Policy & Compliance

  • August 07, 2024

    Amgen Waged Lawfare To Overcharge For Drug, Suit Claims

    Maryland-based independent licensees of the Blue Cross Blue Shield Association claim pharmaceutical giant Amgen Inc. and its subsidiaries have engaged in unlawful monopolistic practices that have inflated the cost of the blockbuster drug Enbrel.

  • August 07, 2024

    Okla. Wants Justices To Step Into Title X Funding Cut Fight

    Oklahoma has filed an emergency application with the U.S. Supreme Court to stop the U.S. Department of Health and Human Services from withholding millions of dollars of Title X funding from the state because of its refusal to refer family planning patients for abortions.

  • August 06, 2024

    Fed. Circ. Told Edwards Filed Safe Harbor Suit With Bad Intent

    The Federal Circuit rightfully held Meril Life Sciences was protected by a patent safe harbor when bringing its preapproval transcatheter heart valve system to an industry conference and that Edwards Lifesciences' attempts to prove otherwise are just delay tactics, Meril told the full court.

  • August 06, 2024

    Ohio Judge Upholds Law Limiting Gender Care, Sports Access

    An Ohio judge on Tuesday allowed the state to begin enforcing a law that restricts gender-affirming care for minors and bans transgender girls' participation in female sports, siding with the state and determining that the law is a legitimate attempt to protect children.

  • August 06, 2024

    A 'Watershed' DOJ Tipster Program Eyes Private Payer Fraud

    A U.S. Department of Justice pilot program promising payouts to qualifying whistleblowers who tip off investigators about schemes at private healthcare payers marks a big shift in federal fraud enforcement efforts, and a significant new liability risk for providers.

  • August 06, 2024

    Cancer Doc In Bitter Firing Dispute Loses At Mont. High Court

    A Montana oncologist's firing from his longtime hospital in Helena prompted an outcry among his former patients. A recent ruling by the Montana Supreme Court in favor of his former employer closed a chapter in an ongoing legal saga.

  • August 06, 2024

    NC Hospital Gets New Shot At Emergency Dept. Plan Approval

    A state appellate panel on Tuesday unraveled a decision overturning approval for a freestanding emergency department in rural North Carolina, ruling that an administrative law judge misapplied precedent when deciding whether a state agency's failure to hold a public hearing prejudiced the decision-making process. 

  • August 07, 2024

    Dinsmore Adds 5-Atty Litigation Group From Bricker Graydon

    Dinsmore & Shohl LLP announced Tuesday that a five-person litigation team led by a healthcare partner with over 30 years of experience joined the firm's Columbus, Ohio, office from Bricker Graydon LLP.

  • August 06, 2024

    Alabama Calls Its Gender Care Law A Rational Policy Choice

    Alabama lawmakers acted out of a desire to protect children — not discriminatory intent — when they passed legislation that restricted gender-affirming care for minors, easily clearing the legal standard required to uphold the law, the state has told a federal judge.

  • August 06, 2024

    CMS Signals States Can Dump Medical Debt After NC Consent

    After the U.S. Centers for Medicare & Medicaid Services approved North Carolina's plan to offer enhanced Medicaid reimbursements for hospitals that forgive medical debts, other states could follow its lead. Some have questioned whether the state agency implementing the program can legally carry it out. 

  • August 06, 2024

    Ethical, Legal Challenges Await La. Surgical Castration Law

    Physicians in Louisiana may be forced to confront unusual ethical questions under a first-in-the-nation state law allowing judges to order the surgical castration of some sex offenders.

  • August 06, 2024

    5 More Podcasts For Health, Life Sciences Attorneys

    As the days get hotter and the start of the school year gets closer, health and life sciences practitioners might need a respite. If you've been there and done that with Law360's first five recommended podcasts, here are five more to take you into the fall and beyond.

  • August 05, 2024

    Indivior Accused Of Overstating Prospects Of 3 Opioid Drugs

    Drugmaker Indivior PLC has been hit with a proposed investor class action in Virginia federal court over claims it overstated the financial prospects of its drugs used to treat opioid use disorders and the company's ability to forecast such financial projections.

