Policy & Compliance
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November 26, 2024
In Court: Abortion, Gender Care, PBMs and Insulin Pricing
An abortion ban bench trial in Idaho. A Texas high court decision on a "heartbeat" ban. A consumer protection agency delays medical debt guidance amid a legal challenge. Law360 Healthcare Authority looks at those and other significant decisions shaping the healthcare industry.
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November 26, 2024
Trump FDA Pick Devoted To Healthcare Price Transparency
The nomination of surgeon Marty Makary to lead the U.S. Food and Drug Administration elevates a healthcare transparency advocate who authored books on the subject and pushed for hospitals to disclose their standard prices during the first Trump administration.
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November 26, 2024
Meet The Attys Arguing Tenn. Trans Care Ban At High Court
Tennessee's solicitor general and the first openly transgender lawyer to appear before the U.S. Supreme Court are set to face off next week to debate the constitutionality of a state ban on gender-affirming care for minors.
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November 26, 2024
Pa. Nursing Home Eying Sale Seeks Fraud Sentencing Delay
The parent company for a troubled Western Pennsylvania nursing home asked a federal court to postpone a sentencing for defrauding state and federal healthcare programs so the company can keep trying to sell the facility, or at least relocate its residents over a longer period of time.
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November 25, 2024
At Trial, Ex-Clinic Head Accuses Seattle Hospital Of Race Bias
A Black ex-clinical director told a Washington state jury Monday that a Seattle hospital owes him millions of dollars for failing to address a "culture of racism" targeting him and the patients of color he advocated for while leading a clinic with a purported mission of advancing equity.
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November 25, 2024
Missouri Gender-Affirming Care Ban Upheld As Constitutional
A Missouri state judge rejected a legal challenge to the state's ban on providing gender-affirming care to minors and adults, finding Monday the court should defer to the Legislature given that challengers hadn't proven the restrictions violated the U.S. Constitution.
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November 25, 2024
5th Circ. Upholds Miss. Ban On Medical Pot Ads
Marijuana dispensaries do not have protections under the First Amendment to advertise their products because the drug is still illicit under federal law, the Fifth Circuit ruled, tossing a lawsuit that sought to upend the state's tight regulations on cannabis ads.
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November 22, 2024
MultiCare $2M Deal Ends Fed's ADA Missing Interpreter Probe
MultiCare Health Systems of Washington will set aside $2 million in compensation to end a federal civil rights investigation into complaints the hospital operator failed to provide interpreters for deaf-blind patients before and after surgery.
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November 22, 2024
Texas Justices Say Court Bungled Ruling In Abortion Case
The Texas Supreme Court said Friday a lower appellate court tried to "prematurely drag the judiciary into highly contentious and politicized debates" around abortion without analyzing a key standing issue, jeopardizing Planned Parenthood's and other abortion rights groups' bid to invalidate the controversial Texas Heartbeat Act.
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November 22, 2024
Texas Panel Says Gender-Affirming Surgery Suit Too Late
A Texas appellate court has backed a counselor's win in a lawsuit from a former client who came to regret undergoing a double mastectomy following the counselor's recommendation for gender-affirming surgery, finding the claims were time-barred.
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November 22, 2024
Duke Health Sacked Worker Over Pregnancy, Suit Claims
A Duke University-affiliated health network fired a radiology technologist just three days after she disclosed she was pregnant with her second child, according to a lawsuit in North Carolina federal court.
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November 22, 2024
3 Takeaways From 6th Circ. ERISA Disability Benefits Revival
A recent Sixth Circuit ruling that handed a worker a new shot at long-term disability benefits gives a boost to plaintiffs battling caps on coverage for mental health conditions, attorneys say. Here, Law360 looks at three takeaways from the appeals court's decision.
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November 22, 2024
Medicaid Fraud Nets 11-Year Sentence For NC Social Worker
A clinical social worker in North Carolina has been sentenced to more than 11 years behind bars on charges of defrauding South Carolina's Medicaid program and falsely obtaining COVID-19 relief checks, prosecutors said.
