On October 17, 2022, this Court vacated the opinion of the Sixth Circuit affirming Petitioner Cynthia Clemons' convictions and remanded for further proceedings in light of Ruan v. United States, 142 S. Ct. 2370, 213 L. Ed. 2d 706 (2022). On remand, the Sixth Circuit agreed with the parties that Ruan applies to 21 U.S.C. § 856(a)(1) prosecutions and also agreed that the jury instructions on the mens rea element required for a conviction under § 856 of a nurse practitioner authorized to prescribed controlled substances were error in light of Ruan. However, in conflict with other circuits' handling of this issue, the Sixth Circuit determined that Mrs. Clemons could not meet the plain error standard. Is the Sixth Circuit's ruling on the plain error standard contrary to this Court's precedents, including Ruan and Henderson v. United States, 568 U.S. 266, 133 S. Ct. 1121, 185 L. Ed. 2d 85 (2013)?

After determining that the District Court did not "spell out the 'knowingly' standard required under Ruan, 142 S. Ct. at 2375, for the second element" of § 856, the Sixth Circuit reasoned that by the district court's insertion of the generic term "illegally" in the instruction, the jury instruction "made clear that the jury had to find that Defendants knowingly opened the clinics for the purpose of illegally distributing Schedule II controlled substances." Did the Sixth Circuit commit error by substituting the generic term "illegally" for the language mandated in Ruan?

Whether the Sixth Circuit's ruling on the plain error standard is contrary to Supreme Court precedents, including Ruan and Henderson