Policy & Compliance

  • June 07, 2024

    Chicago-Area Man Charged With $60M COVID Test Fraud

    A suburban Chicago man is facing healthcare fraud and money laundering charges over more than $60 million in Medicare reimbursement claims for over-the-counter COVID-19 test kits that were allegedly never provided, including thousands of tests for dead people.

  • June 07, 2024

    7 Health Insurers Eye Rate Hikes In Connecticut

    Seven health insurers have asked Connecticut state regulators to approve rate hikes of 7.4% to 12.5% for individual market plans and 5.1% to 13.6% for small groups, averaging out to a lesser increase than last year's, according to an announcement Friday.

  • June 06, 2024

    Chronic Care Co. To Pay $14.9M To End DOJ False Claims Suit

    A provider of chronic disease management services across several states has reached a $14.9 million settlement with the U.S. Department of Justice, resolving a False Claims Act suit alleging it defrauded Medicare and Medicaid by "upcoding" healthcare claims.

  • June 06, 2024

    Justices Say Feds Liable For Tribes' Healthcare Admin Costs

    A split U.S. Supreme Court on Thursday held that the federal government is required to reimburse two Native American tribes millions of dollars in administrative healthcare costs, saying the spending is necessary for the communities to operate programs assumed from the Indian Health Service.

  • June 05, 2024

    House Votes To Block Vets' Access To Gender-Affirming Care

    The U.S. House of Representatives on Wednesday passed a $147.5 billion spending bill along mostly party lines funding military construction and the U.S. Department of Veterans Affairs, which would block veterans' access to gender-affirming care and which the White House has already threatened to veto.

  • June 05, 2024

    Calif. Wage Hike To Cover Nearly All Healthcare Workplaces

    Nearly all workers at healthcare facilities in California will be entitled to a higher minimum wage beginning July 1 regardless of whether they're involved in patient care. One expert called the increase a sweeping change, partly due to broad definitions of what employees and facilities are covered.

  • June 04, 2024

    Divided 9th Circ. Reverses Sutter Health Antitrust Trial Victory

    A split Ninth Circuit panel on Tuesday overturned Sutter Health's win in insurance plan purchasers' $400 million antitrust suit, ruling that the lower court wrongly excluded "highly relevant" evidence — including admissions by Sutter executives — that would've helped the purchasers potentially prove claims they overpaid thanks to Sutter's anticompetitive conduct.

  • June 04, 2024

    Texas Justices Fuel Confusion Over Abortion Ban Exceptions

    The Texas Supreme Court recently ruled that doctors may perform abortions only when "reasonable medical judgment" says a patient's life is in danger — a decision attorneys say puts doctors in the position of weighing the lives of their patients against the risk of criminal prosecution.

  • June 04, 2024

    FDA Advisers Rebuff Bid To Treat PTSD With MDMA

    A panel of public health experts on Tuesday dealt a blow to a historic effort to regulate MDMA therapy for post-traumatic stress disorder, saying although the positive effects shown in clinical trials are promising, the proposal was hindered by too many confounding factors.

  • June 04, 2024

    HHS Guidance, Feud Over FCA Evidence, And A Deposed AG

    States sue the Biden administration over nondiscrimination guidance. A False Claims Act case sees a tussle over evidence. A Connecticut federal judge allows drugmakers to depose the office of D.C.'s attorney general. Here, Law360 Healthcare Authority looks at notable developments in healthcare litigation over the past week.

  • June 04, 2024

    Ga. County Wants 11th Circ. To Rethink Trans Care Ban Ruling

    A Georgia county that lost a legal challenge to a provision of its health plan that bars coverage for gender-affirming surgery has asked the full Eleventh Circuit to revisit the decision, arguing that an opinion last month wrongly found the policy discriminates against transgender people, rather than being isolated to a single procedure.

  • June 04, 2024

    2nd Circ. Says ERISA Blocks Cigna Bill Backpedaling Suit

    The Second Circuit affirmed the dismissal of a podiatric medicine provider's suit alleging Cigna illegally backtracked on covering a patient's $200,000 bill, ruling that a lower court was right to find that federal benefits law blocks the healthcare provider's breach of contract claims.

