Policy & Compliance
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October 18, 2024
Oklahoma Brings Title X Funding Cut Fight To Justices
Oklahoma is asking the U.S. Supreme Court to review the Tenth Circuit's decision allowing the U.S. Department of Health and Human Services to cut Title X funding over the state's refusal to refer family planning patients for abortion care following the high court's Dobbs decision last year.
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October 18, 2024
Tenn. Court Clarifies Scope Of Abortion Ban's Exceptions
A Tennessee state court has partly sided with a group of women who said they were denied or delayed in receiving medically necessary abortions, ruling that certain pregnancy-related conditions constitute serious medical emergencies that meet the state's exception to its criminal abortion ban.
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October 18, 2024
HHS Slams Hackensack Meridian's Chevron-Inspired Suit
The U.S. Department of Health and Human Services has torn into a suit from New Jersey's largest healthcare network over Medicare reimbursements, arguing the network has "chosen to blaze a path … that is both prohibited by Congress and unsanctioned by precedent."
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October 18, 2024
Teva Signs Deal With Indirect Buyers In Effexor Antitrust Suit
A class of consumers and third-party payers have reached a deal with Teva Pharmaceuticals to resolve antitrust litigation over a purported scheme to delay generic competition for the antidepressant drug Effexor XR, according to a court filing.
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October 18, 2024
AGs Slam 4th Circ. Bid To Restore NC Abortion Drug Limits
In a joint amicus brief to the Fourth Circuit, a coalition of 17 states and the District of Columbia has said the abortion drug mifepristone is a part of women's reproductive healthcare, assailing the "needless" limits that states including North Carolina have sought to impose on the drug's access.
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October 18, 2024
Suit Wants Fla. Abortion Measure Struck Over Fraud Claims
A group of Florida voters represented by former Florida Supreme Court Justice Alan Lawson have filed suit to invalidate an abortion rights ballot measure over allegations of wide-scale fraud by the initiative's sponsor during the signature gathering process.
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October 18, 2024
NC Hospital Fights Competitor's Expansion Bid Approval
A North Carolina hospital operator urged a state appellate court to invalidate an administrative judge's approval of a competitor's expansion bid, arguing that members of the public were wrongfully denied input.
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October 18, 2024
Polsinelli Adds K&L Gates Litigation Team In SC
A group of three federal healthcare litigators, plus consultants and support staff, has departed K&L Gates LLP for Polsinelli PC in Charleston, South Carolina.
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October 18, 2024
Campbell's Health Plan Can't Charge Tobacco Fee, Suit Says
Campbell Soup Co. is violating federal benefits law by making workers who use tobacco pay more for health insurance because it doesn't offer a wellness program or comparable alternative, according to a proposed class action in New Jersey federal court.
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October 17, 2024
Acadia Hid Wrongful Detainment Of Patients, Investor Claims
Behavioral healthcare provider Acadia Healthcare was hit with a proposed securities class action in Tennessee federal court alleging that investors were damaged after The New York Times published an investigative report saying the company detained patients in its psychiatric facilities for financial gain rather than out of medical necessity.
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October 17, 2024
Justices Urged To Fix 'Novel Misreading' Of IP Safe Harbor
Edwards Lifesciences is asking the U.S. Supreme Court to rein in what's covered under a drug-development safe harbor to avoid patent infringement, saying the Federal Circuit wrongfully expanded it in a "novel misreading" of the law.
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October 17, 2024
Sen. Report Slams Insurers For Medicare Advantage Denials
A trio of major Medicare Advantage insurers are driving profits by denying coverage for patient stays at "costly but critical" facilities for those recovering from injuries and illnesses, according to a report issued Thursday by a Congressional committee.
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October 17, 2024
Health Co. Must Face State Farm Settlement Interpretation Suit
An automobile-accident-focused healthcare company can't escape State Farm's lawsuit claiming the facility breached a settlement agreement by failing to drop hundreds of personal injury protection suits, a Florida federal court ruled.
