Fourth Circuit Weighs in on Public Disclosure Bar and Retroactivity
Client Alert | 1 min read | 12.13.13
The Fourth Circuit in U.S. ex rel. Radcliffe v. Purdue Pharma.(Dec. 12, 2013) became the first court of appeals to address whether the FCA's public disclosure bar is still jurisdictional after its 2010 amendment by the Affordable Care Act (a topic about which Crowell & Moring attorneys wrote articles in March and September) and held that it is not, reasoning that the word jurisdiction was excised from the statute and that the government was newly empowered to veto application of the bar. This decision came in the context of a broader analysis in which the court clarified that the date of the allegedly fraudulent conduct, not the date that the complaint was filed, governs potential retroactive effect.
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
