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Healthcare

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Healthcare

CONTROLLED SUBSTANCES—SETTLEMENT AGREEMENTS: CVS to pay $315M to settle FCA, CSA allegations

October 16, 2026 | By Sherri M. Schroeder, J.D.

The government alleged that the pharmacy chain illegally filled prescriptions for opioids and other controlled substances and then billed Medicare and other federal health care programs. U.S. pharmacy giant CVS Pharmacy, Inc. and its related corporat...

CONTROLLED SUBSTANCES—SETTLEMENT AGREEMENTS: CVS to pay $315M to settle FCA, CSA allegations
Law Firms Mentioned:Akin Gump Strauss Hauer & Feld LLP | Arnall Golden Gregory | Butler Snow LLP | Crosner Legal, PC | Gravitas Law Group APC | Greenberg Traurig | Hall Render | Jones and Keller PC | Mason and Perry LLP | Mayer Brown | Troutman Pepper Locke | Weller, Green, Toups & Terrell, L.L.P.
Organizations Mentioned:Conduent State Healthcare, LLC | Curium US LLC d/b/a Curium Pharma | M&M Orthodontics, PA | Reed's, Inc.
EXPERT INSIGHTS—Seals and sale bans: California's new non-UPF certification and age limits on dietary supplements & OTC diet products
October 16, 2026
Amaru Sanchez & Oluwaremilekun O. Mehner, Marshall L. Baker & Nathan A. Brown

California continues to lead the way in regulating foods and dietary supplements sold within its borders. Two recent developments are worth highlighting: the nation's first statewide "Non-Ultraprocessed" food certification program, and a second-of-it...

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ELECTRONIC HEALTH RECORDS—E.D. Mo.: Case against pharmaceutical company after data breach moves forwardE.D. Mo.: Case against pharmaceutical company after data breach moves forward
October 16, 2026
Brian Craig, J.D.

The proposed class action lawsuit alleging claims for negligence, negligence per se, and breach of contract following a data breach will proceed. The federal district court in St. Louis, Missouri has held that a pharmaceutical company specializing in...

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LABELING AND PACKAGING (FOOD, DRUGS & MEDICAL DEVICES)—S.D. Cal.: Natural-labeling claims advance over manufactured citric acid
October 16, 2026
George Basharis, J.D.

California consumer protection and warranty claims challenging the natural labeling of ginger ale containing industrially manufactured citric acid may proceed, despite federal regulatory guidance classifying fermentation-derived citric acid as nonsyn...

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MEDICAID—Tex. Sup. Ct.: Orthodontia prior-authorization contractor not an ‘individual’ for purposes of interlocutory appeals jurisdiction
October 16, 2026
Jeffrey H. Brochin, J.D.

The contractor responsible for screening dentists’ requests for state Medicaid funding for children’s orthodontia, was neither a “governmental unit” nor an “individual” for the purposes of conferring interlocutory appeals jurisdiction. The Supreme Co...

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FOOD STANDARDS—FINAL RULES: FDA amends standard of identity regulations regarding salt substitutes
October 16, 2026
WK Editorial Staff

The FDA issued a final rule to amend the standard of identity regulations that specify salt as a required or optional ingredient to permit the use of salt substitutes in standardized foods. The final rule amends the FDA’s standard of identity regulat...

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SAFETY AND EFFECTIVENESS—NOTICES: FDA’s LASIX determination allows for continued approval of ANDAs
October 16, 2026
WK Editorial Staff

The FDA has determined that LASIX (furosemide) oral solution, 10 milligrams (mg)/ milliliter (mL), was not withdrawn from sale for reasons of safety or effectiveness. This determination means that the FDA will not begin procedures to withdraw approva...

