Walgreens to Pay $300 Million to Settle DOJ Claims Over Invalid Opioid Prescriptions -
Walgreens Boots Alliance has agreed to pay more than $300 million to resolve allegations brought by the US Department of Justice (DOJ)...more
4/28/2025
/ Anti-Kickback Statute ,
Causation ,
Controlled Substances ,
Department of Justice (DOJ) ,
Enforcement Actions ,
False Claims Act (FCA) ,
Fraud ,
Healthcare Fraud ,
Opioid ,
Pharmaceutical Industry ,
Pharmacies ,
Settlement ,
Whistleblowers
Seventh Circuit Reverses AKS Conviction Involving Allegations of Illegal Marketing and Advertising -
On April 14, the US Court of Appeals for the Seventh Circuit reversed the criminal conviction of Mark Sorensen after a...more
4/21/2025
/ Anti-Kickback Statute ,
Appeals ,
Criminal Prosecution ,
Department of Justice (DOJ) ,
Department of Veterans Affairs ,
False Claims Act (FCA) ,
Federal Rules of Civil Procedure ,
Healthcare Fraud ,
Medical Devices ,
Medicare ,
Money Laundering ,
Pharmacies ,
Physicians ,
Wire Fraud
A federal court recently rejected arguments by MultiPlan, Inc. and Cigna Health and Life Insurance Company that they had no obligation to ensure payments at the contractually negotiated, in-network rate to Anatomic and...more
Welcome to the Winter 2025 issue of “FCA Enforcement & Compliance Digest,” our quarterly newsletter in which we compile essential updates on False Claims Act (FCA) enforcement trends, litigation, agency guidance, and...more
First Circuit Joins Sixth and Eighth Circuits in Adopting Heightened, But-For Causation Standard for AKS-Based FCA Claims -
On February 18, the US Court of Appeals for the First Circuit became the latest court to agree...more
2/24/2025
/ Anti-Kickback Statute ,
But For Causation ,
Causation ,
Compliance ,
Cybersecurity ,
DCIS ,
Department of Justice (DOJ) ,
Enforcement Actions ,
False Claims Act (FCA) ,
Healthcare Fraud ,
Medicare ,
Overpayment ,
Paycheck Protection Program (PPP) ,
Pharmaceutical Industry ,
SBA ,
Settlement ,
TRICARE
With 2025 underway, the AFS Health Care team highlights some of the most pressing legal issues facing the health care industry this year....more
President Trump Puts a “Pause” on FCPA Enforcement -
On Monday, President Donald Trump signed an executive order (EO) pausing the enforcement of the Foreign Corrupt Practices Act (FCPA). According to the EO, the pause will...more
2/17/2025
/ Bribery ,
Compliance ,
Department of Justice (DOJ) ,
Enforcement Actions ,
Executive Orders ,
Foreign Corrupt Practices Act (FCPA) ,
Fraud ,
Healthcare Fraud ,
Kickbacks ,
Medicare Fraud ,
Securities and Exchange Commission (SEC) ,
Significant Transnational Criminal Organization ,
Trump Administration ,
White Collar Crimes
Trade secrets, noncompetes, and other restrictive covenants continued to make headlines in 2024. Most notably, the Federal Trade Commission (FTC) published a final rule imposing a near total ban on employee noncompetes that...more
On September 9, the US Departments of Labor, Treasury, and Health and Human Services (the Departments) jointly released a final rule to ensure that group health plans comply with the Mental Health Parity and Addiction Equity...more
On July 19, the US District Court for the Northern District of Texas denied a motion to dismiss Blue Cross Blue Shield of Texas (BCBSTX), which claimed sovereign immunity in a suit brought by a group of providers. In so...more
Previously, we discussed how the US Supreme Court’s opinion in Loper Bright Enterprises v. Raimondo and Relentless, Inc. v. Department of Commerce could create opportunities for private litigants to challenge health...more
7/30/2024
/ Centers for Medicare & Medicaid Services (CMS) ,
Chevron Deference ,
Department of Health and Human Services (HHS) ,
Health Care Providers ,
Healthcare ,
Loper Bright Enterprises v Raimondo ,
Payment Systems ,
Regulatory Agenda ,
SCOTUS ,
Secretary of HHS ,
Stark Law
The US Supreme Court recently overturned its ruling in Chevron USA, Inc. v. Natural Resources Defense Council, Inc., changing the landscape for federal agency rulemaking and actions, particularly in the health care industry....more
On June 28, the US Supreme Court overturned the Chevron doctrine — the legal principle that the judiciary should defer to a federal agency’s reasonable interpretation of an ambiguous statute.
