Policy & Compliance
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May 15, 2025
Feds Freeze Parity Enforcement As Agencies Rethink Regs
Federal agencies said Thursday they will hold off on enforcing a rule requiring employer group health plans to analyze how they restrict coverage for mental health and substance use disorder treatments, citing ongoing litigation aimed at blocking the policy and broader plans to reevaluate enforcement priorities.
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May 14, 2025
Mont. Court Blocks 'Ideological' Transgender Youth Care Ban
A Montana judge on Tuesday struck down a state statute that banned gender-affirming care for minors, holding that the state's interest is "ideological rather than medical" and violates the constitutional rights of transgender youth seeking gender-affirming care and of healthcare professionals who provide it.
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May 14, 2025
9th Circ. Doubts Wash. Anti-Vaxxers' Stance In Med Board Suit
A Ninth Circuit judge expressed skepticism on Wednesday that the federal appellate court could revive Robert F. Kennedy Jr.'s suit against the Washington Medical Commission for initiating disciplinary proceedings against physicians who publicly aired anti-vaccination views, pointing out that federal courts generally "don't interfere" with ongoing state litigation.
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May 14, 2025
Sage Therapeutics Brass Sued Over Drug Candidate Claims
The top brass of Sage Therapeutics Inc. have been hit with a shareholder derivative suit in New York federal court alleging they misled investors about the safety, efficacy, durability and commercial prospects of three of the company's drug candidates and overstated their likelihood to be approved by the U.S. Food and Drug Administration.
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May 14, 2025
Houston Midwife Says AG Has No Evidence To Close Clinics
A Houston-area midwife who was arrested earlier this year on a charge of providing an illegal abortion is arguing to a state appellate court that Texas Attorney General Ken Paxton "came nowhere close to meeting the state's burden" in his bid to shut down her clinics.
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May 14, 2025
RFK Jr. Defends HHS Cuts, Pledges To 'Spend Smarter'
In his first appearance on Capitol Hill since his confirmation, U.S. Department of Health and Human Services Secretary Robert F. Kennedy Jr. on Wednesday characterized a massive reorganization and reductions in workforce as practical moves to optimize the sprawling agency.
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May 13, 2025
Healthcare Hires: Ex-DOJ, Fresenius Attys On The Move
An ex-federal prosecutor who led healthcare fraud investigations in Texas has joined Hicks Thomas LLP, and an attorney with in-house experience at Fresenius Medical Care and GE Healthcare joined King & Spalding LLP in its government investigations practice. Here, Law360 Healthcare Authority looks at the week's most notable lateral hires in the healthcare industry.
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May 13, 2025
Health Co. Elevance Faces Suit Over Post-COVID Costs Claims
Health insurance provider Elevance Health Inc. and some of its executives face a proposed investor class action alleging the company hurt shareholders by mismanaging expectations about its Medicaid business's costs amid the post-pandemic eligibility redetermination process in certain markets it served.
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May 13, 2025
A Trump Do-Over On 'Most Favored Nation' Drug Prices
President Donald Trump's move this week to "equalize" U.S. drug prices with lower overseas prices hearkens back to a similar effort made in his first term that faced a swarm of legal challenges before being shelved.
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May 13, 2025
Planned Parenthood Wants Teen Program Fund Rule Blocked
Planned Parenthood on Monday urged a D.C. federal judge to vacate the U.S. government's "unlawful" requirements to "align" with President Donald Trump's executive orders lest risk losing Teen Pregnancy Prevention Program funding, arguing its facilities will suffer staff cuts and loss of medically accurate, age-appropriate education services absent an injunction.
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May 13, 2025
FDA Move On Industry Influence Only 'Cosmetic,' Experts Say
A Trump administration move to boot pharmaceutical employees off U.S. Food and Drug Administration advisory panels won’t do much to address conflicts of interest or change how regulators interact with the industry, experts say. But that doesn't mean other measures shouldn't be considered.
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May 13, 2025
NIH Letters Ending Grants Lack Factual Support, Judge Says
A Massachusetts federal judge said Tuesday that a "blast" of hundreds of virtually identical letters in March canceling National Institutes of Health-funded research projects appeared to offer no factual basis, only unsupported assertions that the projects were unscientific or discriminatory.
