Policy & Compliance

  • July 18, 2024

    DaVita To Pay $34M In Medicare Kickback Whistleblower Suit

    Dialysis company DaVita will pay more than $34 million to settle a Medicare fraud case over alleged kickbacks doctors received in exchange for patient referrals, after a whistleblower from the company's C-suite came forward, the U.S. Attorney's Office for the District of Colorado announced Thursday.

  • July 18, 2024

    6th Circ. Sees 'Fundamental' Shift Post-Chevron In Title X Row

    The toppling of Chevron deference set the tone for a Sixth Circuit hearing on Thursday as the court contemplated Tennessee's arguments that the U.S. Department of Health and Human Services went beyond its statutory power when it introduced new requirements for family planning funding.

  • July 18, 2024

    9th Circ. Revives Fired Doctor's COVID Vax Religious Bias Suit

    The Ninth Circuit revived a doctor's claims that Washington State University failed to accommodate his religious beliefs when it fired him from his residency for refusing the COVID-19 vaccine, ruling Thursday that U.S. Supreme Court precedent necessitates another look at his case.

  • July 18, 2024

    Feds Say Loper Bright Not Relevant In IVF Policy Suit

    The U.S. Department of Defense urged a New York federal court Thursday to throw out a nonprofit's lawsuit challenging its in vitro fertilization coverage policy for service members, countering the group's argument that the agency can't shake the suit because the U.S. Supreme Court upended Chevron deference.

  • July 18, 2024

    PharMerica Inks $100M Deal In 13-Year-Old Whistleblower Suit

    PharMerica Corp. has agreed to pay $100 million to settle a former New Jersey nursing home owner's long-running whistleblower litigation over an alleged drug kickback scheme, according to the plaintiff's law firm.

  • July 17, 2024

    Judge Warns HHS It's Not In 'Reasonable Compliance'

    The Department of Health and Human Services appears not to be in "reasonable compliance" of an injunction ordering it to develop an avenue for Medicare beneficiaries to appeal their hospitalization status, a Connecticut federal judge said in a Tuesday notice.

  • July 17, 2024

    U. Miami Climate Leader Sees Chance For Innovation

    With Miami often called the "ground zero" of the climate change crisis, the University of Miami in 2022 launched a Climate Resilience Academy to coordinate an interdisciplinary response. Nearly a year into his tenure, its leader reflects on the opportunity for midsize city innovation in infrastructure in the face of climate challenges.

  • July 17, 2024

    Burr & Forman Accused Of Aiding Health Insurance Fraud

    Burr & Forman LLP has been hit with a malpractice suit in Georgia federal court by the liquidating trustees of two purported health insurance companies after the firm allegedly aided in a scheme to defraud customers by charging exorbitant fees and denying promised coverage, saying the attorneys helped create a web of LLCs to which it siphoned off millions.

  • July 16, 2024

    No Let-Up On DOJ Medicare Advantage Fraud Probes

    Federal scrutiny of Medicare Advantage fraud is showing no signs of abating.

  • July 16, 2024

    Sanford-Marshfield Tie-Up Portends More Cross-Market Deals

    A merger between two Midwest health systems is evidence of hospitals' desire to strike deals with players in other markets, according to experts in the space, who say the trend may be influenced by a tough antitrust environment and larger industry shift to value-based care.

  • July 16, 2024

    FDA Vet Joins Arnold & Porter As Counsel On Healthcare

    After nearly a decade in high-level roles at the U.S. Food and Drug Administration, regulatory pro Andrew Zacher has joined the life sciences and healthcare team at Arnold & Porter.

  • July 16, 2024

    3rd Circ. Backs Tossing Over 1K Suits In Merck Vaccine MDL

    The Third Circuit on Tuesday affirmed the dismissal with prejudice of 1,189 cases in multidistrict litigation alleging Merck & Co. Inc.'s shingles vaccine, Zostavax, caused the disease, saying the district court did not abuse its discretion by requiring medical tests to support the claims.

  • July 16, 2024

    Union Fund Trustees Say Elevance Usurped Fiduciary Power

    The trustees of two union health plans said Elevance Health Inc. and its subsidiaries violated federal benefits law when they overpaid themselves for administrative services and medical providers for patient care, arguing the insurer had significant control over the management of the plans and their assets.

