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4 

XIULU RUAN v. UNITED STATES 

Syllabus 

Court effectively endorsed its honest-effort standard in United States 
v. Moore, 423 U. S. 122, as that case did not address mens rea at all. 
Nor does United States v. Yermian, 468 U. S. 63, support the Govern-
ment here, as that case dealt with a jurisdictional clause, to which the 
presumption of scienter does not apply. 

Finally, the Government argues that requiring it to prove that a doc-
tor knowingly or intentionally acted not “as authorized” will allow bad-
apple doctors to escape liability by claiming idiosyncratic views about 
their prescribing authority.  But the Court has often rejected this kind 
of argument, see, e.g., Rehaif, 588 U. S., at ___, and does so again here. 
Pp. 9–15.

(d) The  Court of  Appeals  in  both  cases  evaluated  the  jury  instruc-
tions relating to mens rea under an incorrect understanding of §841’s 
scienter requirements.  On remand, those courts may address whether 
the instructions complied with the mens rea standard set forth here, 
as well as whether any instructional error was harmless.  P. 15. 

966 F. 3d 1101 and 989 F. 3d 806, vacated and remanded. 

BREYER, J. delivered the opinion of the Court, in which ROBERTS, C. J., 
and SOTOMAYOR, KAGAN, GORSUCH, and KAVANAUGH, JJ., joined.  ALITO, 
J.,  filed  an  opinion  concurring  in  the  judgment,  in  which  THOMAS,  J., 
joined, and in which BARRETT, J., joined as to Parts I–A, I–B, and II.