Policy & Compliance
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August 27, 2024
Tenn. Medicaid Program Illegally Cut Off Health Coverage
Tennessee's Medicaid program violated the Medicaid Act, the 14th Amendment and the Americans With Disabilities Act by depriving residents of healthcare coverage, a federal judge has ruled, saying the agency was "lethargic in its response and attempts" to fix an eligibility system replete with issues.
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August 27, 2024
Medicare Fraud Case Puts Target On Qui Tam Provisions
In a federal court in Florida, a judge is weighing what was once a pipe dream for the False Claims Act defense bar: the possible invalidation of federal law allowing private parties to bring suits on behalf of the government.
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August 27, 2024
Docs Foggy On Abortion Laws Amid Heated Legal Battles
When Texan Kyleigh Thurman showed up at a hospital in central Texas with an ectopic pregnancy, she alleges that physicians' confusion over the state's strict abortion ban led to inaction and delays in her federally protected care.
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August 27, 2024
6th Circ. Affirms HHS' Denial Of Title X Funds To Tenn.
The Sixth Circuit has upheld the Biden administration's authority to end a family-planning grant awarded to Tennessee after the state refused to offer abortion referrals, saying the state knew the rules when it accepted the grant.
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August 26, 2024
Care.com To Pay $8.5M To Settle FTC's Deception Claims
Caregiver job website Care.com has agreed to shell out $8.5 million in refunds to put to rest allegations it misled caregivers about wages and job availability and also made it difficult for families to cancel paid memberships, the U.S. Federal Trade Commission announced Monday.
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August 26, 2024
Class Attys Get $1.2M In Wash. Health Workers' Wage Deal
A Washington federal judge has awarded two plaintiffs firms almost $1.2 million of a $4.4 million class and collective wage deal ending a group of Evergreen state hospital workers' claims that their employers deducted pay for meal breaks they never took.
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August 26, 2024
Rival Can't Avoid Drugmaker's False Ad Claim Over Pain Med
A Texas federal magistrate on Monday advised against dismissing Pacira Biosciences Inc.'s suit against a rival, finding that Pacira had alleged enough facts to show QuVa Pharma Inc.'s advertising is deceptive in a suit over the former company's compounded drug for pain.
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August 26, 2024
FTC Mulls Proposal To Alter Puerto Rican Pharmacy Deal
The Federal Trade Commission is considering a plan to allow Puerto Rico's largest independent pharmacy cooperative to resume collective negotiations with payors, reexamining a 2012 settlement agreement that the cooperative says is now unnecessary because of changes in the commonwealth's law and pharmacy market.
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August 26, 2024
NY Nursing Homes Can't Duck AG's $83M Fraud Suit
A New York judge shot down a bid by four nursing homes and their operators to dismiss the state attorney general's claims that they defrauded Medicare and Medicaid and neglected residents.
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August 23, 2024
NY Can't Sue Groups Over Abortion 'Reversal' Ads, For Now
A New York federal judge temporarily blocked the state's attorney general from taking enforcement action against certain pregnancy counseling centers for promoting a method of "reversing" medication abortions that medical associations say is not backed by science, saying the groups' conduct is likely protected by the First Amendment.
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August 23, 2024
Ohio Constitution Dooms 24-Hour Abortion Waiting Period
An Ohio state judge on Friday preliminarily blocked multiple Ohio civil and criminal abortion-related statutes requiring informed consent and a 24-hour waiting period, among other restrictions, finding that the statutes likely run afoul of the recently passed voter-backed state constitutional amendment enshrining the right to abortion.
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August 23, 2024
Matthew Perry Death Suit Could Blow Past Calif. Damage Cap
The federal indictment recently unsealed accusing two doctors and others of peddling the ketamine that caused Matthew Perry's death will serve as prime fodder for any wrongful death suit by the actor's estate, experts say, and California's medical malpractice damages cap may not even be a factor.
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August 23, 2024
NY Lawmakers Hit With ADA Suit Over Contentious Mask Ban
A Long Island, New York, county that recently made it illegal for certain individuals to wear face masks in public has been hit with a lawsuit by a legal advocacy group alleging the ban discriminates against people with disabilities.