  • July 16, 2024

    Ga. Denied Extension For Medicaid Work Requirement Plan

    Georgia won't get extra time to administer a work requirement Medicaid expansion program in order to make up for federal regulators' illegal delaying of its rollout after a federal judge ruled Monday that the state didn't go through the proper channels in trying to extend the program's timeline.

  • July 16, 2024

    In Chevron's Fall, Attys See Conflicting Rulings, Circuit Splits

    The end of Chevron deference, along with other U.S. Supreme Court decisions weakening the authority of federal agencies, may make the drug regulatory landscape more volatile — not less — as courts wrestle with new limits on federal power.

  • July 16, 2024

    The Risks And Promise Of Medical Debt Reporting Rule

    A proposed federal rule would prevent medical debt from appearing on credit reports of tens of millions of Americans. Legal and debt experts are conflicted over whether it could backfire on some healthcare consumers and potentially kneecap healthcare providers who still need to collect unpaid bills.

  • July 16, 2024

    Vertex Pharma Widens War On Watchdog's Kickback Views

    A lawsuit from gene therapy-drug maker Vertex Pharmaceuticals over fertility treatment access is a new battle over enforcement kickback theories and health officials' interpretation of "inducement."

  • July 16, 2024

    The 2024 Diversity Snapshot: What You Need To Know

    Law firms' ongoing initiatives to address diversity challenges have driven another year of progress, with the representation of minority attorneys continuing to improve across the board, albeit at a slower pace than in previous years. Here's our data dive into minority representation at law firms in 2023.

  • July 16, 2024

    These Firms Have The Most Diverse Equity Partnerships

    Law360’s law firm survey shows that firms' efforts to diversify their equity partner ranks are lagging. But some have embraced a broader talent pool at the equity partner level. Here are the ones that stood out.

  • July 16, 2024

    Health System Strikes Deal To End EEOC Race Bias Suit

    A Michigan healthcare system has agreed to pay a Black home health aid $30,000 to resolve a U.S. Equal Employment Opportunity Commission suit alleging she was immediately fired in contradiction with system policy after a white worker accused her of starting a verbal conflict.

  • July 15, 2024

    Ex-Pfizer Worker Seeks No Time For Paxlovid Insider Trading

    A former Pfizer employee argued that he shouldn't go to prison after a Manhattan federal jury convicted him of insider trading over clinical trial results for the drug Paxlovid, pointing out that a friend of his and co-defendant had dodged a custodial sentence in the case after helping prosecutors.

  • July 15, 2024

    Cigna, Chuck Close Estate Settle Reneged Benefits Suit

    The estate of renowned artist Chuck Close told a New York federal judge that Cigna has agreed to settle a suit claiming the company wouldn't pay for more than $686,000 in at-home skilled nursing care that it claimed was owed to him under his Pace Gallery employee benefit plan.

  • July 15, 2024

    Split 2nd Circ. Nixes Surgeon's Default In Sex Assault Case

    A split panel of the Second Circuit said a Connecticut surgeon should have been fully freed from the default judgment against him in a sex assault suit after a jury concluded his accuser failed to prove the assault happened, with one judge dissenting Monday that parts of the default ruling should remain.

  • July 15, 2024

    Theranos Ex-Exec's Lead Atty Joins Boutique Firm In LA

    A former BigLaw attorney who was lead defense counsel for Theranos' former president Ramesh Balwani has joined Los Angeles boutique Foundation Law Group LLP to lead its white collar practice, the firm announced Monday.

  • July 15, 2024

    Machinery Co. Defends 'Right' To Ax Trans Care In Health Plan

    A turbomachinery company asked to intervene on a transgender worker's New Hampshire federal court claim that its health plan administrators violated Affordable Care Act anti-bias provisions by enforcing a gender dysphoria treatment ban in the company's health plan, arguing that the issue is intertwined with its mission.

Expert Analysis

  • In The CFPB Playbook: Making Good On Bold Promises

    Author Photo

    The U.S. Supreme Court's decision upholding the Consumer Financial Protection Bureau's funding structure in the second quarter cleared the way for the bureau to resume a number of high-priority initiatives, and it appears poised to charge ahead in working toward its aggressive preelection agenda, say Andrew Arculin and Paula Vigo Marqués at Blank Rome.

