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The American Hospital Association is seeking an emergency stay to delay enforcement of the Trump administration's price transparency when it goes into effect Jan. 1...The AHA and other appellants argue in the filing that the rule should be put on hold until their legal challenge plays out. Hospitals are awaiting a decision from a federal appeals court on the regulation following oral arguments in October...The rule would require hospitals to post payer-negotiated payment rates for 300 shoppable services online beginning Jan. 1. The goal is to encourage patients to shop around for care...READ MORE

Walmart has filed suit against the United States Department of Justice and the Drug Enforcement Administration, asking a US District Court judge to clarify the roles and responsibilities of pharmacists and pharmacies under the Controlled Substances Act...Although Walmart’s pharmacies have blocked “thousands” of questionable physicians from having their opioids scripts filled by its pharmacists, “certain DOJ officials have long seemed more focused on chasing headlines than fixing the crisis,” the retailer said. “They are now threatening a completely unjustified lawsuit against Walmart, claiming in hindsight pharmacists should have refused to fill otherwise valid opioid prescriptions that were written by the very doctors that the federal government still approves to write prescriptions.”...READ MORE

Johnson & Johnson appears to be nearing a final deal that could settle more than 2,000 lawsuits brought by states and cities that claim the company contributed to the opioid crisis by overselling the benefits of its painkillers...The U.S. drugmaker will pour an additional $1 billion into a potential settlement that would resolve those opioid lawsuits, on top of the $4 billion the company set aside a year ago.,,READ MORE

A New Jersey medical office has filed suit against Cigna, alleging that the insurer failed to pay for diagnostic testing and treatment related to COVID-19 in violation of the CARES Act...Open MRI and Imaging of RP Vestibular Diagnostics claims that Cigna owes it nearly $400,000 in unpaid claims for care related to the novel coronavirus, and that the decisions to decline coverage were "arbitrary."..."The explanations given by [Cigna] for its refusal to make payment include unelaborated denials that the services were rendered as billed, or matched the services billed, as well as the occasional contention that the billing was duplicative," according to the lawsuit. "The grounds for rejecting plaintiff's claims were, upon information and belief, false and invalid."...READ MORE

The Trump administration sued Walmart Inc. Tuesday, accusing the retail giant of helping to fuel the nation’s opioid crisis by inadequately screening for questionable prescriptions despite repeated warnings from its own pharmacists...The Justice Department’s lawsuit claims that Walmart sought to boost profits, understaffed its pharmacies and pressured employees to fill prescriptions quickly. That made it difficult for pharmacists to reject invalid prescriptions, enabling widespread drug abuse nationwide, the suit alleges...Walmart, the country’s largest retailer by revenue, has been expecting this complaint and sued the federal government in October to fight the allegations pre-emptively...In its suit, Walmart accuses the Justice Department and Drug Enforcement Administration of attempting to scapegoat the company for what it says are the federal government’s own regulatory and enforcement shortcomings...READ MORE

...Purdue Pharma has signed a massive settlement to walk away from federal civil and criminal charges. But as the company wades throught court-supervised bankruptcy, will the government—or individuals hurt by Purdue's bad behavior—see anywhere close to that amount in damages?...Purdue has reached an $8 billion-plus deal with the U.S. Department of Justice to plead guilty and settle federal criminal and civil claims for its role in fueling the nation's opioid epidemic...Purdue has been assessed a $3.54 billion criminal penalty and will forfeit an additional $2 billion, the government said. The company has also agreed to pay $2.8 billion to settle the government's civil claims. In addition, the company's founding Sackler family will forfeit $225 million in civil damages...READ MORE

With the walls closing in around it on a yearslong generics price-fixing probe, Israeli drugmaker Teva faced two options: Reach a deal with prosecutors or gamble. Teva chose to roll the dice, and now it finds itself facing conspiracy charges—and a potentially bigger penalty on the horizon...Federal prosecutors have charged Teva with conspiring to fix prices for a range of generic medicines between 2013 and 2015 as part of an industrywide scheme to overcharge consumers by more than $350 million, the U.S. Department of Justice said...The DOJ indicted Teva on three counts of criminal conspiracy and acting as a ringleader for a group of drugmakers that have previously pleaded guilty to their own price-fixing charges and are now cooperating with prosecutors...READ MORE

It's no secret that the drug industry isn't thrilled with the Trump administration's last-ditch push to bring down drug prices, including an order allowing drug imports from Canada. Now, PhRMA is taking its objections to court...After the administration unveiled its importation executive order in final form in September, PhRMA and other groups sued the Department of Health and Human Services last month arguing the measure violates the Food, Drug, and Cosmetic Act...The lawsuit claims HHS’ importation effort increases risks for the U.S. drug supply chain and forces companies to disclose trade secrets...READ MORE

Pfizer’s fast-growing and costly heart meds Vyndaqel and Vyndamax have been the subject of drug pricing scrutiny since their launch in 2018. Now, they’re at the center of a Medicare copay lawsuit that could reverberate around the industry...meds list with prices of $225,000 per year, the company is suing the U.S. Department of Health and Human Services in an attempt to help with Medicare patients with their copays...kickbacks laws prohibit drugmakers from assisting with Medicare patient copays; companies can financially help patients on commercial insurance. The laws are designed to keep a check on drug prices, and one expert told Barron’s a ruling in Pfizer's favor “would be a major earthquake” for the industry...READ MORE

Humana has filed suit against Florida-based telehealth company QuivvyTech, saying it was defrauded out of millions of dollars...filed in Southern Florida district court, QuivvyTech telemarketers would cold-call Humana members and ask them questions about common ailments. They would then wire that information to physicians who were in the scheme to secure prescriptions for pricey, unneeded creams...The physicians would prescribe these creams without ever speaking to the patient directly, according to the lawsuit. The prescriptions would then be wired to pharmacies that were also active participants in the scheme to be dispensed to members...One doctor, for instance, submitted 1,600 claims through the scheme to which Humana paid out more than $1.1 million, the insurer alleges in the suit...A New York pharmacy submitted 2,100 claims for one type of cream, for which Humana paid more than $2.5 million, the insurer alleges...READ MORE