Policy & Compliance

  • July 15, 2024

    Cigna, Chuck Close Estate Settle Reneged Benefits Suit

    The estate of renowned artist Chuck Close told a New York federal judge that Cigna has agreed to settle a suit claiming the company wouldn't pay for more than $686,000 in at-home skilled nursing care that it claimed was owed to him under his Pace Gallery employee benefit plan.

  • July 15, 2024

    Split 2nd Circ. Nixes Surgeon's Default In Sex Assault Case

    A split panel of the Second Circuit said a Connecticut surgeon should have been fully freed from the default judgment against him in a sex assault suit after a jury concluded his accuser failed to prove the assault happened, with one judge dissenting Monday that parts of the default ruling should remain.

  • July 15, 2024

    Theranos Ex-Exec's Lead Atty Joins Boutique Firm In LA

    A former BigLaw attorney who was lead defense counsel for Theranos' former president Ramesh Balwani has joined Los Angeles boutique Foundation Law Group LLP to lead its white collar practice, the firm announced Monday.

  • July 15, 2024

    Machinery Co. Defends 'Right' To Ax Trans Care In Health Plan

    A turbomachinery company asked to intervene on a transgender worker's New Hampshire federal court claim that its health plan administrators violated Affordable Care Act anti-bias provisions by enforcing a gender dysphoria treatment ban in the company's health plan, arguing that the issue is intertwined with its mission.

  • July 15, 2024

    Wage Cases To Follow As Justices Rein In Agencies

    A trio of U.S. Supreme Court rulings this term that dulled administrative agencies' power are likely to make an impact on how the U.S. Department of Labor enforces wage and hour law. Here, Law360 reviews six cases where their application is already becoming a point of contention.

  • July 15, 2024

    11th Circ. Upholds UMiami's Win In Retaliation Suit

    The Eleventh Circuit affirmed a Miami federal jury's verdict rejecting claims that the University of Miami fired a compliance officer for his refusal to close an investigation into the college's alleged Medicare overcharging, ruling that the officer had "invited" the jury instruction on which he based his appeal.

  • July 12, 2024

    Law360 Names 2024's Top Attorneys Under 40

    Law360 is pleased to announce the Rising Stars of 2024, our list of 158 attorneys under 40 whose legal accomplishments belie their age.

  • July 12, 2024

    Whistleblower's Attys Get $5.9M After Losing $11.5M Fee Ask

    A Massachusetts federal judge awarded a whistleblower's counsel $5.9 million in fees plus $651,845 in costs and expenses after slashing their prior "exorbitant" $11.5 million fee request in May in a decade-old False Claims Act lawsuit alleging Fresenius Medical Care billed Medicare for unnecessary hepatitis tests.

  • July 12, 2024

    Military's IVF Policy Defense Fails Post-Chevron, Group Says

    A nonprofit that's challenging the U.S. military's in vitro fertilization coverage policy for service members told a New York federal judge that federal agencies cannot claim they're entitled to Chevron deference in the wake of the U.S. Supreme Court's recent decision overturning the decades-old precedent.

  • July 12, 2024

    3 Fla. Labs Settle Medicare Overbilling Case For $2.45M

    Three medical labs in Clermont, Florida, have agreed to pay $2.45 million to resolve allegations they were manipulating diagnosis codes, or "code jamming," to submit more lucrative claims to Medicare and Medicaid for reimbursement by having a computer macro tack on extra diagnosis codes before filing the claims with the government.

  • July 12, 2024

    Boston To Pay $1M To End Health Dept. Harassment Case

    A high-profile sexual harassment case against the city of Boston and its former health director settled for $1 million earlier this month, according to a copy of the agreement released Friday.

  • July 12, 2024

    Widower Drops Suit Over Surgical Robot-Related Death

    A widower agreed Thursday to drop his suit against Intuitive Surgical Inc. over an alleged defect in its da Vinci surgical robots that allowed electricity to arc during his wife's surgery, burning her small intestine and leading to her death.

  • July 12, 2024

    7 Gender-Affirming Care Cases To Watch In 2024's 2nd Half

    The U.S. Supreme Court has agreed to review a constitutional challenge by the federal government to Tennessee's ban on gender-affirming care for minors, while other appeals courts are weighing the constitutionality of states' and employers' restrictions on gender dysphoria treatment. Here are seven cases involving gender-affirming care access that attorneys will be tracking in the second half of the year.

  • July 12, 2024

    Biggest Washington Decisions Of 2024: A Midyear Report

    The first half of 2024 in Washington courts was punctuated by a fizzled startup's $72 million trial win against The Boeing Co., and Monsanto Co.'s appellate reversal of a $185 million verdict in one of a series of high-profile PCB poisoning cases. Here is a closer look at some of the biggest decisions in Washington state and federal courts in the first half of 2024.

  • July 11, 2024

    Panel Says Kansas BCBS Unit Can't Face Rehab Suit In Colo.

    A Kansas Blue Cross Blue Shield unit can't be sued in Colorado for terminating the coverage of a patient who was receiving treatment for an autoimmune syndrome, a state appellate panel ruled Thursday.