  • June 04, 2024

    5th Circ. Medical 'Disinformation' Decision: 5 Things To Know

    A divided 5th Circuit gave a conservative medical group that says it was hurt by a campaign to suppress criticism of Dr. Anthony Fauci another shot at its free-speech claims. Here are five things you should know about the case.

  • June 04, 2024

    Benefits Plan Inks Deal To End Mental Health Coverage Suit

    The employee benefits plan at Mountain Area Health Education Center became the last remaining defendant to reach a settlement in a North Carolina district court lawsuit accusing an insurer and others of refusing to cover the cost of a patient's stay at a residential treatment center.

  • June 04, 2024

    What Clinical Trial Attys Want From FDA Diversity Guidance

    Impending federal guidance on diversifying clinical trial participation marks the latest push to address the historic homogeneity of clinical research. Here, clinical trial attorneys share with Law360 Healthcare Authority the questions they hope the FDA will answer.

  • June 04, 2024

    White House Threatens Veto Over Policy Riders In VA Bill

    The White House has threatened to veto a $147.5 billion bill funding military construction and the U.S. Department of Veterans Affairs, citing partisan policy proposals it said would harm minority groups and risk patient safety at VA medical facilities.

  • June 04, 2024

    Ex-Keller & Heckman Scientist Joins K&L Gates In DC

    K&L Gates LLP announced Tuesday that a longtime scientist at Keller and Heckman LLP joined its Washington, D.C., office as the firm's first senior scientific adviser.

  • June 04, 2024

    NM Cannabis Co. Says Insurers Can't Toss Medical Weed Row

    A group of insurers can't escape a proposed class action demanding they cover medical marijuana costs, a cannabis company and several of its patients said, telling a New Mexico federal court that medical cannabis is a medically necessary behavioral health service that must be covered.

  • June 04, 2024

    Sens. Offer Stark Takes On Abortion Two Years Post-Dobbs

    Republican and Democratic members of the Senate health committee on Tuesday offered two different views of abortion in America two years after the Dobbs Decision overturned the federal right to the procedure.

  • June 04, 2024

    Recent Foley Hoag Addition Tapped As Life Sciences Co-Chair

    Boston-based Foley Hoag LLP announced the appointment of a recently hired patent partner as co-chair of its life sciences industry group, the largest industry sector it services.

  • June 04, 2024

    A Lawsuit 'Field Day' Over Calif. Healthcare Worker Wage Hike

    Even before going into effect, California's new healthcare worker minimum wage is generating complex legal questions about its scope and predictions of legal clashes to come.

  • June 03, 2024

    Colo. Gov Signs Compromise Bill Raising Damages Caps

    Colorado Gov. Jared Polis on Monday signed a law that will increase statutory caps on noneconomic damages for wrongful death and injury claims, as part of a deal to avoid a ballot-box fight between medical providers and personal injury lawyers.

  • June 03, 2024

    House COVID Panel Questions Fauci Over Pandemic Origins

    Anthony Fauci, the former director of the National Institute of Allergy and Infectious Disease responsible for overseeing the pandemic response, was pressed by a U.S. House COVID-19 panel Monday about recent allegations that a senior official tried to evade open records laws regarding the origins of the pandemic.

  • June 03, 2024

    Senate To Vote On Right To Contraception

    The Senate will vote later this week on a bill to codify a statutory right to contraception, ahead of the two-year anniversary of the U.S. Supreme Court's overturning of Roe v. Wade.

  • June 01, 2024

    Blockbuster Summer: 10 Big Issues Justices Still Must Decide

    As the calendar flips over to June, the U.S. Supreme Court still has heaps of cases to decide on issues ranging from trademark registration rules to judicial deference and presidential immunity. Here, Law360 looks at 10 of the most important topics the court has yet to decide.

Expert Analysis

  • SEC Cybersecurity Rule Presents Burden For Health Care Cos.

    Author Photo

    A new rule from the U.S. Securities and Exchange Commission aims to increase cybersecurity resiliency, but may only force regulated entities — particularly those in the health care space — to face a far more complicated environment with increased strategic and litigation risks, say Bess Hinson and Angad Chopra at Holland & Knight.

