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Similar State FCA Allegations Yield Mixed Results

Client Alert | 1 min read | 03.03.05

In two California Civil False Claims Act (FCA) cases recently decided by different districts of the California Court of Appeal, California ex rel. Harris v. PricewaterhouseCoopers LLP (Jan. 20, 2005) and California ex rel. Bowen v. Bank of America (Jan. 31, 2005), qui tam relators got mixed results on their novel “reverse false claims”allegations that the defendants failed to report and turn over to the State unclaimed property as required by California law. In Harris, applying case law under the federal FCA, the court upheld liability against an escrow title company and reversed summary judgment in favor of its accountants; but in Bowen, the Court, also applying federal case law, upheld the dismissal of the consolidated complaint against several banks on the ground that the plaintiffs had failed to allege facts that would make the subject property “certain and liquidated,” such that no reverse false claim could arise from the failure to report and turn over the property.

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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....