You Win Some/You Lose Some
Client Alert | less than 1 min read | 06.01.06
In our Bullet Point of May, 19, 2006, we reported that CMS had lost a bid protest on one of the first competitive procedures to replace the existing fiscal intermediary and Medicare carrier contractors. In a companion protest that the same protester filed on another award under the same RFP, CIGNA Gov't Services, LLC (May 4, 2006, http://www.gao.gov/decisions/bidpro/297915.pdf), CMS prevailed against allegations that CMS had “completely abdicated” its responsibility to perform a cost realism analysis, as GAO found that CMS had considered all relevant information in the awardee's proposal and that there was no basis to question the reasonableness of CMS's analysis.
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
