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Ambiguity Remains After Escobar

Client Alert | 1 min read | 11.09.16

In U.S. ex rel. Nelson v. Sanford-Brown Ltd. (Oct. 24, 2016), the Seventh Circuit, applying the materiality standard articulated by the Supreme Court in Escobar (discussion available here), held that the relator’s allegations that the college inflated grades and job placement figures and paid bonuses to employees for recruitment to fraudulently obtain federal student aid money failed because there was no evidence that the college had made any express or implied representations with its claims for payment or evidence that the government’s payment decision would likely have been different had it known of the alleged misrepresentations. In contrast, the Eighth Circuit in U.S. ex rel. Miller v. Weston Educ. Inc. (Oct. 19, 2016) held that similar allegations withstood summary judgment (as noted by C&M here), suggesting that the Supreme Court’s decision in Escobar may not have resolved the circuit split on implied certification after all.

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Client Alert | 4 min read | 04.10.26

CMS Finalizes Rate Notice for Medicare Parts C and D (CY 2027)

On April 6, 2026, the Centers for Medicare and Medicaid Services (CMS) circulated the Announcement of Calendar Year (CY) 2027 Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies (the CY 2027 Rate Announcement) to communicate Medicare Advantage (MA) capitation rates and Parts C and D payment policies. The Rate Announcement announces decisions regarding proposals initially published on January 26, 2026, in CMS’s CY 2027 Advance Notice for MA and Part D. The following is a summary of the most significant issues in the Rate Announcement, with further details below: ...