A unanimous Third Circuit panel recently held that Section 13(b) of the Fair Trade Commission Act (FTC Act) — which provides a mechanism for the FTC to proceed directly to federal court to enjoin allegedly unlawful conduct...more
In September 2018, we wrote about a draft U.S. Senate bill aimed to protect patients from surprise medical bills, the “Protecting Patients from Surprise Medical Bills Act.” ...more
On October 26, the Centers for Medicare and Medicaid Services (CMS) issued a notice of proposed rulemaking that would significantly alter the risk adjustment data validation (RADV) methodology that applies to Medicare...more
On October 5, a federal district court in California dealt a significant setback to the government’s efforts to extend False Claims Act (FCA) liability to Medicare risk adjustment submissions....more
10/16/2017
/ Centers for Medicare & Medicaid Services (CMS) ,
Dismissals ,
False Claims Act (FCA) ,
FRCP 9(b) ,
Health Insurance ,
Healthcare Fraud ,
Materiality ,
Medicare ,
Medicare Advantage ,
Risk Adjustment Formula ,
Scienter ,
UnitedHealth ,
Whistleblowers
The Sedona Conference’s recent updates to The Sedona Principles provide important guidance on how parties to litigation should handle e-discovery. In particular, the new edition of the Principles set forth best practices...more
In a recent clash between contract principles and the mootness doctrine, contract principles won. Relying on traditional contract principles, the U.S. Supreme Court issued a 6–3 decision on January 20, holding that an...more