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ADMINISTRATION OF MEDICARE/MEDICAID PROGRAMS—DAB DECISIONS: Affiliation with revoked hospice supported Medicare enrollment revocation, preclusion list placement
October 16, 2026
WK Editorial Staff

CMS lawfully revoked a physician’s Medicare enrollment and added him and his medical practice to the preclusion list based on an affiliation deemed to pose an undue risk of fraud, waste, or abuse. The Departmental Appeals Board (DAB) upheld CMS’ revo...

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ADMINISTRATION OF MEDICARE/MEDICAID PROGRAMS—DAB DECISIONS: License revocation related to professional performance supports federal health care program exclusion
October 16, 2026
WK Editorial Staff

An HHS ALJ upheld the Inspector General’s exclusion of a former pharmacy technician from federal health care programs after a state licensing board revoked her license based on findings related to unlawful diversion and possession of controlled subst...

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FALSE CLAIMS ACT—SETTLEMENT AGREEMENTS: Heal 360 clinics, owner reach $20 million settlement to resolve FCA allegations
October 16, 2026
Justin Marcus Smith, J.D.

The providers denied the allegations that it intentionally used the wrong CPT codes to bill substantially higher “office visit” rates than the rates permitted for COVID-19 specimen collection. The Department of Justice (DOJ), acting on behalf of the ...

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HEALTH CARE COMPLIANCE NEWS—OIG Work Plan updates for September 2026
October 16, 2026
WK Editorial Staff

The HHS Office of Inspector General’s (OIG) Work Plan—the list of agency audits, evaluations, and inspections that are planned or underway—is adjusted throughout the year to meet changing agency priorities. The OIG has issued Work Plan updates for Se...

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LAW FIRM NEWS—Noteworthy developments in the legal community
October 16, 2026
WK Editorial Staff

Law firms continue to strengthen health care, life sciences, FDA regulatory and litigation capabilities through strategic attorney additions in key U.S. markets. Arnall Golden Gregory. Arnall Golden Gregory welcomed David O. Ault as a partner in its ...

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Healthcare

LABELING AND PACKAGING (FOOD, DRUGS & MEDICAL DEVICES)—N.D. Cal.: Baby food MDL is dismissed for lack of federal jurisdiction

October 15, 2026 | By Donielle Tigay Stutland, J.D.

A negligence-per-se claim premised on alleged federal Food, Drug, and Cosmetic Act adulteration and misbranding violations does not present a substantial federal question. In a multidistrict litigation involving alleged adulteration and misbranding o...

LABELING AND PACKAGING (FOOD, DRUGS & MEDICAL DEVICES)—N.D. Cal.: Baby food MDL is dismissed for lack of federal jurisdiction
Law Firms Mentioned:Cetrulo LLP | Dow Law Group, LLC | Hogan Lovells Cadwalader US LLP | King & Spalding LLP | Schlichter Bogard LLC | Seyfarth Shaw LLP | Sheppard, Mullin, Richter & Hampton LLP | Wisner Baum LLP
Organizations Mentioned:Amgen Inc. | Amgen USA Inc. | Beech-Nut Nutrition Co. | Humana, Inc. | Novartis Institute for Biomedical Research, Inc. | Walmart, Inc.
EXPERT INSIGHTS—FDA opens applications for new pilot to shorten drug approval times: What sponsors need to know
October 15, 2026
Justine Lei & Jami Fogelhut

Earlier this month, FDA opened applications for a new Expedited Investigational New Drug (IND) Pilot Program (the "Program"), an initiative launched under HHS Operation TrialBlazer[1] that aims to shorten the path from IND-enabling activities to firs...

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ELECTRONIC HEALTH RECORDS—W.D. Ky.: Humana privacy lawsuit advances over alleged tracking of health information
October 15, 2026
George Basharis, J.D.

The insurer allegedly transmitted sensitive health information to third parties even after users restricted tracking through privacy controls on its website and patient portals. Humana must defend a proposed class action alleging that it secretly int...

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PREEMPTION OF STATE LAW—1st Cir.: Seizure patient’s estate may amend complaint against Amgen about Aimovig biologic labeling
October 15, 2026
Justin Marcus Smith, J.D.