  • Critical Questions Remain After High Court's Abortion Rulings

    Author Photo

    The U.S. Supreme Court's decisions in two major abortion-related cases this term largely preserve the status quo for now, but leave federal preemption, the Comstock Act and in vitro fertilization in limbo, say attorneys at Jenner & Block.

  • Navigating FDA Supply Rule Leeway For Small Dispensers

    Author Photo

    As the November compliance deadline for the U.S. Food and Drug Administration's new pharmaceutical distribution supply chain rules draws closer, small dispensers should understand the narrow flexibilities that are available, and the questions to consider before taking advantage of them, say attorneys at Faegre Drinker.

  • 1st Gender Care Ban Provides Context For High Court Case

    Author Photo

    The history of Arkansas' ban on gender-affirming medical care — the first such legislation in the U.S. — provides important insight into the far-reaching ramifications that the U.S. Supreme Court's decision in U.S. v. Skrmetti next term will have on transgender healthcare, says Tyler Saenz at Baker Donelson.

  • 6 Lessons From DOJ's 1st Controlled Drug Case In Telehealth

    Author Photo

    Following the U.S. Department of Justice’s first-ever criminal prosecution over telehealth-prescribed controlled substances in U.S. v. Ruthia He, healthcare providers should be mindful of the risks associated with restricting the physician-patient relationship when crafting new business models, says Jonathan Porter at Husch Blackwell.

  • After Chevron: Scale Tips Favor Away From HHS Agencies

    Author Photo

    The loss of Chevron deference may indirectly aid parties in challenging the U.S. Department of Health and Human Services' interpretations of regulations and could immediately influence several pending cases challenging HHS on technical questions and agency authority, say attorneys at Ropes & Gray.

  • After Chevron: FDA Regulations In The Crosshairs

    Author Photo

    The U.S. Supreme Court's overturning of the Chevron doctrine is likely to unleash an array of challenges against the U.S. Food and Drug Administration, focusing on areas of potential overreach such as the FDA's authority under the Federal Food, Drug and Cosmetic Act, say attorneys at Debevoise.

  • USPTO Disclaimer Rule Would Complicate Patent Prosecution

    Author Photo

    The U.S. Patent and Trademark Office's proposed changes to terminal disclaimer practice could lead to a patent owner being unable to enforce a valid patent simply because it is indirectly tied to a patent in which a single claim is found anticipated or obvious in view of the prior art, say attorneys at Sterne Kessler.

  • Navigating Scrutiny Of Friendly Professional Corps. In Calif.

    Author Photo

    In light of ongoing scrutiny and challenges to private equity participation in the California healthcare marketplace, particularly surrounding the use of the friendly professional corporation model, management services organizations should consider implementing four best practices, say attorneys at Holland & Knight.

  • Takeaways From New HHS Substance Use Disorder Info Rules

    Author Photo

    A new U.S. Department of Health and Human Services rule continues the agency's efforts to harmonize complex rules surrounding confidentiality provisions for substance use disorder patient records, though healthcare providers will need to remain mindful of different potentially applicable requirements and changes that their compliance structures may require, say attorneys at Ropes & Gray.

  • Calif. Banking Brief: All The Notable Legal Updates In Q2

    Author Photo

    The second quarter of 2024 in California, which saw efforts to expand consumer protection legislation and enforcement actions in areas of federal focus like medical debt and student loans, demonstrated that the state's role as a trendsetter in consumer financial protection will continue for the foreseeable future, say attorneys at Sheppard Mullin.

  • How Cannabis Rescheduling May Affect Current Operators

    Author Photo

    The U.S. Drug Enforcement Agency's proposal to reschedule marijuana to Schedule III provides relief in the form of federal policy from the stigma and burdens of Schedule I, but commercial cannabis operations will remain unchanged until the federal-state cannabis policy gap is remedied by Congress, say Meital Manzuri and Alexis Lazzeri at Manzuri Law.

  • Air Ambulance Ruling Severely Undermines No Surprises Act

    Author Photo

    A Texas federal court's recent decision in Guardian Flight v. Health Care Service — that the No Surprises Act lacks a judicial remedy when a health insurer refuses to pay the amount established through an independent review — likely throws a huge monkey wrench into the elaborate protections the NSA was enacted to provide, says Mark DeBofsky at DeBofsky Law.