Court of Federal Claims Permits Affordable Care Act "Risk Corridors" Case to Proceed
Client Alert | less than 1 min read | 12.02.16
In Maine Community Health Options v. U.S. (Dec. 2, 2016) the CFC held that the “existence of separate, active cases” whose outcomes will impact the issues raised by a plaintiff fails to meet the Government’s burden to justify a stay of litigation under Federal Circuit precedent. Plaintiff Maine Community Health Options (represented by C&M) is one of 13 health insurers who have filed suit against the Government under the Tucker Act seeking to recover “risk corridors” payments pursuant to §1342 of the Affordable Care Act.
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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
