Policy & Compliance
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August 28, 2024
Jazz, Hikma Must Face Bulk Of Xyrem Antitrust Suit
Jazz Pharmaceuticals and Hikma Pharmaceuticals appear bound for trial against most solo insurer and class action antitrust claims over alleged efforts to block generic competitors to Jazz's Xyrem narcolepsy drug, under a newly unsealed California federal court order largely rejecting competing motions for summary judgment.
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August 28, 2024
Mont. Hospital Pays $11M In FCA Case For Doc's Fake Billing
Nonprofit healthcare center St. Peter's Health will pay nearly $11 million to settle alleged False Claims Act violations stemming from conduct by a former oncology doctor who submitted fraudulent claims to government programs for up-coded cancer treatment services and who double-billed office visits to boost his own salary, according to the U.S. Attorney's Office for the District of Montana.
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August 27, 2024
Justices Told Gender Care Ban Defies Decades-Old Precedent
A group of transgender adolescents on Tuesday urged the U.S. Supreme Court to overturn a Sixth Circuit decision allowing Tennessee to enforce a state ban on certain medical procedures that they say treats individuals differently based on their assigned sex at birth.
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August 27, 2024
Tenn. Medicaid Program Illegally Cut Off Health Coverage
Tennessee's Medicaid program violated the Medicaid Act, the 14th Amendment and the Americans With Disabilities Act by depriving residents of healthcare coverage, a federal judge has ruled, saying the agency was "lethargic in its response and attempts" to fix an eligibility system replete with issues.
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August 27, 2024
Medicare Fraud Case Puts Target On Qui Tam Provisions
In a federal court in Florida, a judge is weighing what was once a pipe dream for the False Claims Act defense bar: the possible invalidation of federal law allowing private parties to bring suits on behalf of the government.
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August 27, 2024
Docs Foggy On Abortion Laws Amid Heated Legal Battles
When Texan Kyleigh Thurman showed up at a hospital in central Texas with an ectopic pregnancy, she alleges that physicians' confusion over the state's strict abortion ban led to inaction and delays in her federally protected care.
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August 27, 2024
6th Circ. Affirms HHS' Denial Of Title X Funds To Tenn.
The Sixth Circuit has upheld the Biden administration's authority to end a family-planning grant awarded to Tennessee after the state refused to offer abortion referrals, saying the state knew the rules when it accepted the grant.
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August 26, 2024
Care.com To Pay $8.5M To Settle FTC's Deception Claims
Caregiver job website Care.com has agreed to shell out $8.5 million in refunds to put to rest allegations it misled caregivers about wages and job availability and also made it difficult for families to cancel paid memberships, the U.S. Federal Trade Commission announced Monday.
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August 26, 2024
Class Attys Get $1.2M In Wash. Health Workers' Wage Deal
A Washington federal judge has awarded two plaintiffs firms almost $1.2 million of a $4.4 million class and collective wage deal ending a group of Evergreen state hospital workers' claims that their employers deducted pay for meal breaks they never took.
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August 26, 2024
Rival Can't Avoid Drugmaker's False Ad Claim Over Pain Med
A Texas federal magistrate on Monday advised against dismissing Pacira Biosciences Inc.'s suit against a rival, finding that Pacira had alleged enough facts to show QuVa Pharma Inc.'s advertising is deceptive in a suit over the former company's compounded drug for pain.
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August 26, 2024
FTC Mulls Proposal To Alter Puerto Rican Pharmacy Deal
The Federal Trade Commission is considering a plan to allow Puerto Rico's largest independent pharmacy cooperative to resume collective negotiations with payors, reexamining a 2012 settlement agreement that the cooperative says is now unnecessary because of changes in the commonwealth's law and pharmacy market.
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August 26, 2024
NY Nursing Homes Can't Duck AG's $83M Fraud Suit
A New York judge shot down a bid by four nursing homes and their operators to dismiss the state attorney general's claims that they defrauded Medicare and Medicaid and neglected residents.
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August 23, 2024
NY Can't Sue Groups Over Abortion 'Reversal' Ads, For Now
A New York federal judge temporarily blocked the state's attorney general from taking enforcement action against certain pregnancy counseling centers for promoting a method of "reversing" medication abortions that medical associations say is not backed by science, saying the groups' conduct is likely protected by the First Amendment.
