Value of Services Performed Must Be Considered in Fraud Case
Client Alert | less than 1 min read | 05.02.16
On April 28, the Fifth Circuit found in U.S. v. Harris that the government must take into account the value of the work performed in assessing damages in procurement fraud cases, even when sentencing individuals. In a perhaps unique fact pattern, the court upheld the conviction for 16 counts of wire fraud, but overturned the two-year prison sentence of an Army colonel because the government had calculated damages based on the full $1.3 million value of the contracts, rather than properly reducing that total for the value of the work performed.
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Client Alert | 2 min read | 02.03.26
CMS Doubles Down on RADV Audit Changes
On January 27, 2026, the Centers for Medicare and Medicaid Services (CMS) released a Health Plan Management System (HPMS) memo that provided a long-awaited update on how the agency plans to approach previously announced Risk Adjustment Data Validation (RADV) audits for Payment Years (PY) 2020-2024. The memo is the agency’s most comprehensive statement on the subject since September 25, 2025, when the Northern District of Texas vacated the 2023 RADV Final Rule. The memo makes clear that, while CMS has made certain operational adjustments in response to concerns expressed by Medicare Advantage Organizations (MAOs), the agency is largely pressing forward with the accelerated audit strategy announced in May 2025.
Client Alert | 2 min read | 02.03.26
Sedona Model Jury Instructions for DTSA: A Step Forward—But Questions Remain
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
Client Alert | 4 min read | 01.30.26
Optimum’s Shot Across the Bow: An Antitrust Challenge to Cooperation Agreements
