Policy & Compliance
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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.
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February 21, 2025
LGBTQ+ Health Orgs Aim To Halt Trump DEI, Gender Orders
Three executive orders by President Donald Trump barring federal contractors from pushing "gender ideology" and diversity-related programs violate the U.S. Constitution, a group of nonprofit LGBTQ+ organizations told a California federal court.
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February 21, 2025
NIH Research Cuts Stay On Hold As Judge Mulls Objections
A Boston federal judge on Friday extended her hold on a Trump administration proposal to slash reimbursements from the National Institutes of Health for research grant costs, a move colleges, hospitals and other institutions have said would wreak havoc on scientific research.
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February 20, 2025
COVID Fraud Drove Record FCA Caseload, Gov't Officials Say
Federal officials said that the record-setting number of whistleblower False Claims Act cases filed in 2024 was likely driven by COVID-19-related fraud, with the use of data mining having an outsized role in those cases.
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February 20, 2025
Boston, Other Cities And MassBio Back Challenge To NIH Cuts
The city of Boston and 44 other cities, counties and elected officials around the country and, separately, the life sciences industry group Massachusetts Biotechnology Council asked a Massachusetts federal judge on Thursday to extend a temporary restraining order blocking steep cuts to National Institutes of Health reimbursement for research projects.
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February 20, 2025
Feds Say DC Judge Can't Bar 'Hypothetical' Spending Freezes
A Justice Department attorney argued before a D.C. federal judge Thursday that there is no basis to continue blocking the Trump administration from implementing a blanket suspension on federal spending, saying the court cannot bar "hypothetical" future freezes.
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February 20, 2025
Dems Seek Answers, Reversals For 'Reckless' VA Cuts
Democrats in Congress asked Secretary of Veterans Affairs Doug Collins to justify how firing 1,000-plus VA employees could possibly benefit veterans, and they called on him to reverse the cuts, stating that they are causing negative impacts.
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February 20, 2025
AmerisourceBergen Strikes Settlement In 401(k) Fee Suit
AmerisourceBergen and a proposed class of workers who alleged their employee 401(k) plan was saddled with excessive recordkeeping and administrative costs have struck a settlement deal to resolve the dispute, according to a filing in Kentucky federal court.
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February 20, 2025
HHS Rescinds Guidance On Gender-Affirming Care For Minors
The U.S. Department of Health and Human Services on Thursday rescinded guidance for health plans and insurers on complying with the Affordable Care Act's nondiscrimination provisions with regard to gender-affirming care for minors, which President Donald Trump called on the agency to do in a January executive order.
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February 20, 2025
DOJ Official Flags 'Aggressive' FCA Approach Under Trump
A senior U.S. Department of Justice official said Thursday that the Trump administration's focus on government efficiency will include "aggressively" enforcing the False Claims Act, including a strong focus on FCA enforcement of foreign trade issues amid recently imposed tariffs.
Expert Analysis
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OSHA Workplace Violence Citation Highlights Mitigation Steps
The Occupational Safety and Health Administration's recent citation against behavioral health company Circles of Care sheds light on the enforcement risks companies may face for failing to prevent workplace violence, and is a reminder of the concrete steps that can help improve workplace safety, say attorneys at Benesch.
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When Banks Unknowingly Become HIPAA Biz Associates
There appears to be significant confusion regarding the application of the Health Insurance Portability and Accountability Act to financial institutions when serving healthcare-related clients, so these institutions should consider undertaking several steps as a starting point in the effort to achieve compliance, say attorneys at Vorys.
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The Regulatory Headwinds Facing Lab-Developed Tests
Though the U.S. Food and Drug Administration's final rule regarding regulation of laboratory-developed tests outlines a four-year plan for ending enforcement discretion, and though this rule is currently being challenged in courts, manufacturers should heed compliance opportunities immediately as enforcement actions are already on the horizon, say attorneys at Kirkland & Ellis.
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3 High Court Rulings May Shape Health Org. Litigation Tactics
Three separate decisions from the U.S. Supreme Court's most recent term — Loper Bright, Corner Post and Jarkesy — will likely strengthen healthcare organizations' ability to affirmatively sue executive agencies to challenge regulations governing operations and enforcement actions, say attorneys at McDermott.
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A New Way Forward For COVID Vaccine Lawsuit Immunity
As Public Readiness and Emergency Preparedness Act protections for COVID-19 vaccines wane, adding those vaccines to coverage by the National Vaccine Injury Compensation Program would bolster defenses for administrators and manufacturers while also providing stronger remedies for those injured by vaccines, says Altom Maglio at MCT Law.
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Why DOJ's Whistleblower Program May Have Limited Impact
The U.S. Department of Justice’s new whistleblower pilot program aims to incentivize individuals to report corporate misconduct, but the program's effectiveness may be undercut by its differences from other federal agencies’ whistleblower programs and its interplay with other DOJ policies, say attorneys at Milbank.
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How Cos. With Chinese Suppliers Should Prep For Biotech Bill
A proposed bill to prohibit government-affiliated life sciences companies from contracting with Chinese biotech companies of concern may necessitate switching to other sources for research and supplies, meaning they should begin evaluating supply chains now due to the long lead times of drug development, say John O'Loughlin and Christina Carone at Weil Gotshal.
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FTC's Drug Middlemen Probe Highlights Ongoing Scrutiny
The Federal Trade Commission's interim staff report on its inquiry into pharmacy benefit managers suggests that the industry will remain under an enforcement microscope for the foreseeable future due to concerns about how PBMs affect drug costs and accessibility, say attorneys at Arnold & Porter.
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What Cos. Should Note In DOJ's New Whistleblower Pilot
After the U.S. Department of Justice unveiled a new whistleblower pilot program last week — continuing its efforts to incentivize individual reporting of misconduct — companies should review the eligibility criteria, update their compliance programs and consider the risks and benefits of making their own self-disclosures, say attorneys at Skadden.
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Motion To Transfer Venue Considerations For FCA Cases
Several recent decisions highlight the importance for practitioners of analyzing as early as possible whether a False Claims Act case warrants a change of venue, and understanding how courts weigh certain factors for defendants versus whistleblowers, say Ellen London at London & Stout, and Li Yu and Corey Lipton at DiCello Levitt.
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A Primer On EU's Updated Human Substance Regulations
The European Union's updated standards regarding quality and safety of substances of human origin meant for human application carry significant implications for companies that work with cells and tissues, and U.S. companies active in the EU market should pay particular attention to the import and export rules, say Geneviève Michaux and Georgios Symeonidis at King & Spalding.
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CFPB's Medical Debt Proposal May Have Side Effects
The Consumer Financial Protection Bureau’s recent proposal to prevent medical debt information from appearing on consumer reports and creditors from basing lending decisions on such information may have initial benefits for some consumers, but there are potential negative consequences that should also be considered, say attorneys at Cooley.
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15 Areas That Would Change Under Health Data Rule Proposal
If finalized, the Office of the National Coordinator for Health Information Technology's proposed rule will significantly progress its efforts to advance interoperability, respond to stakeholder concerns and clarify compliance with the health IT certification program, say attorneys at Ropes & Gray.