  • Caregiver Flexibility Is Crucial For Atty Engagement, Retention

    Author Photo

    As the battle for top talent continues post-pandemic, many firms are attempting to attract employees with progressive hybrid working environments — and supporting caregivers before, during and after an extended leave is a critically important way to retain top talent, says Manar Morales at The Diversity & Flexibility Alliance.

  • Online Tracking Tech Brings HIPAA Compliance Risks

    Author Photo

    Amid increasing scrutiny and litigation over uses of online tracking technology, it's critical for companies under the purview of the Health Insurance Portability and Accountability Act to carefully navigate website cookies' collection of protected health information, which may happen without website operators' knowledge, says Richard Sheinis at Hall Booth.

  • Nursing Homes Must Prepare For Ownership Scrutiny

    Author Photo

    Due to the Centers for Medicare & Medicaid Services' designation of nursing home ownership changes as a high risk category, and increased transparency and notice obligations for changes in skilled nursing facility ownership set to take effect in Pennsylvania in October, owners should anticipate a heightened level of review and delays, say Mark Mattioli and Paula Sanders at Post & Schell.

  • In-Office Engagement Is Essential To Associate Development

    Author Photo

    As law firms develop return-to-office policies that allow hybrid work arrangements, they should incorporate the specific types of in-person engagement likely to help associates develop attributes common among successful firm leaders, says Liisa Thomas at Sheppard Mullin.

  • A Judge's Pitch To Revive The Jury Trial

    Author Photo

    Ohio state Judge Pierre Bergeron explains how the decline of the jury trial threatens public confidence in the judiciary and even democracy as a whole, and he offers ideas to restore this sacred right.

  • How To Recognize And Recover From Lawyer Loneliness

    Author Photo

    Law can be one of the loneliest professions, but there are practical steps that attorneys and their managers can take to help themselves and their peers improve their emotional health, strengthen their social bonds and protect their performance, says psychologist and attorney Traci Cipriano.

  • Litigation Funding Disclosure Should Be Mandatory

    Author Photo

    Despite the Appellate Rules Committee's recent deferral of the issue of requiring third-party litigation funding disclosure, such a mandate is necessary to ensure the even-handed administration of justice across all cases, says David Levitt at Hinshaw.

  • 4 Employer Action Steps For New Mental Health Parity Rules

    Author Photo

    A recently released guidance under the Mental Health Parity and Addiction Equity Act reiterated that employers contracting with outside service providers to administer their health plans are not relieved of their compliance obligations — so all employers sponsoring a group health plan should consider four action items for success, say attorneys at Ice Miller.

  • Recalling USWNT's Legal PR Playbook Amid World Cup Bid

    Author Photo

    As the U.S. Women's National Soccer Team strives to take home another World Cup trophy, their 2022 pay equity settlement with the U.S. Soccer Federation serves as a good reminder that winning in the court of public opinion can be more powerful than a victory inside the courtroom, says Hector Valle at Vianovo.

  • Parsing Through The FTC's Proposed Health Privacy Updates

    Author Photo

    The Federal Trade Commission's recently proposed updates to its Health Breach Notification Rule contain subtle but significant changes to key terms that help modernize the agency's health app regulation and provide stakeholders an important opportunity to help shape the future of virtual health care, say attorneys at Arnold & Porter.

  • Indivior Ruling May Affect Rebate Wall Litigation

    Author Photo

    A New Jersey federal court's recent decision in Indivior v. Alvogen, in which a claim that an alleged rebate wall anti-competitively blocked generic competition survived summary judgment, may provide a blueprint for successfully challenging other drug rebating practices, say Peter Herrick and Monsura Sirajee at O'Melveny.

  • Compliance Takeaways From HHS Information Blocking Rule

    Author Photo

    A recently finalized rule from the U.S. Department of Health and Human Services' Office of Inspector General demonstrates a renewed focus on investigating practices that may interfere with patients' access to their electronic health information, and should encourage renewed compliance efforts across a range of processes, say attorneys at Ropes & Gray.