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August 23, 2024
Ohio Constitution Dooms 24-Hour Abortion Waiting Period
An Ohio state judge on Friday preliminarily blocked multiple Ohio civil and criminal abortion-related statutes requiring informed consent and a 24-hour waiting period, among other restrictions, finding that the statutes likely run afoul of the recently passed voter-backed state constitutional amendment enshrining the right to abortion.
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August 23, 2024
Matthew Perry Death Suit Could Blow Past Calif. Damage Cap
The federal indictment recently unsealed accusing two doctors and others of peddling the ketamine that caused Matthew Perry's death will serve as prime fodder for any wrongful death suit by the actor's estate, experts say, and California's medical malpractice damages cap may not even be a factor.
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August 23, 2024
NY Lawmakers Hit With ADA Suit Over Contentious Mask Ban
A Long Island, New York, county that recently made it illegal for certain individuals to wear face masks in public has been hit with a lawsuit by a legal advocacy group alleging the ban discriminates against people with disabilities.
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August 23, 2024
NC Not Shielded From Racetrack's COVID Shutdown Suit
The North Carolina Supreme Court on Friday ruled a racetrack owner's lawsuit accusing state officials of violating his constitutional rights with a COVID shutdown order can survive dismissal, reasoning the claims were sufficient to overcome the government's protections from being sued.
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August 23, 2024
Hospital Deducted Bogus Meal Breaks From Wages, Suit Says
A healthcare system automatically deducted 30 minutes per day from workers' wages for meal breaks despite the workers not getting the chance to take uninterrupted meal periods, a proposed collective action filed in Michigan federal court said.
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August 22, 2024
Mich. Panel Upholds Block Of 24-Hour Abortion Waiting Period
Michigan appellate judges have refused to lift a preliminary injunction blocking the enforcement of a 24-hour waiting period and other abortion regulations, leaving in place a lower court decision that found the laws likely violate the state constitution.
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August 22, 2024
Texas Tells High Court It's Not Idaho '2.0' In HHS Abortion Row
Texas and a pair of anti-abortion doctor organizations have urged the U.S. Supreme Court to reject the federal government's appeal of a Fifth Circuit decision blocking the Biden administration's guidance that hospitals must provide emergency stabilizing medical care, including abortions.
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August 21, 2024
Fed. Circ. Won't Rethink IP Safe Harbor Case
The Federal Circuit on Wednesday declined to review its decision affirming the dismissal of Edwards Lifesciences' infringement suit against Meril Life Sciences after Edwards urged the full court to narrow its interpretation of a U.S. Food and Drug Administration safe harbor that essentially allows patent infringement during drug development.
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August 21, 2024
Tobacco Cos. Ask Justices To Review FDA's New Warnings
R.J. Reynolds Tobacco Co. is urging the U.S. Supreme Court to review a Fifth Circuit decision affirming an FDA rule mandating new health warnings on cigarette packaging and advertisements, arguing that the court created an unjustified circuit split when it found the graphic warnings are "purely factual and uncontroversial."
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August 21, 2024
Conn. Justices Back Insurer's Out-Of-Network Patient Bills
The Connecticut Supreme Court on Wednesday limited an emergency physician group's attempt to require a medical insurer to shoulder patient costs under the state's surprise medical billing law, holding that insurers can charge patients for shared costs, such as deductibles and copayments, at lower levels without violating consumer protection laws.
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August 21, 2024
Mich. High Court Asked To Redo Wrongful Death Ruling
The family of a deceased teen asked the Michigan Supreme Court on Tuesday for another chance to show that future earnings awards should be allowed in wrongful death cases, arguing the court's recent ruling restricting those awards ignored important state law.
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August 21, 2024
Union Health Plan Trustees Can't Avoid Fee Claim, Judge Says
Trustees of a UNITE HERE health plan can't topple a group of Southern California workers' claims that they are facing higher administrative expenses compared to another group of workers in Las Vegas, an Illinois federal court ruled Wednesday.
