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Supreme Court Rules in Favor of Health Plans in Landmark $13 Billion Affordable Care Act Case

Client Alert | 1 min read | 04.28.20

On April 27, the U.S. Supreme Court issued a decision in Maine Cmty. Health Options et al v. United States, ruling in favor of Maine and companion insurers in the long running Affordable Care Act §1342 “risk corridors” litigation, and confirming the government’s obligation to pay insurers approximately $13 billion for their work related to the ACA. Under the risk corridors program, the government and the health plans shared risk during the first three years of the ACA exchanges, and had reciprocal statutory payment obligations; however, after the health plans performed, the government refused to make full payment, arguing that Congress’ refusal to appropriate funds vitiated the government’s payment obligation. Reversing the Federal Circuit, the Supreme Court held that the statute contained an unambiguous payment mandate, which was not repealed or otherwise suspended by Congress’ failure to make appropriations available. While a failure to appropriate funds prevents agencies from making the payment, the failure does not relieve the United States of its obligation to pay. Speaking for the majority, Justice Sonia Sotomayor wrote: “These holdings reflect a principle as old as the Nation itself: The Government should honor its obligations. Soon after ratification, Alexander Hamilton stressed this insight as a cornerstone of fiscal policy. ‘States,’ he wrote, ‘who observe their engagements . . . are respected and trusted: while the reverse is the fate of those . . . who pursue an opposite conduct.’” C&M partner Steve McBrady called the decision “important” noting that it “cements bedrock principles of fairness into money mandating statute jurisprudence.” Crowell & Moring represented Maine Community Health Options.

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Client Alert | 4 min read | 04.22.25

First Impressions Matter: Federal Circuit Holds That Patents Claiming Application of Generic Machine Learning to New Data Environments Are Not Patent Eligible

The Federal Circuit recently addressed a case of first impression involving AI patented technology under 35 U.S.C. § 101 to hold that “claims that do no more than apply established methods of machine learning to a new data environment” are not patent eligible. This case provides helpful guidance for patent prosecutors on how to draft claims directed to AI technology to be patent-eligible and for litigators on how to attack or defend AI patents....