Cara Wallace

Perkins Coie

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Latest Posts › False Claims Act (FCA)

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New CMS Rule Requires Extrapolation of Medicare Advantage RADV Audit Findings

The Centers for Medicare and Medicaid Services (CMS) published its final rule regarding the Medicare Advantage (MA) Risk Adjustment Data Validation (RADV) program in early February 2023. Among other matters, the final rule...more

2/15/2023 / Audits , Centers for Medicare & Medicaid Services (CMS) , Compliance , Department of Health and Human Services (HHS) , False Claims Act (FCA) , Medicare Advantage , Medicare Advantage Organizations (MAOs) , New Rules , Required Documentation , Risk Adjustment Formula

SCOTUS Decision on Implied Certification Theory of Liability Under FCA Leaves Many Questions Unanswered

The U.S. Supreme Court handed down an important decision on June 16, 2016 that expands the scope of liability under the False Claims Act, 31 U.S.C. §§ 3729-3733, (the FCA). In Universal Health Services, Inc. v. United...more

6/17/2016 / False Claims Act (FCA) , False Implied Certification Theory , Implied Certification , Medicaid , Reimbursements , SCOTUS , Universal Health Services Inc v United States ex rel Escobar , Unlicensed Medical Providers

Supreme Court Poised to Resolve Circuit Split on False Claims Act Liability Under Theory of Implied Certification

The U.S. Supreme Court is poised to resolve a circuit split over the False Claims Act (FCA) that could have broad implications for those that do business with the federal government. On April 19, 2016, the Supreme Court...more

4/22/2016 / Corporate Counsel , False Claims Act (FCA) , False Implied Certification Theory , Health Care Providers , Implied Certification , Qui Tam , SCOTUS , Universal Health Services Inc v United States ex rel Escobar

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