Policy & Compliance
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February 26, 2025
Merck, Glenmark Trim United Healthcare's Zetia Antitrust Suit
A Minnesota federal judge has trimmed a United Healthcare unit's antitrust suit claiming that Merck and Glenmark conspired to delay a generic version of the anti-cholesterol drug Zetia, throwing out non-Minnesota state-law claims he called a "bare and conclusory pleading."
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February 26, 2025
Planned Parenthood Immune From FCA Suit, 5th Circ. Says
Planned Parenthood is entitled to attorney immunity, the Fifth Circuit said Wednesday in a case that had accused the organization of improperly billing Medicaid programs for millions after losing its Medicaid credentials.
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February 26, 2025
CVS Ordered To Comply With FTC's PBM Subpoena
A D.C. federal judge is ordering CVS to turn over new materials in the Federal Trade Commission's investigation into its pharmacy benefit manager Caremark Rx, saying that just because producing updated documents would cost the company more doesn't mean it faces an "undue burden."
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February 25, 2025
DC Judge Blocks Trump's Federal Funding Freeze
A D.C. federal judge on Tuesday issued a preliminary injunction blocking the Trump administration from implementing a federal spending freeze while a group of nonprofits challenge the freeze, calling the measure "ill-conceived from the beginning."
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February 25, 2025
Trump Demands Enforcement Of Healthcare Price Disclosures
President Donald Trump on Tuesday ordered federal agencies to step up enforcement of regulations requiring hospitals and health plans to publish price information designed to help patients shop for the best deal.
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February 25, 2025
Trump Administration In Court: ACA, Trans Care, Drug Pricing
Directives from the White House threatening gender-affirming care, medical research funding and employment across federal health agencies met resistance in recent days as courts ruled to halt enforcement and states and labor groups filed for injunctive relief.
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February 25, 2025
Meet The FDA's New Chief Counsel Robert Foster
Announced as the top attorney for the U.S. Food and Drug Administration in recent days, Robert Foster brings a career spanning the government's early COVID-19 pandemic response, biopharmaceutical company leadership and legal oversight matters for the U.S. Senate.
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February 25, 2025
4th Circ. Shuts Down HHS Chemist's 'Grinch' Harassment Suit
The Fourth Circuit shut down a chemist's bid Tuesday to revive his suit claiming he faced sex bias and retaliatory harassment within the U.S. Department of Health and Human Services when a colleague called him the "Grinch," ruling his case is devoid of proof of discrimination.
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February 25, 2025
3 Attys Reprimanded, 2 DQ'd In Ala. Judge Shopping Probe
An Alabama federal judge on Tuesday publicly reprimanded three attorneys for judge shopping during their legal efforts against a state law criminalizing gender-affirming care, saying that the trio practiced in bad faith and dropping two of them from litigating the case.
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February 25, 2025
'Colossal Neglect' Sinks Walter Reed Fraud Case, Judge Rules
A Maryland federal judge threw out criminal charges against the alleged mastermind of a more than $3 million healthcare fraud scheme targeting Walter Reed National Medical Center with a Tuesday ruling that ripped prosecutors for "colossal neglect" and "extraordinary, chronic and indefensible" delays in the case.
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February 25, 2025
Fired Worker Couldn't Justify COVID Vax Refusal, 3rd Circ. Says
A software engineer who refused to comply with his company's COVID-19 vaccine policy couldn't claim he had a "sincere religious objection" while shielding his medical records from disclosure and vacillating on his reasons, a Third Circuit panel ruled Tuesday.
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February 25, 2025
Pa. Health System Strikes Deal To Exit Workers' OT Suit
A Pennsylvania health system reached a deal Tuesday to resolve a proposed class action accusing it of stiffing unionized hospital workers on overtime wages, according to a report filed in federal court announcing a successful mediation.
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February 25, 2025
Trump's Efficiency Agenda On The Line In Health Job Cuts
The mass termination of probationary federal employees, including several hundred at the U.S. Department of Health and Human Services, may slow scientific research and harm companies' bottom lines. The Trump administration's efficiency priorities may also be threatened.
