Insights

On August 13, 2026, the Centers for Medicare and Medicaid Services (CMS) published its final rule banning the use of federal funds — through Medicaid and the Children’s Health Insurance Program (CHIP) — to pay for gender-affirming care for children and youth. The final rule takes effect October 13, 2026 (“Prohibition on Federal Medicaid and Children's Health Insurance Program Funding for Sex-Rejecting Procedures Furnished to Children”). While CMS finalized several key elements of its late-2025 proposed rule (Client Alert December 24, 2025), the proposed Medicare hospital Condition of Participation rule remains in proposed form.

On July 23, 2026, the U.S. Department of Justice’s Antitrust Division announced that it will again use targeted Second Request investigations and released a revised Model Timing Agreement, another signal that this Antitrust Division continues to take a more business friendly approach toward merger review. The model introduces an optional “Expedited Consideration” process that gives merging parties the option to address discrete competitive concerns identified by the DOJ before undertaking full Second Request compliance.

Two federal appellate courts have now looked at analogous allegations of price fixing using AI-driven pricing software and reached opposite conclusions—creating an arguable circuit split and providing additional guidance to companies using algorithmic pricing tools.

In the underlying litigation, Epic Games alleged that Apple violated antitrust and unfair competition laws by engaging in anti-steering behavior related to purchases on Apple’s in-app payment system. Apple received a percentage of payments made through this system, and Epic Games argued that Apple prohibited app developers from informing users about alternative payment options.  

RICO was built for the mob. But Congress gave trade secret victims access to it in 2016, and a recent U.S. Court of Appeals for the Fifth Circuit decision shows that access is real.

On Wednesday, June 3, 2026, the Department of Health and Human Services (HHS) published an interim final rule with comment (IFC) instructing all state Medicaid agencies to incorporate “community engagement” as an eligibility condition for program participation by no later than January 1, 2027. The rule (Medicaid Program; Community Engagement Requirement for Certain Individuals) does not impose affirmative operational obligations for Medicaid managed care plans, as it focuses primarily on equipping the states to administer the community engagement requirement. However, it does establish a few specific guardrails to govern the role managed care organizations, prepaid inpatient health plans, and prepaid ambulatory health plans may — and may not — play in that administration.

On June 2, 2026, the U.S. Trade Representative (USTR) announced a landmark set of enforcement actions under Section 301 of the Trade Act of 1974, targeting 60 economies worldwide for failing to prohibit the importation of goods produced with forced labor. This is one of the most sweeping forced labor-related trade enforcement actions in U.S. history. USTR has proposed new tariffs ranging from 10% to 12.5% on all products from these economies. Interested parties may file public comments, due by July 6, and the USTR has scheduled a public hearing on July 7 before final implementation. Companies sourcing from any of the 60 affected economies should assess exposure immediately.

California’s COMPETE Act (AB 1776) narrowly passed the California State Assembly by three votes on Wednesday and now moves to the California State Senate. The bill — introduced in March by Assembly Majority Leader Cecilia Aguiar-Curry — is modeled closely on draft legislation recommended by the California Law Revision Commission in September. AB 1776 would not only significantly expand potential liability for single-firm conduct and monopolization but, based on recent amendments, would also explicitly decouple California antitrust analysis from certain federal standards. Crowell & Moring is representing the California Chamber of Commerce (CalChamber) in monitoring, analyzing, and responding to AB 1776. 

Texas Attorney General (AG) Ken Paxton has embarked on an aggressive campaign of regulation through enforcement against some of the world’s largest technology companies.

The U.S. Court of Appeals for the Seventh Circuit recently vacated the U.S. Tax Court’s decision in Hyatt Hotels v. Commissioner, a case concerning the taxation of loyalty programs. The Seventh Circuit remanded the case to the Tax Court for further review.

On May 6, 2026, the Federal Aviation Administration (FAA) published a long-awaited Notice of Proposed Rulemaking (NPRM) that would create a formal process for designating drone-free zones — known as Unmanned Aircraft Flight Restrictions (UAFRs) — over critical infrastructure facilities. The proposed rule has significant implications for the entire drone ecosystem. Facility operators across a broad range of industries would gain a potential pathway to restrict unauthorized drone access to their airspace, while commercial drone operators and companies that rely on UAS services face new compliance obligations, operational constraints, and potential criminal liability in designated zones.