The court affirmed dismissal for “impossibility” preemption; however, amendment was not certainly futile because the estate made a presentation of newly acquired information forming a basis for a label change. A state law complaint about the labeling...

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CONTROLLED SUBSTANCES—FINAL RULES: DEA revokes exempted status for inactive butalbital products
October 15, 2026
WK Editorial Staff

The Drug Enforcement Administration (DEA) is revoking the exempted status for certain nonnarcotic prescription products that are currently on the DEA’s Table of Exempted Prescription Products. The certain nonnarcotic prescription products’ National D...

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FOOD SAFETY—FDA GUIDANCE NOTICES: FDA issues draft guidance on requirements for food traceability records
October 15, 2026
WK Editorial Staff

The FDA announced the availability of a draft guidance for industry titled “Requirements for Additional Traceability Records for Certain Foods: Enforcement Policy for Certain Retail Food Establishments and Restaurants.” The draft guidance states that...

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MEDICAL DEVICES—FINAL RULES: FDA classifies cell enrichment kit
October 15, 2026
WK Editorial Staff

The FDA has classified the hematopoietic cell enrichment kit into class II (special controls). The special controls that apply to the device type are identified in the order and will be part of the codified language for classification of the hematopo...

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ADMINISTRATION OF MEDICARE/MEDICAID PROGRAMS—DAB DECISIONS: Medicare reactivation effective date tied to receipt of approved revalidation application
October 15, 2026
WK Editorial Staff

An ALJ upheld CMS’ determination that a supplier’s Medicare billing privileges were reactivated on the date CMS received an enrollment application that was later approved. The HHS Departmental Appeals Board (DAB) affirmed CMS’ determination that Octo...

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RURAL HEALTH CLINICS—GAO REPORTS: CMS awarded states $10 billion in RHT program funding
October 15, 2026
K. C. Salcedo

CMS plans to allot up to another $40 billion of the remaining program funds to states over the next four years. In its report to HHS, the Government Accountability Office (GAO) described CMS’s administration of the Rural Health Transformation (RHT) p...

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Healthcare

FALSE CLAIMS ACT—S.D. Ohio: Relator failed to allege that there was anything illegal about referral exchange

October 14, 2026 | By Justin Marcus Smith, J.D.

None of the benefits alleged between the providers were the types of prohibited kickback “remuneration” as defined in Sixth Circuit caselaw. A qui tam relator failed to plead enough specific facts to show that a group of health care providers faciall...

FALSE CLAIMS ACT—S.D. Ohio: Relator failed to allege that there was anything illegal about referral exchange
Law Firms Mentioned:Civil Counsel Group LLP | FBT Gibbons LLP | Malk Pogo Law Group, LLP
Organizations Mentioned:Project 7, Inc. | TriHealth, Inc.
LABELING AND PACKAGING (FOOD, DRUGS & MEDICAL DEVICES)—N.D. Cal.: False advertising action concerning “naturally flavored” candy product may proceed in part
October 14, 2026
Sara Cracau, J.D.

The complaint alleged that a reasonable consumer is likely to be misled by the candy manufacturer’s “naturally flavored” statement on its packaging. A federal district court in California denied a candy maker’s motion to dismiss various consumer prot...

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CONTROLLED SUBSTANCES—PROPOSED RULES: DEA proposes updates to scheduling actions for kratom products, derivatives
October 14, 2026
WK Editorial Staff

In regard to the two synthetic 7-OH derivatives, MGM-15 and MGM-16, the DEA emphasized the commercial marketing of these substances as a significant public health concern. The Drug Enforcement Administration (DEA) recommended in two proposals additio...

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DRUGS AND BIOLOGICS—FDA GUIDANCE NOTICES: FDA issues guidance on postapproval manufacturing changes
October 14, 2026
WK Editorial Staff

The FDA announced the availability of a final guidance for industry entitled “Postapproval Manufacturing Changes to Biosimilar and Interchangeable Biosimilar Products: Questions and Answers.” This guidance provides answers to commonly asked questions...

