Expert Analysis

• What CMS Audit Rule Means For Medicare Advantage Plans

  

  Despite ongoing legal challenges, the Centers for Medicare & Medicaid Services is moving forward with implementation of its risk adjustment data validation audits, raising statistical concerns around overpayments indicated by variance in unbalanced samples, say Stephen Fink, Brad Rice and Igor Karagodsky at Analysis Group.

• Clippers Salary Cap Probe Offers Investigation Tips For Cos.

  

  The NBA's recent investigation into whether the Los Angeles Clippers circumvented salary cap rules offers an unusually detailed look at how a significant organizational probe was conducted and how its findings were presented, offering practical lessons for companies conducting their own investigations, say attorneys at Wiley.

• Parsing The Latest Signals On FTC Section 5 Enforcement

  

  Federal Trade Commission cases brought over the last several years and Commissioner Mark Meador’s recent call for stand-alone Section 5 enforcement suggest businesses should prepare for continued scrutiny of conduct beyond traditional antitrust violations, particularly in essential goods, technology and labor markets, say attorneys at Axinn.

• Calif. PFAS Pesticide Reporting Law Raises Cos.' Legal Risks

  

  A new California law requiring public reporting of how registered pesticides containing intentionally added perfluoroalkyl and polyfluoroalkyl substances are used across the state could increase regulatory scrutiny — and provide a road map for litigation involving growers, applicators, distributors, pesticide manufacturers and upstream chemical suppliers, say attorneys at O'Melveny.

• Terminix Deal Shows Risks Of Calif. Aggregating Local Lapses

  

  California district attorneys’ novel use of an unfair competition law to merge unrelated local enforcement matters against pest control providers Rentokil and Terminix into one recently settled statewide case demonstrates that lack of adequate communication between facilities and corporate compliance managers may cause isolated regulatory violations to snowball into larger challenges, say attorneys at Kazmarek Mowrey.

• As Congress Stalls, SEC Hits Go On 'Innovation Exemption'

  

  While the U.S. Securities and Exchange Commission's recently issued innovation exemption to facilitate on-chain trading of certain tokenized stocks isn't a replacement for a comprehensive legislative framework, it reduces the likelihood that further congressional delay will freeze market development, says Stephen Aschettino at Fox Rothschild.

• What Lawyers Should Know Before Accepting Crypto Payment

  

  As clients increasingly request to pay legal fees, retainers and escrow funds using cryptocurrency, lawyers should consider how only a handful of state bar authorities have addressed the issue with varying ethics opinions, as well as the related questions that no authority has yet answered, says attorney Felix Shipkevich.

• How To Use AI In Employment Contract Drafting

  Excerpt from Practical Guidance

  

  Before using artificial intelligence to draft employment contracts, law firms and employers must assess practical ethical guardrails, appropriate use cases, core risk areas and validation workflows, says Samuel Mitchell at Smith Gambrell.

• NY Severance Rules Persist Despite McLaren Macomb Threat

  

  Despite recent calls to overturn the National Labor Relations Board's decision in McLaren Macomb, New York's robust regulation will remain intact, limiting practitioners' ability to offer nonsupervisory employees severance agreements with confidentiality and nondisclosure provisions, says Matthew Berman at Valli Kane.

• How Evergreen Language Can Sink Landlord Credit Support

  

  A recent pattern in court decisions interpreting letters of credit underscores the importance of using precise language when seeking evergreen protection, so landlords should seek explicit successive-renewal terms, verify issuer forms and calendar deadlines in order to preserve credit support, say attorneys at O'Melveny.

• Bank Regulators' New Risk Guidance Offers More Flexibility

  

  Newly proposed interagency guidance on banks’ third-party risk management would shift rigid compliance frameworks to a principles-based, risk-proportionate approach, potentially creating new opportunities for bank-fintech partnerships and giving smaller institutions a clearer path to innovation, say attorneys at Davis Wright.

• Mo. Official's Indictment Tests Limits Of Federal Bribery Laws

  

  The recent bribery charges filed against a Missouri county executive raise questions about whether field-clearing conversations and job offers between rival candidates can rise to the level of illegal quid pro quos, potentially muddying the line between politics as usual and the federal bribery statutes, say attorneys at ArentFox Schiff.

• Calif. Decision Shows Limits Of Self-Serving Testimony

  

  A California appellate court's recent opinion in a dispute between two home renovation partners is a reminder that where there are admissions or undisputed documentary evidence, litigants need more than self-serving testimony to overcome summary judgment, says Tyler Palmer at Tucker Ellis.

• Conn. Insurers Should Prepare To Explain Premium Hikes

  

  As of Jan. 1, Connecticut insurers must provide a reasonable explanation for personal risk insurance premium increases upon policyholder request, and thus should familiarize themselves with a recent bulletin that prescribes the details, say attorneys at Troutman.

• Where The 3 Prediction Market Appellate Rulings Diverge

  

  Although the recent Third, Sixth and Ninth Circuit opinions concerning prediction markets overlap on some issues, they differ on key statutory questions, deepening a circuit split over both the classification of sports event contracts and the scope of federal preemption, says Levi Giovanetto at Sheppard.