State Higher Ed Entities Face Arm-of-the-State Test
Client Alert | less than 1 min read | 06.25.12
In US ex rel. Oberg v. Ky. Higher Educ., the Fourth Circuit considered whether corporate entities created by several states to provide higher education financing (and accused of making false claims to DOE) are "persons" subject to FCA liability. The court stated that "the critical inquiry is whether [the entities] are truly subject to sufficient state control to render them a part of the state, and not a 'person,'" and instructed that Eleventh Amendment "arm-of-the-state" analysis applies to determine if they are subject to liability.
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Client Alert | 2 min read | 02.03.26
CMS Doubles Down on RADV Audit Changes
On January 27, 2026, the Centers for Medicare and Medicaid Services (CMS) released a Health Plan Management System (HPMS) memo that provided a long-awaited update on how the agency plans to approach previously announced Risk Adjustment Data Validation (RADV) audits for Payment Years (PY) 2020-2024. The memo is the agency’s most comprehensive statement on the subject since September 25, 2025, when the Northern District of Texas vacated the 2023 RADV Final Rule. The memo makes clear that, while CMS has made certain operational adjustments in response to concerns expressed by Medicare Advantage Organizations (MAOs), the agency is largely pressing forward with the accelerated audit strategy announced in May 2025.
Client Alert | 2 min read | 02.03.26
Sedona Model Jury Instructions for DTSA: A Step Forward—But Questions Remain
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
Client Alert | 4 min read | 01.30.26
Optimum’s Shot Across the Bow: An Antitrust Challenge to Cooperation Agreements
