Living in a Material World After Escobar
Client Alert | 1 min read | 02.02.17
On January 26, 2017, the Fourth Circuit heard oral argument in United States ex rel. Omar Badr v. Triple Canopy, one of four False Claims Act decisions that the Supreme Court vacated and remanded for further consideration in light of the Court’s June 2016 holding regarding the implied certification theory in Universal Health Servs. v. United States ex rel. Escobar. Since Escobar was decided, three of the four circuits have grappled with the Escobar holding and issued decisions in the remanded cases. In a "Bloomberg Law Insight," C&M attorneys discuss how these early decisions illustrate the flexible nature of the Escobar materiality test and are an early sign of much litigation to come.
Contacts
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
