range of litigation including patent disputes and unfair competition suits, say attorneys at Goodwin.

  • Politicized OIGs Could Target Federal Employees, Contractors

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    After President Donald Trump fired nearly 20 inspectors general last week, it’s worth exploring how the administration could use Offices of Inspectors General to target federal employees and contractors, why it would be difficult to fight this effort, and one possible bulwark against the politicization of these watchdogs, says Sara Kropf at Kropf Moseley.

  • Takeaways From DOJ Fraud Section's 2024 Year In Review

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    Attorneys at Paul Weiss highlight notable developments in the U.S. Department of Justice Fraud Section’s recently released annual report, and discuss what the second Trump administration could mean for enforcement in the year to come.