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Fourth Circuit Interprets Corporate Knowledge And Materiality Under FCA

Client Alert | 1 min read | 01.08.04

In United States ex rel. Harrison v. Westinghouse Savannah River Co. (Dec. 19, 2003), the Fourth Circuit upheld a civil penalty of $195,000 ($7500 times 26 invoices) because the false cert "negatively affected the integrity of the bidding process," although zero actual damages were proven. The court held that (a) the False Claims Act's "knowledge" element was satisfied when one employee of the corporate defendant had knowledge of the facts making the corporation's certification false, even though there was no evidence that the same employee knew that the cert was required or even that it had been submitted; and (b) the false cert (that no organizational conflict of interest (OCI) existed in connection with a subcontract award) was "material" because it would have "had a natural tendency to influence" the government's decision to fund the subcontract "if it had known the full details" at the time of award, even though the government in fact concluded that no OCI existed when it subsequently learned of the issue and continued to pay for the subcontract work thereafter.

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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

On January 26, 2026, the Centers for Medicare and Medicaid Services (CMS) circulated the Calendar Year (CY) 2027 Advance Notice to communicate proposed changes to Medicare Advantage (MA) capitation rates and Parts C and D payment policies.  The changes are expected to be finalized in April 2026 but may be delayed. The following is a summary of the most significant proposals, with further details below:...