Policy & Compliance

  • May 07, 2024

    MultiPlan, Insurance Cos. Accused Of Algorithmic Collusion

    A medical provider has lodged a proposed class action in Illinois federal court accusing MultiPlan and major insurance companies, including UnitedHealth, Aetna, Kaiser Permanente and Cigna, of using pricing tools to systematically underpay out-of-network providers.

  • May 07, 2024

    Why Midwives Are Fighting Practice Limits Across The US

    Heather Swanson has long hoped to use her training to help pregnant people in Nebraska give birth safely in their homes but is blocked by state law. Today, she’s among a number of midwives battling laws they say unduly restrict skilled healthcare providers while maternity care "deserts” proliferate across the U.S.

  • May 07, 2024

    Rare Texas Discovery Rule Deployed In Abortion Travel Case

    A Lone Star State lawyer pursuing documents and depositions about an out-of-state abortion is relying on a quirk of Texas civil procedure allowing for pre-litigation discovery. The Arnold & Porter attorney representing the targets calls the move "a shot across the bow" meant to discourage women from exercising their rights.

  • May 07, 2024

    Wary Of 'Pharmacy Deserts,' Oregon Agency Eyes Grocer Deal

    A new Oregon board focused on healthcare consolidation has the power to shape a divisive mega-deal between the Kroger and Albertsons grocery chains some fear would create "pharmacy deserts." Some experts think it could further entangle an agreement between chains that together fill a third of all prescriptions in the state.

  • May 07, 2024

    20 Years Ago, One Case Opened Up Billions In FCA Liability

    On the 20-year anniversary of a landmark whistleblower case, attorneys look back on how Franklin v. Parke-Davis shaped the healthcare landscape, put Boston on the map as a hotbed of False Claims Act litigation and changed the drug industry's off-label marketing practices.

  • May 07, 2024

    DOJ Inks FCA, Opioid-Branding Enforcement Settlements

    The U.S. Department of Justice has been busy over the past week settling a variety of False Claims Act claims as well as a case against a pharmaceutical company for allegedly violating the Food, Drug and Cosmetic Act with deceptive opioid marketing.

  • May 07, 2024

    9th Circ. Asks Idaho To Define 'Recruit' In Abortion Travel Ban

    A Ninth Circuit panel grappled Tuesday with an Idaho law that makes it a criminal offense to help minors travel out of state to receive abortions without parental permission, with one judge struggling to understand what it means to "recruit" a pregnant teen to get an abortion under the law.

  • May 07, 2024

    Gov't Seeks Early Win In Ga. Medicaid Expansion Suit

    The Biden administration is urging a federal judge to take its side in a lawsuit in which Georgia is attempting to keep its Medicaid program for low-income residents running until 2028, arguing that the state never properly asked for a program extension and that the court lacks jurisdiction to extend its end date.

  • May 06, 2024

    Judge Trims ESOP Valuation Suit Against Healthcare Co.

    A California federal judge has trimmed a lawsuit against KPC Healthcare Inc., its employee stock ownership plan committee and its investment manager Alerus Financial alleging that a sale of company stock was mismanaged.

  • May 06, 2024

    UChicago Can't Ditch Data Sharing Privacy Claim

    A University of Chicago Medical Center patient accusing the hospital of illegally sharing her and other patients' identifying information with Meta can pursue her claims that the info sharing constitutes a federal wiretap violation, an Illinois federal judge said.

  • May 06, 2024

    Hooper Lundy Adds Government Relations Director

    An attorney who worked in-house for healthcare industry trade and advocacy associations has joined healthcare boutique Hooper Lundy & Bookman PC as director of government relations and public policy.

  • May 03, 2024

    Ala. High Court Won't Rethink Decision On Frozen Embryos

    The Alabama Supreme Court on Friday refused to revisit its February decision finding that frozen embryos count as children, a first-of-its-kind decision that has been received as potentially ruinous for in vitro fertilization services in the Yellowhammer State.

  • May 03, 2024

    Aetna To Pay $2M To End LGBTQ Fertility Coverage Suit

    A group of Aetna policyholders said Friday that the insurance giant has agreed to pay $2 million and revise certain health insurance guidelines to settle a proposed class action alleging its definition of infertility made it difficult and expensive for LGBTQ couples to obtain coverage for fertility treatments.

