Fraud Cases

The Eleventh Circuit affirmed a nurse practitioner’s convictions for drug conspiracy and healthcare fraud in a “pill mill” case. The Court held there was sufficient evidence to convict her of the drug offenses despite the government’s failure to provide any patient testimony that the prescription medications they received were unnecessary, and it affirmed her conviction for healthcare fraud based on her knowledge and participation in filing claims to government programs for office visits where patients received illegal prescriptions. The Court held that the trial court erred in instructing the jury that the parties had stipulated to disputed fact, but held this did not amount to an improper directed verdict or deprive the defendant of her defense because the instruction did not relate to an element of the charged offense or any of the facts necessary to establish one of those elements, and the defendant was still able to present her theory of defense. The Court also rejected the defendant’s evidentiary claims.

The US Attorney’s Office for the Northern District of Georgia has issued a press release regarding the latest developments in some of its fraud cases involving COVID-19 relief funds. Our firm has also compiled a list of COVID-19 relief fraud cases from across the country with the kinds of charges and sentences in each case (link in the post).

The Eleventh Circuit affirmed a doctor-defendant’s conviction for healthcare fraud and dispensing controlled substances unlawfully. The Court held that there was sufficient evidence tying him to the conspiracy based in part on his allowing a medically non-trained co-conspirator to mandate testing requirements, and the Court also found sufficient evidence of unlawful dispensation based on the government expert’s testimony. The Court also held that the district court did not err in using the intended loss amount at sentencing, despite using the lower actual loss amount for the defendant’s co-conspirators, since there was no “unwarranted” disparity given that the co-conspirators had been sentenced according to a plea agreement, and the defendant had not.

The Eleventh Circuit affirmed a defendant’s conviction under 18 USC 1546(a) for using a fraudulent order of supervision from ICE to get a Florida driver’s license. The Court held that the order of supervision was an “other document” under 1546(a) and that the government’s arguments during closing, while misleading, did not constitute plain error.

Ruling on a matter of first impression, the Eleventh Circuit held that an order of supervision from ICE can constitute a document “prescribed by statute or regulation for entry into or as evidence of authorized stay or employment in the United States” under 18 USC 1546(a). The defendant had attempted to use a fraudulent order of supervision to get a driver’s license from Florida.

The Department of Justice recently announced that it has charged 474 defendants with fraud related to COVID-19 relief programs, such as the Paycheck Protection Program (PPP), the Economic Injury Disaster Loan (EIDL) program, and the Unemployment Insurance (UI) program. The DOJ reports that the cases combined involve over $569 million in potential loss amounts, and that they have been brought in 56 federal districts.

In a recent op-ed, former Deputy AG Rod Rosenstein describes emerging trends suggesting that the federal government will soon take a more aggressive approach in investigating and prosecuting federal fraud cases. The article discusses the multi-decade decline in federal prosecutions, statements made by Biden’s DOJ appointees, and the recent COVID-19 relief legislation that could be the focus of several fraud prosecutions in the coming years.

In a fraud case involving wiretap evidence, the Eleventh Circuit affirmed the defendants’ convictions. The Court rejected the defendant’s arguments and held that 1) the evidence supporting probable cause in the wiretap affidavit was not stale because there was evidence the phone in question was still in use and the conspiracy was ongoing, and 2) the wiretap affidavit established necessity because, even though the Government already had enough evidence to convict the defendants, the stated goal of the wiretap was to discover the full scope of the conspiracy and identity of all co-conspirators.

The Sixth Circuit reversed a defendant’s sentence for possession of unauthorized access devices because the loss amount had been based on Guidelines commentary mandating that a minimum loss amount of $500 had to be added for every unauthorized access device. The Court held that the commentary improperly expanded the text of 2B1.1, not merely interpreting it.

The DOJ has announced a state-federal “Cyber Fraud Task Force” targeting suspected “BEC” fraud (Business Email Compromise) in metro Atlanta. Statistics reflect a significant increase in BEC fraud over the years, and the DOJ reports that the metro Atlanta area is one of the top 5 clusters for BEC fraud cases in the country, suggesting there will be a significant increase in BEC fraud prosecutions there.