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August 23, 2024
NC Not Shielded From Racetrack's COVID Shutdown Suit
The North Carolina Supreme Court on Friday ruled a racetrack owner's lawsuit accusing state officials of violating his constitutional rights with a COVID shutdown order can survive dismissal, reasoning the claims were sufficient to overcome the government's protections from being sued.
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August 23, 2024
Hospital Deducted Bogus Meal Breaks From Wages, Suit Says
A healthcare system automatically deducted 30 minutes per day from workers' wages for meal breaks despite the workers not getting the chance to take uninterrupted meal periods, a proposed collective action filed in Michigan federal court said.
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August 22, 2024
Mich. Panel Upholds Block Of 24-Hour Abortion Waiting Period
Michigan appellate judges have refused to lift a preliminary injunction blocking the enforcement of a 24-hour waiting period and other abortion regulations, leaving in place a lower court decision that found the laws likely violate the state constitution.
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August 22, 2024
Texas Tells High Court It's Not Idaho '2.0' In HHS Abortion Row
Texas and a pair of anti-abortion doctor organizations have urged the U.S. Supreme Court to reject the federal government's appeal of a Fifth Circuit decision blocking the Biden administration's guidance that hospitals must provide emergency stabilizing medical care, including abortions.
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August 21, 2024
Fed. Circ. Won't Rethink IP Safe Harbor Case
The Federal Circuit on Wednesday declined to review its decision affirming the dismissal of Edwards Lifesciences' infringement suit against Meril Life Sciences after Edwards urged the full court to narrow its interpretation of a U.S. Food and Drug Administration safe harbor that essentially allows patent infringement during drug development.
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August 21, 2024
Tobacco Cos. Ask Justices To Review FDA's New Warnings
R.J. Reynolds Tobacco Co. is urging the U.S. Supreme Court to review a Fifth Circuit decision affirming an FDA rule mandating new health warnings on cigarette packaging and advertisements, arguing that the court created an unjustified circuit split when it found the graphic warnings are "purely factual and uncontroversial."
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August 21, 2024
Conn. Justices Back Insurer's Out-Of-Network Patient Bills
The Connecticut Supreme Court on Wednesday limited an emergency physician group's attempt to require a medical insurer to shoulder patient costs under the state's surprise medical billing law, holding that insurers can charge patients for shared costs, such as deductibles and copayments, at lower levels without violating consumer protection laws.
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August 21, 2024
Mich. High Court Asked To Redo Wrongful Death Ruling
The family of a deceased teen asked the Michigan Supreme Court on Tuesday for another chance to show that future earnings awards should be allowed in wrongful death cases, arguing the court's recent ruling restricting those awards ignored important state law.
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August 21, 2024
Union Health Plan Trustees Can't Avoid Fee Claim, Judge Says
Trustees of a UNITE HERE health plan can't topple a group of Southern California workers' claims that they are facing higher administrative expenses compared to another group of workers in Las Vegas, an Illinois federal court ruled Wednesday.
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August 21, 2024
Health Co. Investors Fight To Keep Suit Over Migrant Deal
Investors in mobile medical provider DocGo are urging a New York federal judge not to toss a suit alleging it deceived stockholders before a $432 million contract with New York City to provide emergency migrant housing came under public scrutiny, saying the complaint sufficiently establishes that the defendants made material misstatements and omissions.
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August 20, 2024
Ala. AG Can't Prosecute Aiding Abortion Travel, DOJ Says
The Alabama attorney general's threats of criminal prosecution against individuals and corporations who assist others in traveling to obtain lawful abortions out of state violates the constitutional right to travel, the U.S. Department of Justice told an Alabama federal judge in a court filing Monday.
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August 20, 2024
Amgen's Drug Price Suit An Issue For Legislature, Judge Told
A Colorado nonprofit that advocates for the poor told a federal judge Tuesday that Amgen's lawsuit over the state's drug price cap system is little more than a disagreement with lawmakers' policy choices disguised as a constitutional issue.
