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Value of Services Performed Must Be Considered in Fraud Case

Client Alert | less than 1 min read | 05.02.16

On April 28, the Fifth Circuit found in U.S. v. Harris that the government must take into account the value of the work performed in assessing damages in procurement fraud cases, even when sentencing individuals. In a perhaps unique fact pattern, the court upheld the conviction for 16 counts of wire fraud, but overturned the two-year prison sentence of an Army colonel because the government had calculated damages based on the full $1.3 million value of the contracts, rather than properly reducing that total for the value of the work performed.

Insights

Client Alert | 6 min read | 04.29.26

CMS Seeks to Expand Interoperability Requirements to Drug Pre-Authorization (FAQ)

On April 10, 2026, the Centers for Medicare and Medicaid Services (CMS) issued a proposed rule (2026 CMS Interoperability Standards and Prior Authorization for Drugs, or CMS-0062-P) outlining the agency’s plans to impose new interoperability requirements on payors participating in certain Medicare and Medicaid programs. As described by the agency in a recent press release, the proposed rule “builds on” prior rulemaking by clarifying and enhancing interoperability requirements for payors’ prior authorization processes, specifically those associated with coverage requests for pharmaceutical therapies....