On April 6, 2026, the Centers for Medicare & Medicaid Services (CMS) published its final rule governing the Medicare Advantage (Part C) and Prescription Drug Benefit (Part D) programs for Contract Year (CY) 2027. The final rule is effective June 1, 2026, with most provisions applicable to coverage beginning January 1, 2027, and marketing and communications changes taking effect October 1, 2026. Beyond payment, the rule pursues a broad deregulatory agenda aligned with Executive Order 14192, reversing marketing and enrollment safeguards introduced in 2023 and easing documentation and reporting obligations, while introducing new program integrity requirements.

On April 13, 2026, President Trump signed the Small Business Innovation and Economic Security Act of 2026 (S. 3971) (the Act), extending the Small Business Innovation Research (SBIR) and Small Business Technology Transfer (STTR) programs through September 30, 2031. The legislation cleared the U.S. Senate on March 3, 2026 and then was passed by the U.S. House of Representatives on March 17, 2026 after a six-month interruption in program authority that halted the issuance of new awards across federal agencies. The programs’ previous authorization expired on September 30, 2025.

On April 7, 2026, Acting Attorney General Todd Blanche issued a memorandum establishing the National Fraud Enforcement Division (NFED) within the U.S. Department of Justice (DOJ). This new division will be dedicated to the centralized, coordinated investigation and prosecution of fraud against taxpayer dollars and taxpayer-funded programs. AAG Blanche acknowledged that, while DOJ has a “storied history of combatting fraud,” DOJ has “never adopted a comprehensive and coordinated approach to investigating and prosecuting fraud against taxpayer dollars and tax-payer funded programs.” The NFED was created to close that gap with its core mission being to “zealously investigate and prosecute those who steal or fraudulently misuse taxpayer dollars.”

In March 2026, the Office of the United States Trade Representative (USTR) launched two parallel Section 301 investigations: one targeting manufacturing overcapacity across 16 countries (including China, the EU, Japan, India, Mexico, Vietnam, and other major manufactures), and one targeting forced labor enforcement failures across 60 countries. Here are the top seven questions Crowell & Moring’s International Trade team is getting regarding pending Section 301 comment deadlines from our clients and how to address them:

As pharmaceutical weight-loss therapies have surged in popularity, health plans, regulators, and courts have found themselves grappling with a set of increasingly pressing and complex questions: who must cover these drugs, under what circumstances, and for whom?

Legislative efforts to significantly expand California’s antitrust laws are working their way through the state legislature. The most comprehensive overhaul is Assembly Bill 1776 — the Competition and Opportunity in Markets for a Prosperous, Equitable and Transparent Economy (COMPETE) Act, introduced by Assembly Majority Leader Cecilia Aguiar-Curry, on March 23, 2026. AB 1776 is modeled closely after draft legislation recommended by the California Law Revision Commission (CLRC) in December. AB 1776 would not only significantly expand potential liability for single-firm conduct and monopolization but would also explicitly decouple California antitrust analysis from certain federal standards. Companies doing business in California should pay close attention to AB 1776 because of its potentially dramatic impact, including increased exposure to antitrust litigation and increased compliance costs.

On March 10, 2026, the Department of Justice released the first-ever Department-wide Corporate Enforcement and Voluntary Self-Disclosure Policy (the “Department-wide CEP” or “Policy”), which applies to all non-antitrust corporate criminal cases across the Department. The new policy has been anticipated since December 2025, when Deputy Attorney General Todd Blanche announced the Department’s plans to release a new, single corporate enforcement policy for all criminal matters. According to the Department, the new policy is designed to “help ensure consistency across the Department” and “transparently describe the Department’s policies and decisionmaking.”

On March 3, 2026, the Department of Labor (DOL), Department of Health and Human Services (HHS), and Department of the Treasury (TREAS) — collectively, the “Tri-Agencies” — published their fourth annual report to Congress on enforcement of the Mental Health Parity and Addiction Equity Act (MHPAEA). The 2025 Report demonstrates a shift in approach by the Tri-Agencies in its tone and content and suggests that federal regulators, and the DOL in particular, are not as active as they previously were in MHPAEA enforcement. However, federal enforcement remains ongoing, and state enforcement of mental health parity laws continues to grow. Plans and issuers must continue to maintain comprehensive compliance processes and documentation for MHPAEA compliance.