Expert Advice -- Caveat Emptor
Client Alert | 1 min read | 01.15.04
On the heels of a district court rejecting a company's reliance on expert advice in a recent False Claims Act case involving independent research and development charges (U.S. v. Newport News Shipbuilding, Inc., 276 F. Supp. 2d 539 (E.D. Va. 2003)), the Department of Justice has filed a complaint against a major accounting firm alleging that advice provided by that firm to a number of its healthcare clients caused the clients to submit "false claims" in the form of inflated bills for Medicare patients (U.S. v. Ernst & Young, LLP (E.D. Pa., filed Jan. 5, 2004)). Read in conjunction, these cases suggest that reliance on advice from outside accounting experts and other consultants as a defense to FCA charges may not be a safe harbor, particularly in circumstances where there is reason to believe that the expert advice will be perceived as "aggressive" by the government.
Insights
Client Alert | 8 min read | 04.17.26
CMS Finalizes CY 2027 Medicare Advantage and Part D Rule: Key Implications for Plan Sponsors
On April 6, 2026, the Centers for Medicare & Medicaid Services (CMS) published its final rule governing the Medicare Advantage (Part C) and Prescription Drug Benefit (Part D) programs for Contract Year (CY) 2027. The final rule is effective June 1, 2026, with most provisions applicable to coverage beginning January 1, 2027, and marketing and communications changes taking effect October 1, 2026. Beyond payment, the rule pursues a broad deregulatory agenda aligned with Executive Order 14192, reversing marketing and enrollment safeguards introduced in 2023 and easing documentation and reporting obligations, while introducing new program integrity requirements.
Client Alert | 1 min read | 04.17.26
Client Alert | 3 min read | 04.17.26
Client Alert | 2 min read | 04.16.26
