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False Eligibility Application For Grant May Violate FCA

Client Alert | 1 min read | 11.09.05

In a ruling that could expand the exposure of grantees to False Claims Act liability, the Seventh Circuit in United States ex rel. Main v. Oakland City University (Oct. 20, 2005) held that a relator stated an FCA claim based upon a private university's allegedly false representation, made on a "phase one" application to establish institutional eligibility for federal financial aid, that it would comply with laws prohibiting payment of incentive fees to recruiters for enrolling students. Rejecting the argument that the "phase one" application does not by itself seek any payment, the court reasoned that a false "phase one" eligibility application could be actionable as a "false record or statement" under the FCA because it supports subsequent "phase two" requests for specific loans and grants.

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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....

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