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MEDICAL DEVICES—FINAL RULES: Classification of the infant pulse rate, oxygen saturation monitor for OTC use
October 14, 2026
WK Editorial Staff

The FDA identified the risks to health associated with this type of device and the measures required to mitigate these risks. The FDA has classified the infant pulse rate and oxygen saturation monitor for over-the-counter use into class II (special c...

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MEDICAL DEVICES—FINAL RULES: Classification of the system for detection of nucleic acid from non-viral microorganism(s) causing sexually transmitted infections using home-collected specimens
October 14, 2026
WK Editorial Staff

The FDA believes the action will also enhance patients’ access to beneficial innovative devices, in part by reducing regulatory burdens. The FDA has classified the system for detection of nucleic acid from non-viral microorganism(s) causing sexually ...

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FRAUD AND ABUSE—DAB DECISIONS: Health care fraud conviction supports 23-year exclusion
October 14, 2026
WK Editorial Staff

The DAB upheld a 23-year exclusion from federal health care programs, finding that substantial financial losses, prolonged fraudulent conduct, a lengthy prison sentence, and related state disciplinary actions justified the extended exclusion period. ...

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FALSE CLAIMS ACT—SETTLEMENT AGREEMENTS: AIDS Healthcare Foundation to pay $1.44M to settle FCA allegations
October 14, 2026
Sherri M. Schroeder, J.D.

The government alleged that the non-profit organization failed to timely investigate and delete diagnosis codes that were either inaccurate or not documented in medical records. Los Angeles-based AIDS Healthcare Foundation (AHF) d/b/a Positive Health...

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AUDITS AND MONITORING—OIG REPORTS: South Carolina underreported federal share of collections subject to increased COVID-19 FMAP
October 14, 2026
K. C. Salcedo

The state agency’s lack of written policies and procedures for preparing CMS reports and reconciling the reported amounts led to the accounting errors. The HHS Office of Inspector General (OIG) audited records of the South Carolina Department of Heal...

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AGENCY NEWS—HHS Settles With Dental Practice Over HIPAA Shortfalls
October 14, 2026
Tony Foley

The Department of Health and Human Services’ Office for Civil Rights (OCR) has reached a settlement with Shen Smiles P.C., a Pennsylvania-based dental practice, over potential violations of the Health Insurance Portability and Accountability Act (HIP...

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Healthcare

GENERAL HEALTH CARE NEWS—9th Cir.: Breach of confidence constitutes injury-in-fact sufficient to confer Article III standing

October 13, 2026 | By Jeffrey H. Brochin, J.D.

The unauthorized disclosure of sensitive health information was akin to a breach of confidence or contract that courts have traditionally recognized as providing a basis for a lawsuit. The United States Court of Appeals for the Ninth Circuit has reve...

GENERAL HEALTH CARE NEWS—9th Cir.: Breach of confidence constitutes injury-in-fact sufficient to confer Article III standing
Law Firms Mentioned:Hagens Berman Sobol Shapiro, LLP | Lathrop GPM, LLP | Schaerr Jaffe, LLP | Sperling Kenny Nachwalter, LLC | Stoel Rives, LLP | Walsh PLLC
Organizations Mentioned:AbbVie, Inc. | IEC Group, Inc.
WORTH NOTING—Other Health Law litigation and regulatory developments
October 13, 2026
WK Editorial Staff

A roundup of other items of interest to the Health Law community. LONG-TERM CARE FACILITIES—CMS LETTERS: REVISED: Nursing Home Risk-Based Survey National Implementation (CMS Letter , No. QSO-26-14-NH (Sept. 29, 2026)). MEDICAL DEVICES— S.D. W. Va.: P...