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February 25, 2025
VA Fires Another 1,400 Employees Amid Dems' Pushback
The U.S. Department of Veterans Affairs announced Tuesday it is dismissing another 1,400 probationary employees from "non-mission critical" positions amid criticism from Democrats over a round of cuts announced earlier this month.
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February 25, 2025
CDC Layoffs Provoke Legal Questions, Worker Anxiety
Workers and experts with insight into the Centers for Disease Control and Prevention have described the roughly 750 layoffs at the agency as chaotic and confusing, and question Trump's legal authority to unilaterally change the agency. They are also concerned it will impact the agency’s ability to investigate disease outbreaks.
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February 25, 2025
1st Circ. Decision Adds To Defense Momentum In FCA Clash
A First Circuit decision extended a winning streak for the False Claims Act defense bar. The decision's ultimate impact on fraud prosecutions will be shaped by how whistleblowers adjust their legal strategy.
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February 24, 2025
PBMs To Challenge FTC Case At 8th Circ., But Without Pause
A Missouri federal judge summarily refused, again, on Monday to temporarily block the Federal Trade Commission's in-house case accusing Caremark Rx, Express Scripts and OptumRx of artificially inflating insulin prices, letting the case proceed while the pharmacy benefits managers appeal to the Eighth Circuit.
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February 24, 2025
Feds Fight Reinstatement Of Ousted Inspectors General
The Trump administration fired back at a lawsuit brought by eight inspectors general who were fired last month, telling a D.C. federal judge that federal law does not require the president to hold off on the terminations for 30 days after notifying Congress.
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February 24, 2025
Elizabeth Holmes Loses 9th Circ. Appeal Over Theranos Fraud
A Ninth Circuit panel on Monday affirmed the criminal fraud convictions of former Theranos CEO Elizabeth Holmes and former Theranos executive Ramesh "Sunny" Balwani along with their respective 11-year and nearly 13-year prison sentences, rejecting arguments that the lower court made multiple evidentiary errors that unfairly swayed jurors.
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February 24, 2025
Thomas Pans High Court For Skipping Abortion Buffer Zones
The U.S. Supreme Court declined Monday to consider a constitutional challenge to an Illinois city's now-repealed ordinance that created 100-foot speech buffer zones around healthcare facilities providing abortions, shooting down a case aimed at overturning a 20-year-old ruling that such zones don't violate the First Amendment.
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February 24, 2025
Justices Won't Review NJ Town Abortion Buffer Zone Law
A split U.S. Supreme Court said Monday it will not review the Third Circuit's decision to let Englewood, New Jersey, continue enforcing eight-foot "buffer zones" around abortion facilities that protesters are not permitted to enter, in a case brought by an activist who said the zones infringed her free speech.
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February 24, 2025
Supreme Court Won't Revisit Contentious Feres Doctrine
The U.S. Supreme Court on Monday rejected a former Air National Guard reservist's suit seeking damages for a military hospital surgery that left him paralyzed, declining to revisit a doctrine barring injury claims considered "incident to" military service.
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February 21, 2025
Drugmakers Slam 'Untimely' Claims In Employers' Antitrust Suit
Pharmaceutical companies targeted by sweeping antitrust lawsuits from major employers, including Target, Lowe's and American Airlines, have asked a Pennsylvania federal judge to trim conspiracy claims from a lawsuit accusing them of orchestrating illegal agreements for price-fixing and customer allocation, arguing the allegation was unsupported and untimely.
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February 21, 2025
Watchdog Says DOL Struggles To Enforce Mental Health Law
Workers with mental health conditions and substance use disorders are at higher risk of not receiving treatment or having to pay out of pocket for care that should be covered because of the U.S. Department of Labor's limited ability to enforce federal mental health parity laws, an agency watchdog said Friday.
