Sixth Circuit Recognizes Exception to Heightened Standard for Pleading False Claim
Client Alert | less than 1 min read | 10.12.16
In U.S. ex rel. Prather v. Brookdale Senior Living Communities Inc. (Sept. 30, 2016), the Sixth Circuit held that a relator pled the “presentment” element even though the relator did not allege information regarding the submission of a specific request for payment. The court reasoned that, in the majority of cases, plaintiffs would need to plead representative false claims but that a relator could survive a motion to dismiss by pleading specific facts based on personal, billing-related knowledge that support a strong inference that specific false claims were submitted for payment.
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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
On January 26, 2026, the Centers for Medicare and Medicaid Services (CMS) circulated the Calendar Year (CY) 2027 Advance Notice to communicate proposed changes to Medicare Advantage (MA) capitation rates and Parts C and D payment policies. The changes are expected to be finalized in April 2026 but may be delayed. The following is a summary of the most significant proposals, with further details below:
Client Alert | 4 min read | 01.30.26
Optimum’s Shot Across the Bow: An Antitrust Challenge to Cooperation Agreements
Client Alert | 9 min read | 01.30.26
Client Alert | 7 min read | 01.29.26
ASEAN Digital Ministers' Meeting 2026: Spotlight on AI Cooperation in Asia's Rising Markets
