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Pharmacy Benefit Manager (PBM) Department of Justice (DOJ)

Goodwin

DOJ and FTC Host ‘Listening Sessions’ on Competition Issues in the Pharmaceutical Industry

Goodwin on

In two recent public panels, the Department of Justice (DOJ) and the Federal Trade Commission (FTC) hosted the first of three joint listening sessions mandated by Executive Order No. 14273, Lowering Drug Prices by Once Again...more

ArentFox Schiff

Investigations Newsletter: Co-Founder and Accountant of Leading Special Needs Trusts Charged in $100 Million Alleged Fraud Scheme

ArentFox Schiff on

Earlier this week, the government unsealed an indictment against Leo Joseph Govoni, the co-founder of the nonprofit Center for Special Needs Trust Administration (CSNT), and John Leo Witeck, an accountant for CSNT, charging...more

Goodwin

Antitrust & Competition Healthcare Quarterly Update Q1 2025

Goodwin on

While M&A activity has slowed in the tail end of the first quarter of 2025, including in healthcare, there have been several noteworthy developments in the antitrust space in the first 100 days of the Trump Administration. ...more

Quarles & Brady LLP

Proposed Legislation Indicative of Continued Congressional Efforts to Expand PBM Oversight

Quarles & Brady LLP on

On December 11, 2024, a bill was introduced in the U.S. House of Representatives that, if enacted, would have substantial implications for pharmacy benefit managers (“PBMs”) and pharmacies across the country. Titled the...more

Fennemore

Regulatory Landscape of Insurance Claims Denial Practices and Suggestions for a Path Forward to a Sustainable Healthcare Future

Fennemore on

In the wake of the December 4, 2024 fatal shooting of UnitedHealthcare’s CEO Brian Thompson, questions were raised about insurance claim denial practices. Several news outlets noted that UnitedHealth Group’s profits have been...more

Mintz - Health Care Viewpoints

EnforceMintz — Medicare Advantage and Part D Programs to Remain in the Enforcement Spotlight in 2025

As government scrutiny and enforcement targeting the Medicare Advantage (Medicare Part C) program continued in 2024, the industry’s response to agency actions escalated. Last year also resulted in the first sizable Part D...more

Mintz - Health Care Viewpoints

It’s Been a Long Time Coming: Massachusetts Health Care Market Review 2.0

The latest entrant in a national wave of policymakers enacting health care market oversight laws that have a significant impact on providers and investors, Massachusetts Governor Maura Healey has signed into law House Bill...more

Arnall Golden Gregory LLP

Healthcare Authority Newsletter - November 2024 #1

News Briefs - DOJ National Nursing Home Initiative Aims to Boost Enforcement - The Department of Justice's new report details how the bureau is tackling crimes against older adults and how some providers have found themselves...more

Wilson Sonsini Goodrich & Rosati

FTC Sues Nation’s Largest PBMs, Continuing Biden Administration’s Antitrust Scrutiny of the Life Sciences Sector

The Biden administration’s antitrust scrutiny of the life sciences industry continued this week as the Federal Trade Commission (FTC) filed an administrative complaint against the nation’s largest pharmacy benefit managers...more

Quarles & Brady LLP

Justice Department’s New Task Force on Health Care Monopolies and Collusion

Quarles & Brady LLP on

DOJ recently formed the Antitrust Division’s (the “Division”) Task Force on Health Care Monopolies and Collusion (“HCMC”), signaling anticompetitive activity in health care markets as an enforcement priority....more

ArentFox Schiff

Investigations Newsletter: Chicago Laboratory Owner Charged with Defrauding Medicare in $60 Million COVID-19 Test Kit Scheme

ArentFox Schiff on

Chicago Laboratory Owner Charged with Defrauding Medicare in $60 Million COVID-19 Test Kit Scheme - The Chicago-based owner of two laboratories, Zoom Labs Inc. and Western Labs Co., has been charged with health care fraud...more

Holland & Knight LLP

Holland & Knight Health Dose: May 14, 2024

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Holland & Knight Health Dose is an in-depth weekly dose of legislative and regulatory insights to keep stakeholders abreast of happenings in Washington, D.C., impacting the health sector....more

