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Government Urges SCOTUS to Declare ALJ Process Unconstitutional

Client Alert | 1 min read | 12.08.17

On November 29, 2017, the United States filed a brief in support of certiorari in Raymond J. Lucia Cos., Inc. v. SEC, urging the U.S. Supreme Court to use the case to hold that the existing hiring process for federal administrative law judges (ALJs) is unconstitutional. To date, federal courts of appeals have split on the question: the D.C. Circuit ruled that ALJs are mere “employees” of the federal government and are properly hired through a competitive process overseen by the Office of Personnel Management (OPM); the Tenth and Fifth Circuits, on the other hand, ruled that ALJs are “inferior officers” of the United State and must therefore be appointed as dictated by the Appointments Clause of the U.S. Constitution, as previously discussed here and here. The answer to the question could have significant consequences for thousands of ALJs serving in dozens of federal agencies who are routinely charged with overseeing discovery in agency proceedings, issuing subpoenas, making findings of fact, and deciding cases. The Supreme Court should decide whether to accept the case for argument early next year.

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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....