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May 13, 2025
Michigan Judge Strikes Down State's Abortion Restrictions
A Michigan judge struck down several of the state's abortion restrictions Tuesday, including a mandatory waiting period, required counseling materials and a rule that only doctors may perform abortions, finding the laws make it harder for people to access abortion and don't protect patients' health.
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May 13, 2025
PBMs Get Bipartisan Bashing At Hearing On Drug Costs
Senators across party lines slammed pharmacy benefit managers on Tuesday, sometimes in coarse language, as they wrestled with how to reduce drug prices for patients while also preventing the closure of rural pharmacies.
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May 13, 2025
DOJ Puts New Target On Medicare Advantage 'Steering'
U.S. Department of Justice officials' decision to back whistleblower claims that major health insurance companies paid millions in illegal kickbacks to brokers marks a dramatic escalation of an effort to crack down on Medicare Advantage "steering."
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May 13, 2025
Feldesman Grants Atty On 'Chaos' Of HHS Funding Cuts
Massive cuts in federal funding for healthcare programs are testing the avenues of recourse for safety-net hospitals and others that depend on grants to keep their doors open.
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May 13, 2025
Ind. Tells Nonprofit Hospitals To Curb Prices, Or Else
A new Indiana law gives charitable hospitals a stark choice: Lower prices or face the loss of their nonprofit status.
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May 13, 2025
Attys Push 11th Circ. To Weigh Judge Shopping Sanctions
The Eleventh Circuit can hear three attorneys' appeal of sanctions against them for judge shopping during their legal challenge to an Alabama law criminalizing gender-affirming care, because the underlying case was dismissed, making the jurisdictional question moot, two of those lawyers told the appellate court.
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May 13, 2025
Associate GC Of University Hospital In NJ Joins Frier Levitt
New Jersey-based national healthcare boutique Frier Levitt has hired a former in-house counsel at University Hospital in Newark this week as a partner in the firm's healthcare practice group.
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May 13, 2025
Express Scripts, FTC Say Defamation Suit 'Should Proceed'
The Federal Trade Commission's new Republican leadership is ready to defend against an Express Scripts defamation lawsuit targeting an agency report excoriating it and other pharmacy benefit managers for allegedly inflating drug costs, the agency and the PBM told a Missouri federal judge Monday.
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May 13, 2025
Canada Drug Import Plan On The Rocks Amid Tension With US
In his first turn through the White House, President Donald Trump said a plan to import cheap prescription drugs from Canada would be a "game-changer." Five years later, the roadblocks to the program have only gotten higher.
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May 12, 2025
W.Va. High Court Declines 4th Circ. Request For Opioid Input
The West Virginia Supreme Court of Appeals on Monday declined the Fourth Circuit's request to answer whether the state's public nuisance law applies to the distribution of opioids, saying disputed facts in litigation between local governments and drug distribution companies must first be resolved.
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May 12, 2025
Pa. Mental Health Rejection Suits Could Rise, Atty Says
The Pennsylvania Supreme Court's recent decision to greenlight a suit accusing two hospitals of negligently rejecting a man seeking mental health treatment who later murdered his girlfriend could spark a rise in such lawsuits, one attorney warned.
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May 12, 2025
Missouri Hit With Sanctions In Generics Price-Fixing Fight
A Connecticut federal judge Monday agreed to sanction and potentially dismiss for good the state of Missouri from antitrust litigation by state enforcers accusing generic-drug makers of conspiring to raise drug prices, finding Missouri violated a court order by ignoring the drugmakers' repeated discovery requests.
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May 12, 2025
Mass. Court Says NIH Grant Disruption Suit Is In The Right Place
A Massachusetts federal court ruled Monday that it has jurisdiction over several states' lawsuit challenging delays and cancellations of federal grant programs linked to issues they say are "disfavored" by the Trump administration, rejecting the federal government's contention that the claims instead belonged in the U.S. Court of Federal Claims.