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November 21, 2024
Health Exec Who Fled Gets 3 Years For $8M Medicare Scheme
A home healthcare executive who led a scheme to defraud Medicare of nearly $8 million through fraudulent billing practices and who fled the country after his indictment has been sentenced to more than three years in prison, according to a judgment filed in Michigan federal court Wednesday.
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November 21, 2024
In Tight Vote, Senate Panel OKs Bill To Set New PTAB Limits
The Senate Judiciary Committee on Thursday narrowly voted to advance a bill that would impose new restrictions on Patent Trial and Appeal Board challenges, with several members expressing concern that it could drive up the cost of prescription drugs.
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November 21, 2024
NY Health Insurer Sued Over Booting Up, Logging Off Time
A New York health insurer failed to pay customer service representatives for the time needed to get their workstations ready, leading to unpaid overtime and missed lunch breaks, according to a proposed class and collective action filed in federal court Friday.
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November 21, 2024
NY Hospital GC Accuses State Of Mishandling Medicaid Funds
The general counsel of Nassau University Medical Center, who is also serving as interim president and CEO, is leading the Long Island hospital into a legal battle with the state of New York over $1 billion in federal Medicaid funds.
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November 20, 2024
Musk, Ramaswamy Say High Court Rulings OK Federal Cuts
Billionaire Elon Musk and former presidential candidate Vivek Ramaswamy, President-elect Donald Trump's picks to lead a newly created "Department of Government Efficiency," on Wednesday said two recent U.S. Supreme Court rulings will give them the authority to cut off power to regulatory agencies and conduct massive federal layoffs.
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November 20, 2024
Hospital's Med Mal Win Axed By Mich. Appeals Panel
A divided Michigan Court of Appeals panel has revived a medical malpractice lawsuit against a Michigan hospital, finding that the patient established a genuine fact dispute regarding her reasonable belief that the gynecologist treating her was acting as the hospital's agent.
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November 20, 2024
PBMs Sue To Block FTC's In-House Insulin Pricing Case
Caremark Rx, Express Scripts and OptumRx have lodged a constitutional challenge of the Federal Trade Commission's in-house case accusing the pharmacy benefits managers of artificially inflating insulin prices through unfair rebate schemes.
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November 20, 2024
3 States To Challenge Abortion Regs After Docs Drop Claims
Anti-abortion medical groups that were dealt a loss by the U.S. Supreme Court earlier this year have now dropped out of their lawsuit challenging federal approvals for mifepristone, leaving Missouri, Idaho and Kansas to carry on litigation over the abortion medication.
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November 19, 2024
W.Va. Amendment Marks Obstacle For Aid-In-Dying Movement
A first-of-its-kind prohibition in West Virginia on medically assisted suicide represents a new form of opposition to a growing movement that supports allowances for doctors to help patients with terminal illnesses end their lives.
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November 19, 2024
UnitedHealthcare Can't Escape Patient's Proton Beam Suit
A Florida federal judge on Tuesday refused to toss a federal benefits lawsuit from a patient who alleged that UnitedHealthcare wrongly denied him coverage for proton beam therapy to treat tongue cancer, rejecting the insurer's argument that an exclusion for unproven treatments applied.
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November 19, 2024
Insurers Urge Arbitration Of Union Fund's ERISA Claims
Elevance Health Inc. and several affiliated health insurers want a Connecticut federal judge to force arbitration of claims brought by a union fund that alleges excessive fees violated benefits law, arguing that the companies were unaware of an arbitration agreement with the plaintiff when they started litigating the early stages of a proposed class action.
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November 19, 2024
Widow Can't Get Malpractice Suit Over Husband's Fall Revived
A North Carolina appeals court on Tuesday declined to reinstate a suit by a widow alleging that nurses at Charlotte-Mecklenburg Hospital were responsible for a fall taken by her husband while he was recovering from brain surgery, saying the trial court rightly excluded her expert's testimony.
Expert Analysis
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In The CFPB Playbook: Making Good On Bold Promises
The U.S. Supreme Court's decision upholding the Consumer Financial Protection Bureau's funding structure in the second quarter cleared the way for the bureau to resume a number of high-priority initiatives, and it appears poised to charge ahead in working toward its aggressive preelection agenda, say Andrew Arculin and Paula Vigo Marqués at Blank Rome.
