United States v. Christopher Perry , 757 F.3d 166 ( 2014 )


Menu:
  •                              PUBLISHED
    UNITED STATES COURT OF APPEALS
    FOR THE FOURTH CIRCUIT
    No. 13-4012
    UNITED STATES OF AMERICA,
    Plaintiff – Appellee,
    v.
    CHRISTOPHER GEORGE PERRY, f/k/a Christopher Parry,
    Defendant – Appellant.
    Appeal from the United States District Court for the District of
    Maryland, at Baltimore.    Richard D. Bennett, District Judge.
    (1:12-cr-00173-RDB-1)
    Argued:   March 20, 2014                  Decided:   July 1, 2014
    Before DUNCAN, AGEE, and WYNN, Circuit Judges.
    Affirmed by published opinion. Judge Wynn wrote the opinion, in
    which Judge Duncan and Judge Agee joined.
    ARGUED: Heather H. Martin, QUINN EMANUEL URQUHART & SULLIVAN,
    LLP, Washington, D.C., for Appellant.    Sandra Wilkinson, OFFICE
    OF THE UNITED STATES ATTORNEY, Baltimore, Maryland, for
    Appellee.   ON BRIEF: James D. Wyda, Federal Public Defender,
    OFFICE OF THE FEDERAL PUBLIC DEFENDER, Baltimore, Maryland, for
    Appellant. Rod J. Rosenstein, United States Attorney, OFFICE OF
    THE UNITED STATES ATTORNEY, Baltimore, Maryland, for Appellee.
    WYNN, Circuit Judge:
    A federal jury convicted Christopher Perry of three counts
    of     fraud     related    to    his    receipt       of    Social     Security           and
    healthcare       benefits.        On    appeal,       Defendant      argues     that       the
    district court should have dismissed the indictment because it
    did not include essential elements of the fraud charges and was
    barred by the statute of limitations.                       In addition, Defendant
    contends that the government failed to prove that he engaged in
    a scheme or artifice to defraud the government.                       For the reasons
    that    follow,      we    disagree     and     affirm      the      district        court’s
    judgment.
    I.
    In   December      1995,   Defendant       applied     for     Social     Security
    disability insurance benefits.                  In his application, Defendant
    agreed to report to the Social Security Administration (“SSA”)
    if his medical condition improved such that he could work or if
    he returned “to work whether as an employee or a self-employed
    person.”       J.A. 454.     SSA approved the application and found that
    Defendant      had   been    eligible      for     disability         benefits        as   of
    October     1,    1995.       Sometime        thereafter,       in    1996      or     1997,
    Defendant started receiving payments.
    Yet in 1996, Defendant began working at Macy’s.                         And, with
    the    exception     of    2001   to    2004,    he    worked     for   a     variety       of
    2
    employers      including        Hertz      Corporation,         L&J     Cleaning,        and
    Nordstrom      until    2007.        In   1999,     SSA   sent       Defendant    a    form
    requesting information about his employment, but there is no
    record of any response.              In 1999 and 2000, SSA employees added
    notations      to      Defendant’s        file     because       Defendant’s       posted
    earnings in 1997 and 1998 were above the allowable income for
    benefits recipients.
    In    January      2006,      Defendant         began     to     receive       fully
    subsidized prescription drug benefits under the Medicare Part D
    program.       His eligibility was based on the SSA’s understanding
    that    Defendant’s      only     income     was       from    his    Social     Security
    disability benefits.            Later, in August 2006, Defendant received
    a   letter     from    Medicare      seeking      to    verify       that   he   was   not
    receiving income from sources other than his Social Security
    disability      benefits       and    thus       continued      to    be    entitled      to
    benefits.      Defendant did not respond to this inquiry.
    In April 2007, Defendant applied for the Low Income Subsidy
    (“LIS”) program.         The LIS is an additional benefit for Medicare
    Part D beneficiaries that pays co-pays on expensive medicines
    for individuals with a “lack of income” and is based on an
    “official poverty determination.”                  J.A. 774.         In essence, it is
    “an    extra    layer     of    benefit”     complementing            Medicare    Part    D
    prescription drug benefits.               J.A. 773.           Despite being employed
    by Hertz at the time of his application, Defendant reported that
    3
    he “expect[ed] no earnings this year.”                      J.A. 779.        In addition,
    Defendant stated in his application that he was receiving no
    income other than Social Security disability.
    In   June     2007,    Defendant       was       accepted      into    the       Federal
    Career      Intern    Program,      a   two-year         paid    training       program     to
    become a Benefits Technical Examiner with the SSA.                                  This job
    involved      reviewing      applications          for    disability         benefits      and
    compiling information regarding the eligibility of individuals
    for    disability      benefits.         At       the    time,    Defendant      continued
    submitting claims for Medicare benefits during the period from
    June 2007 to 2009.
    In July 2007, SSA’s review of IRS records reflected that
    Defendant was receiving income.                   SSA thus sent Defendant a work
    activity report form asking about Defendant’s employment history
    in March 2008.         Defendant completed the form and returned it in
    July 2008, reporting some, but not all, of his employment from
    the previous years.
    In 2009, SSA twice sent employment inquiries to Defendant
    to determine whether he was receiving any work-related expenses
    or    subsidies      from    SSA.       Then,      SSA    sent     Defendant        a   letter
    advising him that his benefits would cease, but also that he
    could    submit      additional     evidence        about       his   employment         status
    within      ten    days.       Defendant          failed     to       respond    to       these
    inquiries, and SSA then terminated his benefits.
    4
    In March 2012, the government charged Defendant in a three-
    count    indictment   with   Social    Security   fraud,   federal   health
    benefit program fraud, and health care fraud.              Defendant moved
    to dismiss the indictment, and the district court denied the
    motion but directed the government to file a bill of particulars
    “to delineate specifically the employment Defendant ha[d] failed
    to report.”      J.A. 132.   The government responded by identifying
    Defendant’s specific employers during the period that he was
    receiving benefits.
    Defendant went to trial in September 2013.         At the close of
    evidence, he moved for judgment of acquittal on the basis of the
    statute of limitations, but his motion was denied.                The jury
    found Defendant guilty on all three counts.           After the district
    court sentenced Defendant to concurrent terms of 24 months on
    Count One, 12 months on Count Two, and 24 months on Count Three,
    he appealed.
    On appeal, Defendant argues that Counts One and Two of the
    indictment were unconstitutionally defective because they failed
    to specify the “event” that triggered his obligation to disclose
    his employment to the government; that the indictment failed to
    allege specific intent for all three counts; that the indictment
    failed to allege a scheme or artifice to defraud the government
    on Count Three; and that the indictment is time-barred by the
    statute     of   limitations.         Defendant   also     challenges   the
    5
    sufficiency of the evidence on Count Three.                         We address each
    argument in turn.
    II.
    Defendant first contends that the district court erred in
    denying his motion to dismiss the indictment because Counts One
    and   Two   were      unconstitutionally         defective.         “We    review     the
    district    court’s       factual     findings    on   a   motion    to     dismiss   an
    indictment for clear error, but we review its legal conclusions
    de novo.”        United States v. Woolfolk, 
    399 F.3d 590
    , 594 (4th
    Cir. 2005).
    “When a criminal defendant challenges the sufficiency of an
    indictment       prior    to    the   verdict,”—as      Defendant     did     here—“we
    apply   a   heightened         scrutiny”    to   ensure    that     every    essential
    element     of   an   offense     has    been    charged.      United       States    v.
    Kingrea, 
    573 F.3d 186
    , 191 (4th Cir. 2009).                 Specifically,
    [a]n indictment must contain the elements                           of the
    offense charged, fairly inform a defendant                          of the
    charge, and enable the defendant to plead                            double
    jeopardy as a defense in a future prosecution                       for the
    same offense. . . . [T]he indictment must                           include
    every essential element of an offense, . . . .
    
