Bad Alchemy: Turning Estimates Into Fraud
Client Alert | less than 1 min read | 02.08.06
Building on comments at the Nash & Cibinic Roundtable, David Bodenheimer challenges the oxymoronic trend of government agencies and qui tam whistleblowers to assert defective pricing or false claims based upon second-guessing poor estimates. In his article "'False' or 'Inaccurate' Estimates" published in the December 2005 Briefing Paper (http://www.crowell.com/pdf/Expertise/GovtContracts/BriefingPapers_Bodenheimer.pdf), he explains that estimating -- due to its inherently risky and predictive nature -- requires judgmental forecasts long recognized as appropriate by government pricing guidelines and not suitable for defective pricing and fraud suits complaining about bad estimates of future events.
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.
Client Alert | 8 min read | 04.27.26
Client Alert | 5 min read | 04.27.26
Drift Protocol Exploit: Why “Social Trust” Is the Newest Cybersecurity Gap
Client Alert | 4 min read | 04.27.26
Gaming Addiction Litigation: Turner v. Epic Games & Roblox and What It Means for the Industry