Expert Analysis
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When Calif. Health Shield Law Reaches Beyond State Borders
In light of California's newly signed shield law to increase protections for reproductive health and gender-affirming care, it's important to understand how the law's covered services and key legal protections could affect patients and providers nationwide, says Natalie Birnbaum at Nelson Hardiman.
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FDA's Lab-Developed Test Rule Faces High Hurdles
The U.S. Food and Drug Administration's recently announced plans to explicitly regulate lab-developed tests will likely face resistance from industry stakeholders and congressional actions, and lead to significant litigation, say attorneys at Hogan Lovells.
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FTC's Health Co. Suit Indicates Agency's Private Equity Focus
The Federal Trade Commission's latest lawsuit against an anesthesia company and its private equity investor highlights the agency's willingness to regulate the health care industry even when relevant acquisitions are relatively dated or when the controlling entity's economic interest is under 50%, say attorneys at Simpson Thacher.
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What Marijuana Status Change Would Mean For Industry
If the Drug Enforcement Administration accepts the U.S. Department of Health and Human Services’ recent recommendation to change marijuana’s classification under federal law, it would be a significant regulatory shift that could foster many industry benefits — but questions, risks and uncertainties at both the state and federal levels would remain, say attorneys at Neal Gerber.
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Top 4 Antitrust Enforcement Issues In Health Care Today
The Federal Trade Commission's recent lawsuit against U.S. Anesthesia Partners exemplifies antitrust enforcement authorities' efforts to aggressively reshape the health care industry, ranging from new proposed rules to withdrawals of previous guidance, say attorneys at Fried Frank.
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Calif. Climate Disclosure Bills Promise Challenges For Cos.
Two novel climate disclosure bills recently passed by the California Legislature will pose challenges for many businesses — especially private companies that are less familiar with climate-related reporting obligations — and will require investments of significant time and effort in processes, procedures and personnel, say John Rousakis and Chris Bowman at O'Melveny.
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Maximizing Law Firm Profitability In Uncertain Times
As threats of an economic downturn loom, firms can boost profits by embracing the power of bottom-line management and creating an ecosystem where strategic financial oversight and robust timekeeping practices meet evolved client relations, says Shireen Hilal at Maior Strategic Consulting.
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5th Circ. Ruling Reminds Attys That CBP Can Search Devices
The Fifth Circuit’s recent Malik v. Department of Homeland Security decision adds to the chorus of federal courts holding that border agents don’t need a warrant to search travelers’ electronic devices, so attorneys should consider certain special precautions to secure privileged information when reentering the U.S., says Jennifer Freel at Jackson Walker.
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ESG Around The World: European Union
As the EU makes ESG regulation a priority, companies — both those based in the EU and others just doing business there — need to keep abreast of myriad new legislation that has either already taken effect or will in the near future, as noncompliance could result in fines, damages and director liability, say attorneys at Steptoe & Johnson.
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Avoiding The Ethical Pitfalls Of Crowdfunded Legal Fees
The crowdfunding of legal fees has become increasingly common, providing a new way for people to afford legal services, but attorneys who accept crowdsourced funds must remember several key ethical obligations to mitigate their risks, say Hilary Gerzhoy and Julienne Pasichow at HWG.
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4 Pharma Industry Arguments Against CMS Drug Pricing Plan
The Centers for Medicare & Medicaid Services is facing significant pushback regarding its plans for implementing the Inflation Reduction Act's Medicare drug price negotiation program, due to a number of potential repercussions for manufacturers, say attorneys at Mintz Levin.
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Issues Ahead As Psychedelic Medicine Faces Pivotal Moment
Recent regulatory changes and decriminalization efforts have opened doors for research and development in psychedelic medicine, but challenges like stigma, access and funding persist, meaning companies will need to address these issues to support the industry’s credibility, say consultants at FTI Consulting.
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An Overview Of 6 PBM Bills Moving Through Congress
As legislators turn to pharmacy benefit manager reform as a potential next step in addressing the cost of prescription drugs, six congressional committees have recently advanced PBM-related legislation with generally high bipartisan support, suggesting that a final package is likely to advance through Congress, say Rachel Stauffer and Katie Waldo at McDermott+Consulting.