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GAO Sustains TRICARE Protest On Multiple Grounds

Client Alert | 1 min read | 11.18.09

In Health Net Fed Servs., Inc. (Nov. 4, 2009), GAO sustained the protest of Health Net (represented by C&M) against a $16 billion TRICARE award because (1) the agency's past performance evaluation unreasonably gave the awardee significant credit for contracts much smaller than the contract to be awarded and improperly attributed to the awardee the past performance of the awardee's parent and its affiliates; (2) the agency's price realism evaluation failed to consider whether the awardee's staffing reflected a lack of understanding of the technical requirements; (3) the agency overlooked the risk associated with the awardee's proposed plan to hire large percentages of the incumbent workforce; and (4) the agency did not consider, as part of the technical evaluation, the cost savings associated with the protester's proposed approach. In addition to the fatal evaluation errors, GAO also determined that the awardee's use of a former high-level government employee in preparing its proposal created an appearance of impropriety based on the unfair competitive advantage stemming from the individual's earlier access to non-public, proprietary, and source-selection-sensitive information.

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Client Alert | 4 min read | 09.26.25

Court Vacates CMS’s 2023 Final Rule on RADV Audits

On September 25, 2025, the Northern District of Texas granted plaintiffs’ motion for summary judgment in Humana v. Becerra, vacating CMS’s 2023 Final Rule regarding risk adjustment data validation (RADV) audits. In the litigation, Humana challenged CMS’s decision in the Final Rule to not continue applying a Fee-for-Service (FFS) adjuster to its RADV audit methodology....