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 | 4 min read | 03.25.26
NAIC Intensifies AI Regulatory Focus: What Health Insurance Payors Need to Know
The National Association of Insurance Commissioners (NAIC) is intensifying its oversight of how insurers use AI — and the pace of regulatory activity shows no signs of slowing. Over the past several months, the NAIC has published a formal Issue Brief staking out its position on federal AI legislation, launched a multistate AI Evaluation Tool pilot aimed at examining insurers’ AI governance programs, and continued to expand adoption of its AI Model Bulletin across state lines. These developments continue a trend towards enhancing regulation; the NAIC adopted AI Principles in 2020 and a Model Bulletin in 2023 clarifying that existing insurance laws apply to AI systems and establishing expectations for governance, documentation, testing, and third-party oversight. That Model Bulletin has now been adopted in approximately 24 states.
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
Client Alert | 2 min read | 03.23.26