  • May 03, 2024

    Ohio Statehouse Catch-Up: Trans, Abortion Laws Face Battles

    Ohio lawmakers have shepherded controversial bills impacting healthcare, social media and other matters into law in recent months, prompting lawsuits and even a veto from Gov. Mike DeWine.

  • May 03, 2024

    6 States Strike $270M Opioid Deal With Amneal

    The New York state attorney general on Friday said that a $270 million multistate deal had been reached with opioid manufacturer Amneal Pharmaceuticals for its role in the addiction epidemic over allegations that the company failed to report suspicious orders of the narcotics.

  • May 02, 2024

    7th Circ. Mostly Backs Ill. Home Health Kickbacks Judgment

    The Seventh Circuit on Thursday largely left intact an Illinois federal judge's $6 million ruling that a home health care company broke federal kickback laws, refusing to reverse the lower court's liability finding but directing it to ensure its damages award was calculated correctly.

  • May 02, 2024

    Endo Judge Hopes Criminal Sentence Warns Opioid Makers

    A Michigan federal judge said Thursday she hoped Endo's criminal sentence for falsely advertising a pain medication as "abuse deterrent" would itself be a deterrent for other opioid makers, as she accepted the company's recent $200 million settlement deal with federal prosecutors. 

  • May 02, 2024

    Feds Call Out Gilead's Efforts To Revise HIV Drug IP Judgment

    The U.S. Department of Justice has asked a Delaware federal judge to reject Gilead Sciences' motion to modify a judgment finding that two medications in its HIV prevention regimen directly infringe voided patents owned by the government, arguing that the pharmaceutical company's attempt to rewrite the judgment is "unnecessary as well as improper."

  • May 02, 2024

    Lawmaker Wants Antitrust Probe Of Health Insurance Data Co.

    Sen. Amy Klobuchar, D-Minn., is calling for antitrust enforcers to investigate concerns that MultiPlan and other healthcare data companies are hurting competition by helping health insurers effectively collude when making pricing decisions.

  • May 02, 2024

    Biden Announces $3B To Fund Lead Pipe Replacement

    The Biden administration is distributing $3 billion to states so they can replace lead water pipes that pose a health risk to those who rely on them for drinking water, as part of the larger goal to remove all lead service lines nationwide.

  • May 02, 2024

    State Legislators Urge Feds To Change Cannabis' Status

    A coalition of state lawmakers on Thursday urged the heads of the U.S. Department of Justice and its drug enforcement agency to prioritize changing cannabis' status as a highly restricted drug.

  • May 01, 2024

    Sens. Slam UnitedHealth's Security Lapses, Breach Response

    UnitedHealth's top executive faced heavy criticism during his first appearance before a U.S. Senate committee since a cyberattack rocked its Change Healthcare subsidiary, with lawmakers blasting the company for lacking basic security measures and for still not being able to confirm the scale and scope of the incident.

  • May 01, 2024

    Ariz. AG Warns Repeal Of 1864 Abortion Ban May Be Too Late

    Legislation narrowly adopted Wednesday to repeal Arizona's 1864 abortion law won't be enough on its own to keep the near-total ban from taking effect this summer, the state attorney general warned, because the bill lacks an emergency clause.

  • May 01, 2024

    J&J Unit Cuts Deal To End Cancer Drug Trade Secret Fight

    A New Jersey federal judge has signed off on a consent judgment that permanently bars Chinese drugmaker Jiangsu Hengrui Pharmaceuticals Co. from misappropriating Johnson and Johnson's pharmaceutical subsidiary Janssen's trade secrets for its popular chemotherapy drug Yondelis.

  • May 01, 2024

    5th Circ. Judge Skeptical Of Medicare Drug 'Price-Setting'

    A Fifth Circuit judge on Wednesday sharply criticized the Biden administration's Medicare drug pricing program, characterizing it as government "price-setting" and questioning "what possible procompetitive justification" there can be for penalizing companies that don't participate.

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.