  • August 05, 2024

    Chinese Drug Co. Says Sanctions In Valsartan MDL Too Harsh

    Chinese drug firm Zhejiang Huahai Pharmaceutical Co. Ltd. told a New Jersey federal court Friday that sanctions authorizing two adverse jury instructions in multidistrict litigation over generic drugs contaminated with carcinogens should be overturned, arguing the plaintiffs did not allege the bad faith required for such a harsh penalty.

  • August 05, 2024

    Mich. Says HHS Can't Get Back $195M Medicaid Payments

    The state of Michigan is asking a D.C. federal judge to bar the federal government from seeking repayment for $195 million in Medicaid payouts made to two state-operated hospitals that provided psychiatric services to state criminal defendant inmates, saying the government's payment withdrawal decision was made years too late and without proper notice.

  • August 05, 2024

    Mich. AG Defends Judge's Block Of Abortion Waiting Period

    A Michigan judge's suspension of several state abortion regulations should be upheld, Michigan Attorney General Dana Nessel told appellate judges, saying the restrictions don't pass constitutional muster because they don't serve to protect women's health.

  • August 05, 2024

    Insurer Must Face Pa. Trans Firefighter's Surgery Claim

    A Pennsylvania federal judge has refused to toss a suit from a transgender Philadelphia firefighter suing Independence Blue Cross for discrimination over the insurer's denial of coverage for facial feminization surgery, finding that claims under federal healthcare law could proceed, but not the Title VII claims.

  • August 05, 2024

    Nursing Home Flubs Make Reports Fair Game, NJ Justices Say

    Two Garden State healthcare facilities failed to follow state regulations in after-incident reviews, making the normally privileged reports accessible to plaintiffs, the New Jersey Supreme Court ruled Monday.

  • August 05, 2024

    7th Circ. Backs Insurer's Win In Family's Autism Claims Fight

    The Seventh Circuit on Monday affirmed a win for a Wisconsin health insurer in a family's dispute over coverage for autism therapies, finding that the insurer's denials of speech therapy to treat autism for a minor child were valid under a policy exclusion for treatments that weren't evidence-based.

  • August 05, 2024

    Fla. Man Gets 44 Months For $5M MilliporeSigma Export Scam

    A Florida federal judge sentenced a Taiwanese citizen who lives in the Sunshine State to three years and eight months in prison for his role in a $5 million scheme to defraud life sciences company MilliporeSigma and the U.S. government by illegally exporting MilliporeSigma products to China.

  • August 02, 2024

    5th Circ. Upholds Challenge To Surprise Medical Billing Rule

    The Fifth Circuit on Friday affirmed wins for plaintiffs challenging provisions of a federal surprise medical billing rule that relate to payment fights between out-of-network providers and health insurers, agreeing with a Texas federal judge that the rule places "a thumb on the scale" in insurers' favor.

  • August 02, 2024

    Fla.'s Trans Healthcare Ban Violates Title VII, Judge Says

    A Florida federal judge has ruled the state's Department of Management Services illegally excluded gender-affirming treatment for transgender employees under state-sponsored health benefits plans, finding the state's exclusion only applies to trans individuals and is facially discriminatory under Title VII of the Civil Rights Act.

  • August 02, 2024

    Split 2nd Circ. Orders Partial Redo In Docs', Attys' Injury Scam

    A divided Second Circuit panel on Friday upheld the convictions of three men who recruited patients for a more than $31 million trip-and-fall fraud scam that personal injury lawyers and doctors orchestrated, but remanded the case for further findings on the number of bogus accidents involved in the scheme.

  • August 02, 2024

    2nd Circ. Backs Conviction Over Fake-Therapy Scheme

    The Second Circuit on Friday refused to overturn the conviction of a therapist who was found guilty of bilking a New York state program for developmentally disabled children, saying the trial court didn't err in declining to excuse a juror who had loose ties to a government witness.

  • August 02, 2024

    Family Denied Quick Win In Insurer's $2M Nursing Home Suit

    An insurer for a now-bankrupt Georgia nursing home doesn't have to cover a $2.1 million judgment awarded to the family of a woman who died in the facility's care, a federal judge ruled Friday, finding an agreement between the facility and the family released the facility from all liability.