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Critical Questions Remain After High Court's Abortion Rulings
The U.S. Supreme Court's decisions in two major abortion-related cases this term largely preserve the status quo for now, but leave federal preemption, the Comstock Act and in vitro fertilization in limbo, say attorneys at Jenner & Block.
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Navigating FDA Supply Rule Leeway For Small Dispensers
As the November compliance deadline for the U.S. Food and Drug Administration's new pharmaceutical distribution supply chain rules draws closer, small dispensers should understand the narrow flexibilities that are available, and the questions to consider before taking advantage of them, say attorneys at Faegre Drinker.
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1st Gender Care Ban Provides Context For High Court Case
The history of Arkansas' ban on gender-affirming medical care — the first such legislation in the U.S. — provides important insight into the far-reaching ramifications that the U.S. Supreme Court's decision in U.S. v. Skrmetti next term will have on transgender healthcare, says Tyler Saenz at Baker Donelson.
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6 Lessons From DOJ's 1st Controlled Drug Case In Telehealth
Following the U.S. Department of Justice’s first-ever criminal prosecution over telehealth-prescribed controlled substances in U.S. v. Ruthia He, healthcare providers should be mindful of the risks associated with restricting the physician-patient relationship when crafting new business models, says Jonathan Porter at Husch Blackwell.
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After Chevron: Scale Tips Favor Away From HHS Agencies
The loss of Chevron deference may indirectly aid parties in challenging the U.S. Department of Health and Human Services' interpretations of regulations and could immediately influence several pending cases challenging HHS on technical questions and agency authority, say attorneys at Ropes & Gray.
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After Chevron: FDA Regulations In The Crosshairs
The U.S. Supreme Court's overturning of the Chevron doctrine is likely to unleash an array of challenges against the U.S. Food and Drug Administration, focusing on areas of potential overreach such as the FDA's authority under the Federal Food, Drug and Cosmetic Act, say attorneys at Debevoise.
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USPTO Disclaimer Rule Would Complicate Patent Prosecution
The U.S. Patent and Trademark Office's proposed changes to terminal disclaimer practice could lead to a patent owner being unable to enforce a valid patent simply because it is indirectly tied to a patent in which a single claim is found anticipated or obvious in view of the prior art, say attorneys at Sterne Kessler.
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Navigating Scrutiny Of Friendly Professional Corps. In Calif.
In light of ongoing scrutiny and challenges to private equity participation in the California healthcare marketplace, particularly surrounding the use of the friendly professional corporation model, management services organizations should consider implementing four best practices, say attorneys at Holland & Knight.
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Takeaways From New HHS Substance Use Disorder Info Rules
A new U.S. Department of Health and Human Services rule continues the agency's efforts to harmonize complex rules surrounding confidentiality provisions for substance use disorder patient records, though healthcare providers will need to remain mindful of different potentially applicable requirements and changes that their compliance structures may require, say attorneys at Ropes & Gray.
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Calif. Banking Brief: All The Notable Legal Updates In Q2
The second quarter of 2024 in California, which saw efforts to expand consumer protection legislation and enforcement actions in areas of federal focus like medical debt and student loans, demonstrated that the state's role as a trendsetter in consumer financial protection will continue for the foreseeable future, say attorneys at Sheppard Mullin.
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How Cannabis Rescheduling May Affect Current Operators
The U.S. Drug Enforcement Agency's proposal to reschedule marijuana to Schedule III provides relief in the form of federal policy from the stigma and burdens of Schedule I, but commercial cannabis operations will remain unchanged until the federal-state cannabis policy gap is remedied by Congress, say Meital Manzuri and Alexis Lazzeri at Manzuri Law.
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Air Ambulance Ruling Severely Undermines No Surprises Act
A Texas federal court's recent decision in Guardian Flight v. Health Care Service — that the No Surprises Act lacks a judicial remedy when a health insurer refuses to pay the amount established through an independent review — likely throws a huge monkey wrench into the elaborate protections the NSA was enacted to provide, says Mark DeBofsky at DeBofsky Law.