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ANTITRUST—N.D. Ill.: Health plan’s suit seeking damages against AbbVie over drug pricing dismissed
October 13, 2026
Brian Craig, J.D.

While the court dismissed the claims seeking damages, the health plan can proceed with seeking injunctive relief and amend the complaint. The federal district court in Chicago, Illinois has dismissed claims brought by a self-funded health plan for sh...

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LABELING AND PACKAGING (FOOD, DRUGS & MEDICAL DEVICES)—9th Cir.: Hair care manufacturer secures reversal of class certification in animal-testing labeling suit
October 13, 2026
Ravindra Kumar Singh, B.L.

Although the product labels supported classwide reliance and materiality, the purchasers’ damages models were too preliminary to establish classwide damages. A hair care products manufacturer secured reversal of an order certifying a consumer class a...

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ADMINISTRATION OF FDC ACT—NOTICES: Determination that oxandrin (oxandrolone) tablets, 2.5mg and 10mg, were withdrawn from sale for reasons of safety or effectiveness
October 13, 2026
WK Editorial Staff

Corrections made to address ANDA changes. The FDA corrected a notice that appeared in the Federal Register of September 13, 2023 (88 Fed. Reg. 62799). The notice announced the determination that oxandrin (oxandrolone) tablets, 2.5 milligrams (mg) and...

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GENERAL HEALTH CARE NEWS—FINAL RULES: Removal of obsolete, suspended HIS regulations
October 13, 2026
WK Editorial Staff

Removing these regulations will not change the IHS’s existing practices or authorities. The Indian Health Service (IHS) of the Department of Health and Human Services (HHS or “the Department”) is issuing this final rule to remove regulations appearin...

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ADMINISTRATION OF MEDICARE/MEDICAID PROGRAMS—DAB DECISIONS: Twenty-year exclusion from Medicare, Medicaid affirmed for $3M fraud loss, other aggravating factors
October 13, 2026
Justin Marcus Smith, J.D.

The purpose of excluding health care practitioners from participating in government health care programs is to protect the programs from fraud and abuse, exclusion is remedial, not punitive. A physician’s felony conviction for participation in a cons...

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QUALITY OF CARE—DAB DECISIONS: Quality-of-Care requirements mandate timely assessment, monitoring, physician notification post-changes in resident condition
October 13, 2026
WK Editorial Staff

The ALJ upheld a determination that a skilled nursing facility violated Medicare quality-of-care requirements by failing to adequately monitor, assess, document, and respond to a resident’s significant change in condition, and upheld a $14,330 per-in...

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FRAUD AND ABUSE—OIG REPORTS: 90% of Medicaid reimbursements for Wisconsin’s school-based program may have been improperly claimed
October 13, 2026
Erick Jorgenson

Wisconsin disagreed with the OIG’s findings. The HHS Office of Inspector General (OIG) concluded that of the $505.5 million Medicaid reimbursement to Wisconsin’s School-Based Program, $454.9 million (89.9 percent) may have been improperly claimed. Br...

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REGULATION TRACKER—Information on pending or recently adopted regulations and regulation amendments
October 13, 2026
WK Editorial Staff

This Health Law Regulation Tracker includes a Proposed Rules Comment Calendar and a Table of Final Rule Effective Dates. New proposed rules. On October 8, 2026, CMS issued a proposed rule to amend the Clinical Laboratory Improvement Amendments of 198...

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Healthcare

ADMINSTRATION OF MEDICARE/MEDICAID PROGRAMS—D. Idaho: Absolute immunity bars suit against Idaho health officials over disputed hearing

October 9, 2026 | By Steven Melendez

A federal court found the officials serve functions analogous to a judge and prosecutor, dismissing a federal claim. A federal judge dismissed Allegiance Behavioral Health LLC’s claim alleging due process violations in an administrative hearing, find...

