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Author: John Libby

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FCA Case Spotlight: District of Massachusetts Finds Insufficient Evidence of Remuneration or Willfulness in Janssen’s Infusion-Suite Support Programs

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United States ex rel. Long v. Janssen Biotech, Inc., No. 1:16-cv-12182-FDS, 2026 WL 2949353 (D. Mass. Sept. 30, 2026) Healthcare / False Claims Act · Anti-Kickback Statute · Manufacturer Practice Support · Scienter Introduction Manufacturers of physician-administered drugs have long supported the practices that administer them, with reimbursement hotlines, coding guides, nurse training, and advice […]

CONTINUE READING FCA Case Spotlight: District of Massachusetts Finds Insufficient Evidence of Remuneration or Willfulness in Janssen’s Infusion-Suite Support Programs 13 min read
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FCA Case Spotlight: An Indiana Federal Court Holds That Medicaid’s Failure to Recoup Contractor-Flagged Overpayments Does Not Defeat Materiality at the Pleading Stage

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United States ex rel. McCullough v. Anthem Insurance Companies, Inc., No. 1:21-cv-00325-TWP-TAB, 2026 WL 2448954 (S.D. Ind. Aug. 20, 2026) Healthcare / False Claims Act · Medicaid Managed Care · Materiality · Government Knowledge Introduction In Universal Health Services, Inc. v. United States ex rel. Escobar, 579 U.S. 176, 194 (2016), the Supreme Court held […]

CONTINUE READING FCA Case Spotlight: An Indiana Federal Court Holds That Medicaid’s Failure to Recoup Contractor-Flagged Overpayments Does Not Defeat Materiality at the Pleading Stage 16 min read
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FCA Case Spotlight: The Ninth Circuit Holds That a $200 Million HUD Compliance Agreement Was Not an “Alternate Remedy” and Affirms a $38.3 Million Qui Tam Settlement

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United States ex rel. Ling v. City of Los Angeles, No. 25-249, ___ F.4th ___, 2026 WL 2871734 (9th Cir. Sept. 24, 2026) | United States ex rel. Novak v. Walgreens Boots Alliance, Inc., No. 18 C 5452, 2026 WL 2920869 (N.D. Ill. Sept. 29, 2026) False Claims Act · Qui Tam Settlement Approval · […]

CONTINUE READING FCA Case Spotlight: The Ninth Circuit Holds That a $200 Million HUD Compliance Agreement Was Not an “Alternate Remedy” and Affirms a $38.3 Million Qui Tam Settlement 17 min read
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Payor-Provider Alert: District Courts Turn Away Insurer Challenges to No Surprises Act Awards, and Three Circuits Will Decide Whether the Door Stays Shut

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Anthem Blue Cross Life & Health Insurance Co. v. HaloMD LLC, No. 8:25-cv-01467-KES, 2026 WL 982629 (C.D. Cal. Apr. 9, 2026), appeal docketed, No. 26-2355 (9th Cir. Apr. 16, 2026) | Aetna Health Inc. v. Radiology Partners, Inc., No. 3:24-cv-1343-BJD-LLL (M.D. Fla. Apr. 16, 2026), appeal docketed, No. 26-11607 (11th Cir. May 8, 2026) | […]

CONTINUE READING Payor-Provider Alert: District Courts Turn Away Insurer Challenges to No Surprises Act Awards, and Three Circuits Will Decide Whether the Door Stays Shut 17 min read
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Payor-Provider Case Spotlight: The Third and Ninth Circuits Draw ERISA’s Preemption Line Between the Verification Call and the EOB

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Ahn v. Cigna Health & Life Insurance Co., No. 25-1723, ___ F.4th ___, 2026 WL 1813215 (3d Cir. June 24, 2026), aff’g No. 2:19-cv-07141, 2025 WL 830217 (D.N.J. Mar. 17, 2025) | Healthcare Ally Management of California, LLC v. WSP USA, Inc., No. 24-3479, ___ F.4th ___, 2026 WL 2319896 (9th Cir. Aug. 11, 2026), […]

CONTINUE READING Payor-Provider Case Spotlight: The Third and Ninth Circuits Draw ERISA’s Preemption Line Between the Verification Call and the EOB 13 min read
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Payor-Provider Alert: The Fifth Circuit Holds En Banc What Can and Can’t Be Included in the No Surprises Act’s Qualifying Payment Amount

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Texas Medical Association v. U.S. Department of Health and Human Services, No. 23-40605, ___ F.4th ___, 2026 WL 2322331 (5th Cir. Aug. 11, 2026) (en banc) (per curiam) | Texas Medical Association v. U.S. Department of Health and Human Services, 120 F.4th 494 (5th Cir. 2024), reh’g en banc granted, opinion vacated, 138 F.4th 961 […]

CONTINUE READING Payor-Provider Alert: The Fifth Circuit Holds En Banc What Can and Can’t Be Included in the No Surprises Act’s Qualifying Payment Amount 16 min read
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Payor-Provider Case Spotlight: The Second Circuit Holds That Providers Cannot Sue to Enforce No Surprises Act Arbitration Awards

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East Coast Advanced Plastic Surgery, LLC v. Cigna Health & Life Insurance Co., No. 25-2204, ___ F.4th ___ (2d Cir. Sept. 17, 2026), aff’g Nos. 25 Civ. 255, 25 Civ. 1686, 2025 WL 2371537 (S.D.N.Y. Aug. 14, 2025) | Guardian Flight, L.L.C. v. Health Care Service Corp., 140 F.4th 271 (5th Cir. 2025) Healthcare / […]

CONTINUE READING Payor-Provider Case Spotlight: The Second Circuit Holds That Providers Cannot Sue to Enforce No Surprises Act Arbitration Awards 13 min read
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Arbitration Alert: Five Faces of Finality

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Introduction Courts enforce arbitration agreements and review awards narrowly. It is, therefore, notoriously difficult to overturn an unfavorable arbitration award – the grounds are narrow by statute, and courts are loath to expand the grounds by judicial fiat. This past summer brought five decisions in under two months that turned away five different theories: functus […]

CONTINUE READING Arbitration Alert: Five Faces of Finality 19 min read
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Healthcare Case Spotlight: The D.C. Circuit Joins the Broad Reading of the Anti-Kickback Statute — and Strikes OIG’s Advisory-Opinion Timing Rules

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Vertex Pharmaceuticals Incorporated v. United States Department of Health and Human Services, No. 25-5133, ___ F.4th ___, 2026 WL 2617588 (D.C. Cir. Sept. 4, 2026) | affirming in part and reversing in part Vertex Pharms. Inc. v. U.S. Dep’t of Health & Hum. Servs., 774 F. Supp. 3d 211 (D.D.C. 2025) Healthcare / Anti-Kickback Statute […]

CONTINUE READING Healthcare Case Spotlight: The D.C. Circuit Joins the Broad Reading of the Anti-Kickback Statute — and Strikes OIG’s Advisory-Opinion Timing Rules 11 min read
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Arbitration Practice Note: Ten Things Counsel Can Do to Make an Arbitration More Efficient and Less Expensive for Their Clients

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Arbitration (US and International) / Case Management and Advocacy Introduction Arbitral institutions are competing on efficiency — the ICC’s revised Rules took effect June 1, 2026 with a highly expedited track and codified early determination, and the AAA amended its Commercial Rules in 2022 to make arbitrators weigh the cost of a dispositive motion before […]

CONTINUE READING Arbitration Practice Note: Ten Things Counsel Can Do to Make an Arbitration More Efficient and Less Expensive for Their Clients 5 min read
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