Federal Employees as Relators OK'ed
Client Alert | less than 1 min read | 08.07.12
In Little v. Shell Exploration & Production Co., the Fifth Circuit joined the Tenth and Eleventh Circuits in holding that federal employees, like private citizens, can bring whistleblower suits under the False Claims Act--even when those employees are auditors whose job is to investigate fraud. The Sixth and Ninth Circuits have also implicitly held that federal employees are not barred from acting as relators, while the First Circuit has held that at least some federal employees may not be qui tam plaintiffs.
Insights
Client Alert | 2 min read | 03.27.26
CMS Releases PY 2020 RADV Audit Methods and Instructions: Key Takeaways for Health Plans
On March 20, 2026, the Centers for Medicare and Medicaid Services (CMS) released new guidance outlining the agency’s audit methods and instructions for Medicare Advantage (MA) plans subject to upcoming risk adjustment data validation (RADV) audits for payment year (PY) 2020. In addition to providing necessary context for MA plans selected for auditing, this resource clarifies CMS’s methodological and procedural expectations. While the high-level takeaways are recapped below for convenience, we strongly recommend that MA organizations selected for PY 2020 audits closely review the guidance to understand what may be involved — or required — during the agency’s review.
Client Alert | 4 min read | 03.25.26
NAIC Intensifies AI Regulatory Focus: What Health Insurance Payors Need to Know
Client Alert | 11 min read | 03.25.26
White House National AI Policy Framework Calls for Preempting State Laws, Protecting Children
Client Alert | 3 min read | 03.24.26
California Considering A Massive Expansion of Its Antitrust Laws
