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Ambiguity Remains After Escobar

Client Alert | 1 min read | 11.09.16

In U.S. ex rel. Nelson v. Sanford-Brown Ltd. (Oct. 24, 2016), the Seventh Circuit, applying the materiality standard articulated by the Supreme Court in Escobar (discussion available here), held that the relator’s allegations that the college inflated grades and job placement figures and paid bonuses to employees for recruitment to fraudulently obtain federal student aid money failed because there was no evidence that the college had made any express or implied representations with its claims for payment or evidence that the government’s payment decision would likely have been different had it known of the alleged misrepresentations. In contrast, the Eighth Circuit in U.S. ex rel. Miller v. Weston Educ. Inc. (Oct. 19, 2016) held that similar allegations withstood summary judgment (as noted by C&M here), suggesting that the Supreme Court’s decision in Escobar may not have resolved the circuit split on implied certification after all.

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Client Alert | 7 min read | 08.19.26

CMS’s Final Rule Bans Federal Medicaid Funding for Youth Gender-Affirming Care

On August 13, 2026, the Centers for Medicare and Medicaid Services (CMS) published its final rule banning the use of federal funds — through Medicaid and the Children’s Health Insurance Program (CHIP) — to pay for gender-affirming care for children and youth. The final rule takes effect October 13, 2026 (“Prohibition on Federal Medicaid and Children's Health Insurance Program Funding for Sex-Rejecting Procedures Furnished to Children”). While CMS finalized several key elements of its late-2025 proposed rule (Client Alert December 24, 2025), the proposed Medicare hospital Condition of Participation rule remains in proposed form....