Nayak paid doctors a kickback in order to get them to send their business to his surgery center. After learning of the kickback scheme, the government indicted Nayak. It later filed superseding information charging him with honest-services mail fraud. Although both the indictment and the superseding information alleged that Nayak intended "to defraud and to deprive patients of their right to honest services of their physicians" through his scheme, neither alleged that Nayak caused or intended to cause any sort of tangible harm to the patients in the form of higher costs or inferior care. In fact, the government later represented to the district court that the scheme did not cause patients any physical or monetary harm. Nayak filed a motion to dismiss the mail fraud count, contending that the government needed to allege some form of actual or intended physical harm to the referring physicians' patients as an element of the crime. Why do you think Nayak lost his appeal? Nayak v. United States, 769 F.3d 968 (2014).