Policy & Compliance

  • August 19, 2024

    9th Circ. Told Psilocybin Petition Is Backed By Precedent

    A Ninth Circuit panel on Monday dissected opposing arguments from the U.S. Drug Enforcement Administration and a Seattle doctor over whether there is precedent to allow the dispensing of psilocybin — a psychedelic compound — to treat terminally ill patients.

  • August 19, 2024

    MOVEit MDL Judge's Call For Order Met With Atty Squabbles

    A federal judge's effort to streamline multidistrict litigation over a 2023 data breach involving Progress Software's MOVEit file transfer tool instead led to a lengthy and contentious joint filing in which the parties accused one another of gamesmanship.

  • August 19, 2024

    Second Pharmacist To Avoid Meningitis Murder Trial

    A pharmacist charged with murder in a deadly fungal meningitis outbreak that killed dozens of people is expected to plead no contest to involuntary manslaughter charges this week, averting a Michigan trial that had been set for November.

  • August 16, 2024

    Humana To Pay $90M To End 8-Year Medicare Drug FCA Battle

    Humana Inc. has agreed to pay the federal government $90 million to settle long-running False Claims Act allegations it submitted fraudulent bids for Medicare prescription drug deals, Phillips & Cohen LLP said Friday in announcing the "first case of its kind" to resolve allegations of fraud in the Medicare Part D contracting process.

  • August 16, 2024

    Baltimore Inks $152.5M Opioid Deal With Cardinal Health

    Baltimore announced Friday that it settled claims for $152.5 million with Cardinal Health over its alleged role in helping fuel the city's opioid crisis, reaching the deal with the pharmaceutical distributor ahead of a September trial against five remaining defendants and following separate $45 million settlements with Allergan and CVS.

  • August 16, 2024

    24-Hour Abortion Delay Violates Ohio Constitution, Court Told

    In the wake of an Ohio constitutional amendment enshrining the right to abortion, a state court heard arguments Friday as it considers whether to block laws requiring pregnant individuals to wait at least 24 hours before they can access abortions in the state.

  • August 16, 2024

    NC Litigation Highlights Of 2024: A Midyear Report

    Several-high profile cases in North Carolina came to a close in the first half of the year, from a second bribery conviction against an insurance magnate beset by legal woes, to the anticlimactic withdrawal of a state Supreme Court justice's much-watched free speech suit. Here, Law360 looks at those and other notable rulings so far in North Carolina.

  • August 16, 2024

    New Jersey Litigation Highlights Of 2024: A Midyear Report

    A court's upheaval of New Jersey's longstanding "county line" ballot layout for the Democratic primary fueled both sides of the lively political aisle this year, while the same federal judge also riled the state's pharmaceutical hotbed by ending two challenges to Medicare's ability to negotiate drug prices. Here, Law360 looks at some of the notable cases so far in New Jersey.

  • August 15, 2024

    2023 Rule Revising Hospital Payments Struck Down

    A Texas federal judge on Thursday sided with about a dozen hospitals challenging a federal regulation that they say will curtail their payments for treating low-income patients, declaring the rule unlawful and setting it aside.

  • August 15, 2024

    Matthew Perry's Assistant And 2 Drs. Charged In Actor's Death

    The former personal assistant for actor Matthew Perry and two doctors have been criminally charged in connection with the "Friends" star's death last year from an overdose of ketamine, according to a criminal complaint unsealed Thursday in California federal court.

  • August 15, 2024

    9th Circ. Judges Seem To Split On Wash. Abortion Coverage

    A Ninth Circuit judge asked Thursday how a church could be harmed by a Washington law requiring employee health plans to cover abortions, since none of its workers had ever actually sought one, while another judge asked if tossing the case would slam the door on religious objections.

  • August 15, 2024

    CMS Posts Final Costs For 1st Set Of Drugs After Negotiations

    The federal government released on Thursday the final prices of the first 10 drugs negotiated by Medicare under the Inflation Reduction Act, in a long-anticipated move set to shape the future of drug price negotiations.

  • August 15, 2024

    Ill. Health Center Challenges NLRB Constitutionality

    An Illinois health center on Wednesday filed the latest constitutional challenge to the National Labor Relations Board, urging an Illinois federal judge to block an NLRB prosecution over its decision to fire employees who allegedly provided fake Social Security numbers when they were hired.

  • August 15, 2024

    Del. Chancery OKs $175M Judgment Against Insys Founder

    The convicted founder of drugmaker Insys has told Delaware's Chancery Court he agreed to accept a $175 million judgment as part of a settlement with the company's liquidation trust over his role in an opioid kickback scheme that drove the firm into bankruptcy.

