Earlier Complaint Fails 9(b), But Bars FCA Suit
Client Alert | 1 min read | 11.08.11
Addressing a question of first impression for it, the D.C. Circuit in U.S. ex rel Batiste v. SLM Corp. held that the FCA’s “first-to-file” rule deprives the district courts of subject matter jurisdiction when a complaint filed earlier alleges “the same material elements of a fraudulent scheme,” even if the earlier complaint did not meet the heightened standard of Rule 9(b). In so holding, the D.C. Circuit disagreed with the Sixth Circuit in Walburn v. Lockheed Martin Corp., noting that nothing in the FCA incorporates Rule 9(b)’s particularity requirement into the first-to-file rule and that the earlier complaint was sufficient to allow the government to investigate the fraudulent scheme.
Insights
Client Alert | 2 min read | 02.03.26
CMS Doubles Down on RADV Audit Changes
On January 27, 2026, the Centers for Medicare and Medicaid Services (CMS) released a Health Plan Management System (HPMS) memo that provided a long-awaited update on how the agency plans to approach previously announced Risk Adjustment Data Validation (RADV) audits for Payment Years (PY) 2020-2024. The memo is the agency’s most comprehensive statement on the subject since September 25, 2025, when the Northern District of Texas vacated the 2023 RADV Final Rule. The memo makes clear that, while CMS has made certain operational adjustments in response to concerns expressed by Medicare Advantage Organizations (MAOs), the agency is largely pressing forward with the accelerated audit strategy announced in May 2025.
Client Alert | 2 min read | 02.03.26
Sedona Model Jury Instructions for DTSA: A Step Forward—But Questions Remain
Client Alert | 7 min read | 01.30.26
CMS Proposes CY 2027 Growth Rate and Changes to Risk Adjustment for Medicare Parts C and D
Client Alert | 4 min read | 01.30.26
Optimum’s Shot Across the Bow: An Antitrust Challenge to Cooperation Agreements