  • July 11, 2024

    9th Circ. Signals Dr.'s Vax-Refusal Case Deserves New Chance

    Ninth Circuit judges signaled Thursday that they were likely to revive a doctor's case claiming he was wrongfully fired from his Washington State University residency for refusing to get a COVID-19 vaccination, with two judges questioning if the school went far enough to accommodate his religious beliefs.

  • July 11, 2024

    Fed. Circ. Pauses Ouster Of Teva Patents From Orange Book

    Teva can keep challenged asthma inhaler device patents listed on, and protected by, an important government database after the Federal Circuit agreed Wednesday to pump the brakes on the patents' delisting while the Israeli drugmaker appeals an order won by Amneal in an infringement lawsuit.

  • July 11, 2024

    Opiate MDL Judge Flags Evidence Preservation Shortfall

    An Ohio federal judge has said "at least some" of the plaintiff local government entities in four chosen bellwether cases against pharmacy benefit managers for the multidistrict litigation over the opioid epidemic failed to preserve documents and evidence for trial, warning the parties he may replace those cases.

  • July 11, 2024

    Hospital Urges 4th Circ. To Back Win In Worker's Vax Bias Suit

    A Virginia health system told the Fourth Circuit to let its win stand in a former nurse's lawsuit claiming she was unlawfully fired for refusing the COVID-19 vaccine because of her Christian beliefs, saying the nurse raised only her personal misgivings, not religion, in her exemption request. 

  • July 11, 2024

    Sens. Say Medical Debt Acute 'Symptom' Of Chronic Issues

    A Senate health committee panel said that medical debt is a "symptom" of high costs in the healthcare system in a hearing on Thursday, with lawmakers and federal agencies proposing solutions to stabilize the issue that impacts consumers and providers. 

  • July 10, 2024

    Drug Test Co. Pays $1M To Settle Medicare Fraud Claims

    A Los Angeles drug testing lab will pay at least $1 million to settle claims it doubled-billed Medicare for toxicology tests for people undergoing treatment for opioid use disorder, Boston federal prosecutors said Wednesday.  

  • July 10, 2024

    Buyers Say Teva Had Multipart Scheme To Delay Inhaler Rivals

    Employee benefit funds accusing Teva of orchestrating a decadelong scheme to delay generic competition for its QVAR asthma inhalers told a Massachusetts federal court the drugmaker is trying to end the case by addressing merely one aspect of a multipart scheme.

  • July 09, 2024

    Pharma Co. Fined $16.9M For Fake Scripts, Ex-VP Arrested

    A subsidiary of bankrupt DMK Pharmaceuticals Corp. faces a $16.9 million criminal fine after pleading guilty to conspiring in a scheme to ship drugs using false prescriptions, federal prosecutors announced Tuesday, adding that the subsidiary's former vice president of sales was also arrested.

  • July 09, 2024

    With Chevron's End, LGBTQ+ Healthcare Regs Face New Risk

    The end of Chevron deference is already disrupting regulation meant to protect LGBTQ+ access to healthcare, with three federal judges blocking enforcement of a Biden administration rule prohibiting discrimination based on gender identity in healthcare.

  • July 09, 2024

    Healthcare Cases To Watch: A 2024 Midyear Report

    Courts across the U.S. this year will oversee key cases to the healthcare industry, from multidistrict litigation over the Change Healthcare hack to a challenge of a state gender-affirming care ban at the Supreme Court. Here are the healthcare cases to watch in the second half of 2024.

Expert Analysis

  • What Marijuana Status Change Would Mean For Industry

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    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.

  • Top 4 Antitrust Enforcement Issues In Health Care Today

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    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.

  • Calif. Climate Disclosure Bills Promise Challenges For Cos.

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    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.

  • Maximizing Law Firm Profitability In Uncertain Times

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    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.

  • 5th Circ. Ruling Reminds Attys That CBP Can Search Devices

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    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.

  • ESG Around The World: European Union

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    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.

  • Avoiding The Ethical Pitfalls Of Crowdfunded Legal Fees

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    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.

  • 4 Pharma Industry Arguments Against CMS Drug Pricing Plan

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    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.

  • Issues Ahead As Psychedelic Medicine Faces Pivotal Moment

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    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.

  • An Overview Of 6 PBM Bills Moving Through Congress

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    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.

  • 10th Circ. ERISA Ruling Is Promising For Self-Funded Plans

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    Though some recent appellate decisions have seemingly narrowed application of Employee Retirement Income Security Act preemption, which generally helps protect self-funded health plans from state regulation, the Tenth Circuit's decision in PCMA v. Mulready takes a big step toward reaffirming preemption, say attorneys at Bass Berry.

  • What Large Language Models Mean For Document Review

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    Courts often subject parties using technology assisted review to greater scrutiny than parties conducting linear, manual document review, so parties using large language models for document review should expect even more attention, along with a corresponding need for quality control and validation, say attorneys at Sidley.

  • Checking In On How SuperValu Has Altered FCA Litigation

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    Four months after the U.S. Supreme Court's ruling in U.S. ex rel. Chutte v. SuperValu, the decision's reach may be more limited than initially anticipated, with the expansion of the scienter standard counterbalanced by some potential defense tools for defendants, say Elena Quattrone and Olivia Plinio at Epstein Becker.