  • August 15, 2024

    Full 11th Circ. To Weigh Georgia Deputy's Trans Health Win

    The Eleventh Circuit agreed Thursday to a full-court rehearing of an appeal from Georgia county officials looking to overturn a deputy's win in her suit alleging a health plan coverage exclusion for gender-affirming surgery violated federal anti-discrimination law.

  • August 14, 2024

    HHS Eyes 2025 For New Medicare Appeal Rule

    In response to a Connecticut federal judge's stern demand for quicker progress, the U.S. Department of Health and Human Services has said in a court filing that it should be able to implement a new rule creating an avenue for Medicare beneficiaries to appeal their hospitalization status by Jan. 1.

  • August 14, 2024

    Hospital Groups Tell High Court HHS 'Stingy' In SSI Pay Row

    Six of the nation's leading hospital associations told the Supreme Court on Wednesday that the U.S. Department of Health and Human Services is being "stingy" when miscalculating a formula that could cost hospitals treating low-income patients more than a billion dollars in special payments each year. 

  • August 14, 2024

    Texas Sues HHS Over 'Arbitrary' Nursing Home Staffing Rule

    The state of Texas on Wednesday challenged a new federal rule that sets minimum staffing standards at nursing homes, contending the Biden administration overstepped its statutory authority and crafted a rule almost impossible to meet because of nursing shortages.

  • August 14, 2024

    HHS Calls For More Research, Planning To Combat Heat Risks

    Citing a sharp increase in deaths from extreme heat, the Biden administration unveiled a national strategy Wednesday that calls for better communicating the health risks of hot weather to the public and taking other steps to protect people from life-threatening heat waves.

  • August 14, 2024

    1st Circ. Revives Vax Refusal Suit Against Beth Israel

    The First Circuit on Tuesday revived a suit against health facility system Beth Israel Lahey Health Inc. from an office manager who was fired over her refusal to be vaccinated against COVID-19, disagreeing with a lower court that said she hadn't shown a genuine religious belief meriting a vaccine exemption.

  • August 14, 2024

    Medical Device Maker Pleads Guilty To $2.4M Tax Evasion

    A man who made millions of dollars on medical devices and sold one purporting to eradicate viruses by using sound waves pled guilty to evading $2.4 million in taxes in a trust scheme involving his girlfriend, according to Florida federal court documents.

  • August 13, 2024

    CMS Takes Baby Steps In New 'Breakthrough' Device Policy

    The Centers for Medicare and Medicaid Services recently finalized highly anticipated guidance providing a new pathway for Medicare coverage of breakthrough medical devices, but attorneys worry the agency's plans to accept just five products each year will blunt the program's impact.

  • August 13, 2024

    Test-Makers See Way Out Of FDA Rule With Chevron Reversal

    This spring, despite widespread industry opposition, the U.S. Food and Drug Administration granted itself oversight of laboratory-developed diagnostic tests. Now, industry groups say they're facing a costly and convoluted agency approval process — one they hope they can dismantle based on the Supreme Court's recent decision to overturn Chevron deference.

  • August 13, 2024

    Wash. Social Media Ban Violates Workers' Free Speech

    The Washington State Court of Appeals has said a state law barring injured workers from posting videos of their state workers' compensation medical exams on social media is an unconstitutional violation of free speech rights.

  • August 13, 2024

    Biotechs Walk Tightrope On Drug Price Negotiation Messaging

    Biotech companies whose products have been affected by Medicare price negotiations under the Inflation Reduction Act largely reassured investors on recent earnings calls of their success, even as they argue in court that the program could upend their businesses and the larger industry.

Expert Analysis

  • NIST March-In Framework Is As Problematic As 2021 Proposal

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    While the National Institute of Standards and Technology's proposed march-in framework on when the government can seize patents has been regarded as a radical departure that will support lowering prescription drug costs, the language at the heart of it is identical to a failed 2021 notice of proposed rulemaking, says attorney Kelly Morron.

  • Spartan Arbitration Tactics Against Well-Funded Opponents

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    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.

  • The Road Ahead For Florida's Drug Importation Program

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    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.

  • Assessing CDC's Revised Guideline On Opioid Prescriptions

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    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.

  • Valeant Ruling May Pave Way For Patent-Based FCA Suits

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    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.

  • Suits Against Insulin Pricing Are Driven By Rebate Addiction

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    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.

  • When Physician Retirement Arrangements May Be Legal

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    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.

  • ESG Around The World: Gulf Cooperation Council

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    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.

  • Navigating ACA Reporting Nuances As Deadlines Loom

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    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.

  • Lessons From Rare Post-Verdict Healthcare Fraud Acquittal

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    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.

  • ChristianaCare Settlement Reveals FCA Pitfalls For Hospitals

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    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.

  • Patent Waiver For COVID Meds Would Harm US Biopharma

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    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.

  • New CMS Rule Will Change Nursing Facility Disclosures

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    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.