ADMINSTRATION OF MEDICARE/MEDICAID PROGRAMS—D. Idaho: Absolute immunity bars suit against Idaho health officials over disputed hearing
Law Firms Mentioned:Covington & Burling LLP | Dorsey & Whitney LLP | Harris Welsh & Lukmann | Reed Smith LLP | Shapiro & Teitelbaum LLP
Organizations Mentioned:Allegiance Behavioral Health LLC | Howmedica Osteonics Corporation | Janssen Biotech, Inc. | State of Idaho | State of Idaho Department of Health and Welfare
ELECTRONIC HEALTH RECORDS—N.D. Tex.: Action for privacy breach may proceed with respect to negligence claim
October 9, 2026
Sara Cracau, J.D.

Action for privacy breach may proceed with respect to negligence claim but not breach of fiduciary duties, unjust enrichment, and declaratory judgment. A district court in Texas has granted in part and denied in part the motion to dismiss of a financ...

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MEDICAL DEVICES—N.D. Ind.: Breach of warranty claim not sufficiently distinct from time-barred tort claim in hip device lawsuit
October 9, 2026
Leah S. Poniatowski, J.D.

The patient was given another chance to pursue warranty claims under the UCC. A patient whose implanted hip nailing system failed could not recover against the manufacturer on breach of warranty theories because the nature of her allegation was based...

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CLINICAL RESEARCH—PROPOSED RULES: CLIA virtual access, gynecologic cytology proficiency testing, personnel qualifications changes
October 9, 2026
WK Editorial Staff

Existing CLIA certification regulations do not account for remote review of digital laboratory data, digital results, or digital images since these technologies were not available when the original regulations were codified. This proposed rule would ...

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CONTROLLED SUBSTANCES—NOTICES: Arenbii Pharmacy LLC registration suspended
October 9, 2026
WK Editorial Staff

The OSC/ISO also proposed the revocation of Registrant’s DEA Certificate of Registration, alleging that Registrant’s continued registration is inconsistent with the public interest. On September 17, 2025, the Drug Enforcement Administration (DEA or G...

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CONTROLLED SUBSTANCES—NOTICES: Medpharm Research, LLC marijuana bulk manufacturer registration denied
October 9, 2026
WK Editorial Staff

The applicant’s corporate structure, acting through the company that owns and controls it and its sister company, all of which are managed by the same CEO, engaged in the unregistered manufacture of marijuana for at least a decade and has diverted ma...

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GENERAL HEALTH CARE NEWS—FINAL RULES: Removal of obsolete portion of regulation relating to care and treatment of ineligible individuals
October 9, 2026
WK Editorial Staff

HHS will remove outdated language appearing in the CFR at 42 CFR 136.14(b), which stablished general principles and program requirements for carrying out Indian health programs. The Indian Health Service (IHS) of the HHS issued a final rule to remove...

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ADMINISTRATION OF MEDICARE/MEDICAID PROGRAMS—DAB DECISIONS: Cooperation with federal officials not a mitigating factor if no statutory outcomes result
October 9, 2026
Jeffrey H. Brochin, J.D.

There was no dispute that a physician participated in multiple proffer sessions in which he cooperated with investigators and prosecutors, but the ALJ did not err in finding that such cooperation did not rise to the level necessary to find a mitigati...

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QUALITY OF CARE—DAB DECISIONS: Gait-belt lapse supports $188,165 nursing facility penalty
October 9, 2026
WK Editorial Staff

An HHS administrative law judge upheld immediate-jeopardy penalties after a skilled nursing facility failed to provide a high-risk resident with the gait belt and supervision required by her care plan, and the resident fell and fractured her wrist. A...

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TOBACCO—GAO REPORTS: Tobacco application backlog spurs inquiry into FDA’s process
October 9, 2026
Sherri M. Schroeder, J.D.

A new GAO report examines eight years of tobacco product applications, the timeliness of the review process, and what the agency has done to improve its review process. In a new report to Congress entitled, “Tobacco Products: FDA Should Monitor Timel...

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