Chevron reflected the view...more
7/15/2024
/ Chevron Deference ,
Chevron v NRDC ,
Department of Health and Human Services (HHS) ,
Food and Drug Administration (FDA) ,
Healthcare ,
Hospitals ,
Judicial Review ,
Loper Bright Enterprises v Raimondo ,
Medicaid ,
Medicare ,
National Marine Fisheries Service ,
Regulatory Agenda ,
Reimbursements ,
Relentless Inc v US Department of Commerce ,
Rulemaking Process ,
SCOTUS
Last week, the US Court of Appeals for the Fourth Circuit issued a decision holding that state health care plans in North Carolina and West Virginia must cover gender-affirming surgeries.
A copy of the decision, Kadel v....more
2023 was a banner year for trade secrets, non-competes, and other restrictive covenants. Employee non-competes continued to garner attention at the federal agency level, drawing commentary and action from the Federal Trade...more
3/13/2024
/ Competition ,
Confidential Information ,
Contract Terms ,
Cybersecurity ,
Damages ,
Department of Justice (DOJ) ,
Employment Contract ,
Enforcement ,
Federal Labor Laws ,
Federal Trade Commission (FTC) ,
Former Employee ,
Intellectual Property Protection ,
New Legislation ,
NLRA ,
NLRB ,
Non-Compete Agreements ,
Restrictive Covenants ,
State Labor Laws ,
Trade Secrets
In a recent opinion, E.W. v. Health Net Life Insurance Co., the US Court of Appeals for the Tenth Circuit clarified the elements that plaintiffs must plead to state claims under the Mental Health Parity and Addiction Equity...more
Last week, the US Court of Appeals for the Ninth Circuit, in its third opinion in the case, reversed a lower court’s decision allowing patients challenging United Behavioral Health’s (UBH) internal mental health coverage...more
On July 25, 2023, the US Departments of Labor (DOL), Treasury (DOT), and Health and Human Services (HHS) (the Departments) released a much-anticipated interim final rule to ensure that group health plans comply with the...more
8/16/2023
/ Biden Administration ,
Department of Health and Human Services (HHS) ,
Department of Labor (DOL) ,
Department of Transportation (DOT) ,
Interim Final Rules (IFR) ,
Mental Health ,
Mental Health Parity Rule ,
MHPAEA ,
NQTLs ,
Proposed Rules ,
Rulemaking Process ,
Substance Abuse
In a case involving government contracts, the Fourth Circuit held that a company could proceed with its claims against three former employees for actions they took as employees – through their newly formed company - to pursue...more
In a recent decision, the US District Court for the District of Utah granted United Healthcare’s (UHC) motion for summary judgment on the plaintiff’s facial and as-applied claims under the Mental Health Parity Act. If...more
On December 5, 2022, the US District Court for the Middle District of North Carolina held that the North Carolina State Health Plan (NCSHP) constitutes a “Health Program or Activity” under the Affordable Care Act (ACA). In so...more
12/14/2022
/ Affordable Care Act ,
Bostock v Clayton County Georgia ,
Civil Rights Act ,
Employee Retirement Income Security Act (ERISA) ,
Gender Discrimination ,
Health Insurance ,
North Carolina ,
Rulemaking Process ,
SCOTUS ,
Summary Judgment ,
Transgender
Earlier this month, the US District Court for the Western District of Washington certified a class of individuals who were denied gender-affirming care by a third-party administrator, Blue Cross Blue Shield of Illinois...more
11/22/2022
/ Affordable Care Act ,
Anti-Discrimination Policies ,
Blue Cross ,
Blue Shield ,
Declaratory Relief ,
Employee Retirement Income Security Act (ERISA) ,
Gender Discrimination ,
Motion for Summary Judgment ,
Preliminary Injunctions ,
Religious Freedom Restoration Act (RFRA) ,
Transgender
Earlier this month, the US District Court for District of Maryland denied a partial motion for summary judgment in a case filed by Infotek Corporation against Mr. Dwight Preston, a former employee. See Infotek Corp v....more
In a previous article, Litigating Spoliation Claims in Trade Secret Cases, we discussed the rise of spoliation in trade secret and restrictive covenant cases. In that article, we provided background on trade secret laws and...more
On June 15, Lina Khan was sworn in as Chairwoman of the Federal Trade Commission. In an interview with The Wall Street Journal last week, Khan announced that the agency plans to use enforcement actions to curtail the use of...more