Expert Analysis
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2 Recent Suits Show Resiliency Of Medicare Drug Price Law
Though pharmaceutical companies continue to file lawsuits challenging the Inflation Reduction Act, which enables the federal government to negotiate for lower prescription drug prices, recent decisions suggest that the reduced drug prices are likely here to stay, says Jose Vela Jr. at Clark Hill.
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Defense Attys Must Prep For Imminent AI Crime Enforcement
Given recent statements by U.S. Department of Justice officials, white collar practitioners should expect to encounter artificial intelligence in federal criminal enforcement in the near term, even in pending cases, say Jarrod Schaeffer and Scott Glicksman at Abell Eskew.
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Lessons For Nursing Facilities From DOJ Fraud Settlement
The U.S. Department of Justice's recent settlement with the owner of skilled nursing and assisted living facilities in Florida provides a cautionary tale of potential fraud risks, and lessons on how facilities can mitigate government enforcement actions, say Callan Stein and Rebecca Younker at Troutman Pepper.
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HHS' Updated Tracking Tech Guidance Offers Little Clarity
The U.S. Department of Health and Human Services' Office for Civil Rights' updated guidance on the use of online tracking technologies appears more focused on legal issues raised in ongoing litigation with the American Hospital Association and less on practical guidance for covered entities, say attorneys at Sheppard Mullin.
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Takeaways From The 2023 DOJ Fraud Section Report
Attorneys at Wiley discuss notable trends from the U.S. Department of Justice's recently reported Fraud Section activity last year and highlight areas of enforcement to watch for in the future, including healthcare fraud and Foreign Corrupt Practices Act violations.
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NIST March-In Framework Is As Problematic As 2021 Proposal
While the National Institute of Standards and Technology's proposed march-in framework on when the government can seize patents has been regarded as a radical departure that will support lowering prescription drug costs, the language at the heart of it is identical to a failed 2021 notice of proposed rulemaking, says attorney Kelly Morron.
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Spartan Arbitration Tactics Against Well-Funded Opponents
Like the ancient Spartans who held off a numerically superior Persian army at the Battle of Thermopylae, trial attorneys and clients faced with arbitration against an opponent with a bigger war chest can take a strategic approach to create a pass to victory, say Kostas Katsiris and Benjamin Argyle at Venable.
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The Road Ahead For Florida's Drug Importation Program
Though the U.S. Food and Drug Administration approved Florida's drug importation program in January, a series of hurdles — including requisite buy-in from Canada — and potential legal challenges must be addressed before importation can begin, say attorneys at Ropes & Gray.
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Assessing CDC's Revised Guideline On Opioid Prescriptions
Kenneth Weinstein, Nicholas Van Niel and Kate Uthe at Analysis Group look at newly available data to evaluate the impact that the Centers for Disease Control and Prevention's revised opioid monitoring guideline have had on prescription trends in recent years, highlighting both specific and overall decreases.
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Valeant Ruling May Pave Way For Patent-Based FCA Suits
The Ninth Circuit’s recent ruling in Silbersher v. Valeant marks a significant development in False Claims Act jurisprudence, opens new avenues for litigation and potentially raises the stakes for patent applicants who intend to do business with the government, say Joshua Robbins and Rick Taché at Buchalter.
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Suits Against Insulin Pricing Are Driven By Rebate Addiction
A growing wave of lawsuits filed by states, cities and counties against insulin manufacturers and pharmacy benefit managers improperly allocate the blame for rising insulin costs, when in actuality the plaintiffs are partially responsible, says Dan Leonard at Granite Capitol Consulting.
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When Physician Retirement Arrangements May Be Legal
A recent advisory opinion from the Office of Inspector General regarding physician retirement arrangements sheds light on key considerations and mitigating factors that may be useful when attempting to balance healthcare operational needs with statutory conformity, says Magda Rodriguez at Day Pitney.
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ESG Around The World: Gulf Cooperation Council
The Gulf Cooperation Council is in the early stages of ESG policy implementation, but recent commitments by both states and corporations — including increases in sustainable finance transactions, environmental commitments, female representation on boards and human rights enforcement — show continuing progress toward broader ESG goals, say attorneys at Cleary.