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October 17, 2024
Texas Sues Doctor For Providing Kids Gender-Affirming Care
The state of Texas sued a pediatrician Thursday, alleging she broke state law by providing gender-affirming care to children.
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October 16, 2024
Direct Buyers Get Final OK For $44M Drug Price-Fixing Deal
A Pennsylvania federal court has granted final approval to $44.4 million in settlements between drugmakers Apotex, Breckenridge and Heritage and direct purchasers in a multidistrict litigation over alleged price-fixing in the generic-drug industry.
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October 16, 2024
Caremark, Optum Say FTC Insulin Case Gets PBMs All Wrong
Caremark Rx, Express Scripts and OptumRx continue to attack the Federal Trade Commission's in-house case accusing the country's three largest pharmacy benefit managers of artificially inflating insulin prices by relying on unfair rebate schemes, arguing the agency's case lacks authority, facts and the right targets.
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October 16, 2024
Houston Pharma Exec Found Guilty In $160M Health Fraud
A Houston man was convicted on 15 criminal charges in connection with orchestrating a massive healthcare scheme that defrauded the government out of $160 million, following a 10-day trial in which prosecutors said doctors were "bamboozled" by the conspiracy.
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October 15, 2024
Horizon Lodges 4-Fold Attack On Tepezza MDL Bellwethers
Horizon Therapeutics argued Tuesday that an Illinois federal judge should toss out nine of the dozen cases selected as bellwethers in multidistrict litigation targeting hearing loss issues with its biologic Tepezza, saying they're preempted because the label was approved with those problems in mind.
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October 15, 2024
Anti-Abortion Nonprofit Moves To Block NJ AG's Subpoena
An anti-abortion pregnancy center urged a New Jersey federal court Tuesday to immediately block Attorney General Matt Platkin's subpoena seeking information about its donors, arguing it will suffer irreparable harm if it is forced to comply before any of its constitutional claims are considered by the court.
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October 15, 2024
Wash. Hospital Wants Spinal Surgeon Scandal Suit Tossed
A healthcare system in Washington state has urged a federal judge to throw out the government's civil lawsuit alleging it perpetuated a doctor's scheme to earn millions of dollars from unnecessary surgeries, accusing prosecutors of "second-guessing" the organization's legitimate processes for hiring physicians and addressing internal complaints.
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October 15, 2024
Conn. Medical Group Hit With $30M Verdict In C-Section Suit
A Connecticut state jury has slapped a Greenwich medical group with a $30 million verdict — which could more than double after interest — finding that the medical staff botched a pregnant patient's cesarean delivery, precluding her from giving birth to another child.
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October 15, 2024
Feds Cut Whistleblowers Out Of Kickback Deal, Court Told
Whistleblowers who accused a medical device company of a kickback scheme said Tuesday that the government left them out to dry when it settled False Claims Act claims with surgeons for $3.3 million and refused to share any of it with them.
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October 15, 2024
Citing Jarkesy, E-Cig Store Seeks To Vaporize FDA Penalties
A vape store's lawsuit against the U.S. Food and Drug Administration may provide an early look at how judges will apply this year's landmark Supreme Court decision limiting the power of administrative courts to levy civil monetary penalties.
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October 15, 2024
Ex-WH Senior Associate Counsel Rejoins Ropes & Gray
Ropes & Gray LLP announced Tuesday that an attorney rejoined the firm's Washington, D.C., office as counsel after most recently serving as senior associate counsel to President Joe Biden.
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October 15, 2024
Law Firms Diverge As Anti-ESG Pushback Continues
A continuing onslaught of legislation and litigation opposing corporate environmental, social and governance actions has created a fork in the road for law firms, with some choosing to scale back efforts and others pushing ahead with their internal ESG and diversity, equity and inclusion goals.
Expert Analysis
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Spartan Arbitration Tactics Against Well-Funded Opponents
Like the ancient Spartans who held off a numerically superior Persian army at the Battle of Thermopylae, trial attorneys and clients faced with arbitration against an opponent with a bigger war chest can take a strategic approach to create a pass to victory, say Kostas Katsiris and Benjamin Argyle at Venable.
