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GAO Teaches Course in Cost Realism 101

Client Alert | 1 min read | 06.06.07

In Magellan Health Services (Jan. 5, 2007, http://www.gao.gov/decisions/bidpro/298912.pdf), GAO sustained a protest of HHS's award of a cost-plus-fixed-fee contract for employee assistance program services when the agency's cost realism evaluation was unreasonable for several reasons, including a failure to account for insufficient levels of effort and labor rates in the awardee's cost proposal. After chiding the agency for not adjusting the awardee's cost proposal in accordance with the recommendations of the agency's own cost analyst, GAO found the adjusted costs were still lower than the protestor's but the smaller delta required the agency to take another look at its unsupported conclusion that the offerors were "technically equal."

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Client Alert | 10 min read | 12.24.25

CMS Proposed Rules Prohibit Provision and Coverage of "Sex-Rejecting Procedures" for Minors Enrolled in Medicare and Medicaid

Since the signing of Executive Order 14187 (“Protecting Children from Chemical & Surgical Mutilation”) in late January 2025, the Trump Administration has made its skeptical stance on gender-affirming care—especially regarding services provided to minors—clear....