State attorneys general (AGs) continue to play a pivotal role as innovators, shaping the regulatory environment by leveraging their expertise and resources to influence policy and practice. The public-facing nature of AG offices across the U.S. compels them to respond to constituent concerns on abbreviated timetables. This political sensitivity, combined with the AGs’ authority to address both local and national issues, underscores their significant influence in the current regulatory environment.

West Virginia Attorney General (AG) Patrick Morrisey announced a total $17 million settlement agreement with pharmaceutical companies, Pfizer and Ranbaxy after more than a decade of litigation regarding the companies’ alleged “pay-for-delay” antitrust violations related to the cholesterol drug, Lipitor.

On January 6, the Department of Health and Human Services (HHS) Office for Civil Rights (OCR) published significant proposed amendments (proposed rule) to the Security Rule under the Health Insurance Portability and Accountability Act of 1996 (HIPAA). Key drivers for the proposed rule include the dramatic increase in cyberattacks, including ransomware, the rapid adoption of cloud computing, mobile devices, and other technologies, and inconsistent compliance with the existing Security Rule identified by the OCR’s investigations.

What Happened

On November 12, the Kentucky Attorney General (AG) issued a formal opinion, concluding that the Kentucky Board of Pharmacy lacks the authority to regulate nonresident pharmacists beyond what is specified in KRS Chapter 315. The board cannot mandate Kentucky licensure for nonresident pharmacists, except for the pharmacist-in-charge per KRS 315.0351(1)(g). Therefore, the board’s proposed amendment to 201 KAR 2:030, which would require all out-of-state pharmacists filling prescriptions for Kentucky residents to be licensed in Kentucky, exceeds the board’s statutory authority.

On October 15, Maryland Attorney General Anthony G. Brown announced that his office reached a $27 million settlement with Precision Toxicology to resolve allegations that it submitted false claims to government health programs for medically unnecessary urine drug tests and provided illegal kickbacks to physicians.

In 2024, the landscape of state attorneys general (AGs) is poised for significant change, with numerous elections and regulatory actions reshaping priorities and enforcement strategies. This dynamic environment reflects the critical role AGs play in addressing key issues across various sectors, from environmental regulations and consumer protection to health care and privacy. As state AGs continue to influence policy and legal frameworks, their actions will have far-reaching implications for businesses and consumers alike. Troutman Pepper’s State AG team is pleased to provide you with this mid-year review summarizing the activities in this regulatory space over the past six months.

North Carolina Attorney General Josh Stein and the U.S. Attorney’s Office for the Middle District of North Carolina have reached a $500,000 settlement with Sharon Raynes Halliday and RAPHA Healthcare Services LLC, resolving a false claims lawsuit filed in July 2022 related to requests for payment submitted to the North Carolina Medicaid program.

On August 11, Illinois Governor J.B. Pritzker signed House Bill 2222 (Public Act 103-0526) into law — bolstering Illinois’ antitrust prevention efforts by expanding the oversight purview of its Attorney General’s (AG) office with respect to health care transactions. Under the new law, the Illinois AG now has the power to review and assess certain “covered transactions” entered into between health care facilities and providers.