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The Road Ahead For Florida's Drug Importation Program
Though the U.S. Food and Drug Administration approved Florida's drug importation program in January, a series of hurdles — including requisite buy-in from Canada — and potential legal challenges must be addressed before importation can begin, say attorneys at Ropes & Gray.
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Assessing CDC's Revised Guideline On Opioid Prescriptions
Kenneth Weinstein, Nicholas Van Niel and Kate Uthe at Analysis Group look at newly available data to evaluate the impact that the Centers for Disease Control and Prevention's revised opioid monitoring guideline have had on prescription trends in recent years, highlighting both specific and overall decreases.
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Valeant Ruling May Pave Way For Patent-Based FCA Suits
The Ninth Circuit’s recent ruling in Silbersher v. Valeant marks a significant development in False Claims Act jurisprudence, opens new avenues for litigation and potentially raises the stakes for patent applicants who intend to do business with the government, say Joshua Robbins and Rick Taché at Buchalter.
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Suits Against Insulin Pricing Are Driven By Rebate Addiction
A growing wave of lawsuits filed by states, cities and counties against insulin manufacturers and pharmacy benefit managers improperly allocate the blame for rising insulin costs, when in actuality the plaintiffs are partially responsible, says Dan Leonard at Granite Capitol Consulting.
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When Physician Retirement Arrangements May Be Legal
A recent advisory opinion from the Office of Inspector General regarding physician retirement arrangements sheds light on key considerations and mitigating factors that may be useful when attempting to balance healthcare operational needs with statutory conformity, says Magda Rodriguez at Day Pitney.
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ESG Around The World: Gulf Cooperation Council
The Gulf Cooperation Council is in the early stages of ESG policy implementation, but recent commitments by both states and corporations — including increases in sustainable finance transactions, environmental commitments, female representation on boards and human rights enforcement — show continuing progress toward broader ESG goals, say attorneys at Cleary.
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Navigating ACA Reporting Nuances As Deadlines Loom
Stephanie Lowe at Liebert Cassidy walks employers through need-to-know elements of Affordable Care Act reporting, including two quickly approaching deadlines, the updated affordability threshold, strategies for choosing an affordability safe harbor, and common coding pitfalls.
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Lessons From Rare Post-Verdict Healthcare Fraud Acquittal
A Maryland federal court recently overturned a jury verdict that found a doctor guilty of healthcare fraud related to billing levels for COVID-19 tests, providing defense attorneys with potential strategies for obtaining acquittals in similar prosecutions, says attorney Andrew Feldman.
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ChristianaCare Settlement Reveals FCA Pitfalls For Hospitals
ChristianaCare's False Claims Act settlement in December is the first one based on a hospital allegedly providing private physicians with free services in the form of hospital-employed clinicians and provides important compliance lessons as the government ramps up scrutiny of compensation arrangements, say attorneys at Sheppard Mullin.
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Patent Waiver For COVID Meds Would Harm US Biopharma
If the Biden administration backs the World Trade Organization in waiving patent rights on COVID-19 treatments, it would negatively affect the U.S. biopharmaceutical industry and help foreign competitors, without necessarily expanding global access to COVID-19 care, says clinical pathologist Wolfgang Klietmann.
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New CMS Rule Will Change Nursing Facility Disclosures
A new rule from the Centers for Medicare & Medicaid Services significantly expands disclosure requirements for nursing facilities backed by private equity companies or real estate investment trusts, likely foreshadowing increased oversight that could include more targeted audits, say Janice Davis and Christopher Ronne at Morgan Lewis.
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Skirting Anti-Kickback Causation Standard Amid Circuit Split
Amid the federal circuit court split over the causation standard applicable to False Claims Act cases involving Anti-Kickback Statute violations, which the First Circuit will soon consider in U.S. v. Regeneron, litigators aiming to circumvent the heightened standard should contemplate certain strategies, say Matthew Modafferi and Terence Park at Frier Levitt.