Contractor's Report to OIG Insufficient to Trigger Public Disclosure Bar
Client Alert | less than 1 min read | 03.27.14
In U.S. ex rel Saunders v. Unisys Corp. (E.D. Va.), the court found that the relator's FCA claim was not precluded by the public disclosure bar despite the defendant providing its internal investigation report to OIG because (1) the report failed to reveal allegations or transactions creating an inference of fraud (its conclusion that the alleged fraudulent billing practices were "unacceptable" was not enough) and (2) it was made available only to the DOD IG and the government agency overseeing the contract and not the general public.
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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