Expert Analysis
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Reproductive Health Under Trump So Far, And What's Next
Based on priorities stated so far, the Trump administration will likely continue to weaken Biden-era policies that protect reproductive health, with abortion, in vitro fertilization and contraception all being issues to watch closely amid a post-Dobbs shift, say attorneys at McDermott.
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What's Next For Lab Test Regulation Without FDA Authority
A recent Texas federal court decision vacating the U.S. Food and Drug Administration's final rule that would apply FDA regulations to laboratory-developed tests signals potential positive impacts in the diagnostic space, and could inspire more healthcare entities to litigate against the government, say attorneys at Hooper Lundy.
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6 Criteria Can Help Assess Executive Branch Actions
With new executive policy changes announced seemingly every day, several questions can help courts, policymakers and businesses determine whether such actions are proper, effective and in keeping with our democratic norms, say Marc Levin and Khalil Cumberbatch at the Council on Criminal Justice.
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Learning From COVID-19 Enforcement Against Nursing Homes
Five years after the COVID-19 outbreak caused a high number of deaths in nursing homes, an examination of enforcement actions against nursing homes in New York and elsewhere in the country highlights obstacles that may arise when bringing cases of this type, and ways to overcome them, says Kenneth Levine at Stone & Magnanini.
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How Plan Sponsors Can Mitigate Risk In PBM Contracts
A recent lawsuit in New York federal court alleges that JPMorgan caused exorbitant prescription costs by mishandling the pharmacy benefit manager arrangement, adding to a growing body of Employee Retirement Income Security Act fiduciary breach litigation and affirming that fiduciaries must proactively manage their healthcare plan vendors, say attorneys at Hall Benefits Law.
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4th Circ. Health Data Ruling Opens Door To State Law Claims
In Real Time Medical v. PointClickCare, the Fourth Circuit recently clarified that state law claims can rest in part on violations of a federal law that prohibits electronic health information blocking, expanding legal risks for health IT companies and potentially creating exposure to a range of competitive implications, say attorneys at BCLP.
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Unpacking Trump Admin Plans For Value-Based Care
Recent developments from the Center for Medicare and Medicaid Innovation suggest the Trump administration intends to put its own stamp on value-based care, emphasizing cost savings assessment in particular, with its recent cancellation of several payment models that had supported primary care, says Miranda Franco at Holland & Knight.
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What To Expect For Stem Cell Regulation Under Trump Admin
The new administration's push for deregulation, plus the post-Chevron legal landscape, and momentum from key political and industry players to facilitate stem cell innovation may create an opportune backdrop for a significant reduction in the U.S. Food and Drug Administration's regulatory framework for stem cells, say attorneys at Sheppard Mullin.
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How Importers Can Minimize FCA Risks Of Tariff Mitigation
False Claims Act risks are inherent in many tariff mitigation strategies, making it important for importers to implement best practices to identify and report potential violations of import regulations before they escalate, says Samuel Finkelstein at LMD Trade Law.
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10 Practical Takeaways From FDA's Biopharma AI Guidance
Recent guidance from the U.S. Food and Drug Administration provides much-needed insight on the usage of artificial intelligence in producing information to support regulatory decision-making regarding drug safety, with implications ranging from life cycle maintenance to AI tool acquisition, say attorneys at Covington.
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Lawmakers Shouldn't Overlook Rare Disease Therapies' Value
As the ORPHAN Cures Act is pending in Congress, policymakers assessing the value of certain drugs for price regulation should consider data beyond what is collected in clinical trials, say Alice Chen at the University of Southern California, and Molly Frean and Yao Lu at Analysis Group.
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What Trump's Order Means For The Legal Status Of IVF
An executive order signed by President Donald Trump last month signals the administration's potential intention to increase protections for in vitro fertilization services, though more concrete actions would be needed to resolve the current uncertainty around IVF access or bring about a binding legal change, says Jeanne Vance at Weintraub Tobin.
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Mitigating Tariff Risks For Healthcare In US And Canada
Healthcare stakeholders should take steps to evaluate the impact of cross-border tariffs, as the historically strong ties between Canada and the U.S. demonstrate the potential for real disruption and harm to the healthcare industry in both countries, say attorneys at Norton Rose.