Expert Analysis

  • White House Activity Is A Band-Aid For Regulating AI In Health

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    In the medium term, recent White House actions will have a greater impact on AI in the health care industry than Congress' sluggish efforts to regulate it, but ultimately legislation of AI's development and use in the health space will fall to Congress, say Wendell Bartnick and Vanessa Perumal at Reed Smith.

  • Understanding Discovery Obligations In Era Of Generative AI

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    Attorneys and businesses must adapt to the unique discovery challenges presented by generative artificial intelligence, such as chatbot content and prompts, while upholding the principles of fairness, transparency and compliance with legal obligations in federal civil litigation, say attorneys at King & Spalding.

  • How Mental Health Ruling Paves Road For Equal Coverage

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    The Tenth Circuit’s recent ruling in E.W. v. Health Net, which clarified the pleading requirements necessary to establish a Mental Health Parity and Addiction Equity Act violation, is a win for plaintiffs as it opens the door to those who have been denied coverage for behavioral health treatment to prove a mental health parity violation, says Mark DeBofsky at DeBofsky Law.

  • ESG Around The World: Mexico

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    ESG has yet to become part of the DNA of the Mexican business model, but huge strides are being made in that direction, as more stakeholders demand that companies adopt, at the least, a modicum of sustainability commitments and demonstrate how they will meet them, says Carlos Escoto at Galicia Abogados.

  • The Case For Post-Bar Clerk Training Programs At Law Firms

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    In today's competitive legal hiring market, an intentionally designed training program for law school graduates awaiting bar admission can be an effective way of creating a pipeline of qualified candidates, says Brent Daub at Gilson Daub.

  • 10 Takeaways From New HHS Federal Compliance Guidelines

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    The U.S. Department of Health and Human Services' recently issued general compliance program guidance is the first of its kind that would apply across all health care stakeholders, and signals the agency’s first step to improve and update existing compliance guidance, says Melissa Wong at Holland & Knight.

  • 2 HHS Warnings Highlight Anti-Kickback Risks For Physicians

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    Two recent advisory opinions issued by the U.S. Department of Health and Human Services' Office of Inspector General involve different scenarios and rationales, but together they illustrate the OIG's focus on and disapproval of contractual joint ventures and other revenue-maximizing physician arrangements, say Robert Threlkeld and Elliott Coward at Morris Manning.

  • Attorneys Have An Ethical Duty To Protect The Judiciary

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    The tenor of public disagreement and debate has become increasingly hostile against judges, and though the legislative branch is trying to ameliorate this safety gap, lawyers have a moral imperative and professional requirement to stand with judges in defusing attacks against them and their rulings, says Deborah Winokur at Cozen O'Connor.

  • Cross-Market Implications In FTC's Anesthesia Complaint

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    The Federal Trade Commission's recent complaint against a private equity firm's acquisition of anesthesiology practices highlights the controversial issue of cross-market harm in health care provider mergers, and could provide important insights into how a court may view such theories of harm, say Christopher Lau and Dina Older Aguilar at Cornerstone Research.

  • AI Can Help Lawyers Overcome The Programming Barrier

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    Legal professionals without programming expertise can use generative artificial intelligence to harness the power of automation and other technology solutions to streamline their work, without the steep learning curve traditionally associated with coding, says George Zalepa at Greenberg Traurig.

  • Preparing Law Students For A New, AI-Assisted Legal World

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    As artificial intelligence rapidly transforms the legal landscape, law schools must integrate technology and curricula that address AI’s innate challenges — from ethics to data security — to help students stay ahead of the curve, say Daniel Garrie at Law & Forensics, Ryan Abbott at JAMS and Karen Silverman at Cantellus Group.

  • ESG Around The World: South Korea

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    Numerous ESG trends have materialized in South Korea in the past three years, with impacts ranging from greenwashing prevention and carbon neutrality measures to workplace harassment and board diversity initiatives, say Chang Wook Min and Hyun Chan Jung at Jipyong.

  • General Counsel Need Data Literacy To Keep Up With AI

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    With the rise of accessible and powerful generative artificial intelligence solutions, it is imperative for general counsel to understand the use and application of data for myriad important activities, from evaluating the e-discovery process to monitoring compliance analytics and more, says Colin Levy at Malbek.