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False Statement Liability Involving Federal Grantees Curtailed Again

Client Alert | 1 min read | 10.01.04

Musing that, if 18 U.S.C. 1001 were interpreted to prohibit any false statements to any private entity whose funds in part originated with the federal government, a person who lied about his address to get a local library card could be a federal felon, a divided 11th Circuit panel in U.S. v. Blankenship (Aug. 26, 2004) overturned the criminal convictions of the principal of a Disadvantaged Business Enterprise (DBE) under 18 U.S.C. 1001 because the sham contracts are false certified payroll records that were used to obtain payment under a federally-funded state highway project were not statements made to federal agencies. The Eleventh Circuit's analysis, together with the D.C. Circuit's civil False Claims Act decision in U.S. ex rel. Totten v. Bombardier Corp. (see C&M Bullet Point, Sept. 16) represents a significant cutback of federal authority to sanction contractors doing business with federal grantees.

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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....