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February 21, 2025
Wash. Health System Says Nurse Must Arbitrate Wage Claims
A Washington-based healthcare system facing a proposed class and collective wage action in Seattle federal court contends the plaintiff nurse agreed to arbitrate any claims with the third-party staffing agencies he contracted with to work at its facilities.
Expert Analysis
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3 Healthcare FCA Deals Provide Self-Disclosure Takeaways
Several civil False Claims Act settlements of alleged healthcare fraud violations over the past year demonstrate that healthcare providers may benefit substantially from voluntarily disclosing potential misconduct to both the U.S. Department of Justice and the U.S. Department of Health and Human Services, say Brian Albritton and Raquel Ramirez Jefferson at Phelps Dunbar.
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Takeaways From High Court's Tribal Health Admin Cost Ruling
The U.S. Supreme Court's recent determination that the government must reimburse two Native American tribes for administrative healthcare costs will help tribes maintain equal footing with the Indian Health Service when administering programs, and continues a pattern of how the current court aligns on tribal concerns, say attorneys at Lewis Roca.
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FTC Focus: Private Equity Investments In Healthcare
As the Federal Trade Commission is tightening its scrutiny of private equity investment in healthcare, the agency is finding novel grounds to challenge key focus areas, including rollup acquisitions, the flip-and-strip approach and minority investments in rival providers, say attorneys at Proskauer.
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High Court's Expert Ruling May Help Health Fraud Defendants
The U.S. Supreme Court's decision in Diaz v. U.S. appears to give the government a powerful new tool in calling its own agents as expert witnesses, but it could also benefit defense counsel in criminal healthcare fraud and other white collar criminal cases that arise in complex legal or regulatory environments, say attorneys at Holland & Knight.
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Unpacking HHS' Opinion On Cell Therapy Refund Programs
A recent advisory opinion from the U.S. Department of Health and Human Services, determining that a biopharma company's refund program for its cell therapy will not be penalized, indicates an encouraging willingness to engage, but the regulator's assumptions about the program's limited term warrant a closer look, says Mary Kohler at Kohler Health.
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DOJ Innovasis Settlement Offers Lessons On Self-Disclosure
The recent $12 million settlement with Innovasis and two of its executives demonstrates the U.S. Department of Justice's continued prioritization of Anti-Kickback Statute enforcement amid the growing circuit split over causation, and illustrates important nuances surrounding self-disclosure, say Denise Barnes and Scott Gallisdorfer at Bass Berry.
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How Orange Book Antitrust Scrutiny Is Intensifying
Pharmaceutical patent holders should be reviewing Orange Book listing practices, as the Federal Trade Commission takes a more aggressive antitrust approach with actions such as the Teva listing probe, and the U.S. Food and Drug Administration calls attention to potentially improper listings, say attorneys at McDermott.
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After Chevron: Slowing Down AI In Medical Research
The U.S. Supreme Court's recent decision overturning the Chevron doctrine may inhibit agencies' regulatory efforts, potentially slowing down the approval and implementation of artificial intelligence-driven methodologies in medical research, as well as regulators' responses to public health emergencies, say Ragini Acharya and Matthew Deutsch at Husch Blackwell.
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FDA's Multifaceted Role On Display In MDMA Therapy Scrutiny
Ongoing deliberations at the U.S. Food and Drug Administration regarding MDMA-assisted therapy for post-traumatic stress disorder serves as a window into the intricate balance of scientific innovation and patient safety oversight, and offers crucial insights into regulatory nuances, say Kimberly Chew at Husch Blackwell and Kevin Lanzo at Pharmaka Clinical Consulting.
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Analyzing FDA Draft Guidance On Clinical Trial Diversity
In light of the U.S. Food and Drug Administration's draft guidance on clinical trial diversity action plans, there are several important considerations for sponsors and clinical researchers to keep in mind to prevent delay in a drug or device application, say attorneys at Crowell & Moring.
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In The CFPB Playbook: Making Good On Bold Promises
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.
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Critical Questions Remain After High Court's Abortion Rulings
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.
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Navigating FDA Supply Rule Leeway For Small Dispensers
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.