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FCA Managed Care Case Update: A Court’s View of ICD Guidelines in Risk Adjustment Cases

Addressing a recent motion to dismiss, the Northern District of California predominantly denied Kaiser Permanente’s (“Kaiser”) motion to dismiss the government’s complaint in United States ex rel. Osinek v. Permanente Medical...more

False Claims Act: Prediction on Supreme Court Ruling on Government Dismissal Authority

On December 6, 2022, the Supreme Court heard argument in United States ex rel. Polansky v. Executive Health Resources, Inc., a case with potential implications on the cost and longevity of certain False Claims Act (FCA)...more

Managed Care & the FCA: Are Courts Getting It Right?

Courts are grappling with unique questions in the context of managed care programs in False Claims Act (FCA) cases. But are they getting it right? Two questions trending in courts relate to: (1) materiality under the FCA when...more

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