King & Spalding

DOJ Introduces Task Force on Health Care Monopolies and Collusion

King & Spalding on

On May 9, 2024, the DOJ announced the formation of a new task force on health care monopolies and collusion (the HCMC Task Force) that will “guide the division’s enforcement strategy and policy approach in health care,...more

Holland & Knight LLP

Holland & Knight Health Dose: March 5, 2024

Holland & Knight LLP on

Holland & Knight Health Dose is an in-depth weekly dose of legislative and regulatory insights to keep stakeholders abreast of happenings in Washington, D.C., impacting the health sector. ...more

Wiley Rein LLP

Wiley Consumer Protection Download (July 24, 2023)

Wiley Rein LLP on

Welcome to Wiley’s update on recent developments and what’s next in consumer protection at the Consumer Financial Protection Bureau (CFPB) and Federal Trade Commission (FTC). In this newsletter, we analyze recent regulatory...more

Mintz - Antitrust Viewpoints

FTC and DOJ Antitrust Memorialize Joint Workshop on the Future of Antitrust Enforcement in the Pharmaceutical Industry

The Federal Trade Commission, in coordination with the U.S. Department of Justice Antitrust Division, recently released a summary of the Agencies’ June 2022 joint workshop titled “The Future of Pharmaceuticals: Examining the...more

Hogan Lovells

FTC and DOJ outline potential changes to agencies’ review of pharmaceutical mergers

Hogan Lovells on

On June 1, 2023, the Federal Trade Commission (FTC) and the Antitrust Division of the US Department of Justice (DOJ) released a summary of a workshop jointly held by the agencies in June 2022 titled “Future of...more

ArentFox Schiff

Investigations Newsletter: Anticipated Landmark Supreme Court Decision May Be Anything But

ArentFox Schiff on

Anticipated Landmark Supreme Court Decision May Be Anything But On - April 18, 2023, the US Supreme Court heard oral arguments in a set of highly anticipated cases regarding the scienter—or knowledge—provision of the False...more

Morrison & Foerster LLP

FTC Will Move Forward with Robinson-Patman Act Enforcement “in Short Order”

The Federal Trade Commission’s (FTC) efforts to revive the depression-era Robinson-Patman Act, which forbids price discrimination, certain types of rebates, and commercial bribery by distributors, will enter a new, more...more

ArentFox Schiff

Pharmacy Benefit Manager Reform Remains Legislative Priority

ArentFox Schiff on

The 2022 midterms have concluded, but the Republican underperformance is not expected to dampen Congressional enthusiasm for Pharmacy Benefit Manager (PBM) reform. The issue remains at the forefront of the healthcare pricing...more

Rivkin Radler LLP

Fraud Week: Pharmacy Kickbacks, Fake Medical Directorships and More

Rivkin Radler LLP on

Federal and state enforcement activity involving pharmacy fraud tops the list of categories in this edition of Rivkin Rounds’ Fraud Week. We’ll list just a sampling of cases....more

Mintz - Antitrust Viewpoints

DOJ and FTC Virtual Workshop: Agencies Discuss Novel Approaches to Address Competition Issues in Pharmaceutical Mergers

On June 14 and 15, 2022, the Department of Justice Antitrust Division (“DOJ”) and the Federal Trade Commission (“FTC”) hosted a virtual workshop to discuss antitrust analysis of pharmaceutical mergers and anticipated focal...more

Foley & Lardner LLP

Department of Justice’s Antitrust Priorities in Health Care Target Private Equity, Labor, and More

Foley & Lardner LLP on

In a keynote speech delivered to the American Bar Association’s Antitrust in Healthcare Conference in Arlington, Virginia on Friday, June 3, 2022, Deputy Assistant Attorney General Andrew Forman of the Department of Justice’s...more

ArentFox Schiff

Investigations Newsletter: DOJ Denies Alleged Circuit Split on Particularity Requirement in FCA Cases

ArentFox Schiff on

DOJ Denies Alleged Circuit Split on Particularity Requirement in FCA Cases - In a much-anticipated filing by the Department of Justice (DOJ), following the US Supreme Court’s request for briefing by the US Office of the...more

Foley & Lardner LLP

The Biden Administration Looks to Push Regulatory Change in 2022

Foley & Lardner LLP on

The first year of the Biden Administration marked the passage of major spending packages, including the American Rescue Plan and the Infrastructure Investment and Jobs Act. Yet, with President Biden’s social spending package,...more

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