    Id. (citations and
      quotation    marks      omitted);     accord     United
    States v. Resendiz-Ponce, 
    549 U.S. 102
    , 108 (2007).
    “It is generally sufficient that an indictment set forth
    the offense in the words of the statute itself, as long as
    6
    ‘those     words    of     themselves    fully,         directly,      and     expressly,
    without any uncertainty or ambiguity, set forth all the elements
    necessary to constitute the [offense] intended to be punished.’”
    Hamling    v.    United     States,     
    418 U.S. 87
    ,   117    (1974)     (quoting
    United States v. Carll, 
    105 U.S. 611
    , 612 (1882)); accord United
    States v. Lockhart, 
    382 F.3d 447
    , 449 (4th Cir. 2004).                          However,
    any general description based on the statutory language “must be
    accompanied with such a statement of the facts and circumstances
    as will inform the accused of the specific [offense], coming
    under     the    general     description,         with     which     he   is   charged.”
    
    Hamling, 418 U.S. at 117-18
    (quotation mark omitted); see also
    Russell v. United States, 
    369 U.S. 749
    , 765 (1962) (noting that
    an indictment must “descend to particulars” where the definition
    of an offense includes generic terms (quotation marks omitted)).
    “Thus,    the    indictment     must     also      contain     a    statement       of   the
    essential       facts    constituting        the    offense        charged.”        United
    States v. Quinn, 
    359 F.3d 666
    , 673 (4th Cir. 2004) (quotation
    marks omitted).
    In    this    case,     Count     One       charges    Defendant        with   Social
    Security fraud, in violation of 42 U.S.C. § 408(a)(4), and Count
    Two charges Defendant with federal health benefit program fraud,
    in violation of 42 U.S.C. § 1320a-7b.                       Both statutes penalize
    anyone who “conceals or fails to disclose” any event affecting
    his right to disability or health benefits and payments “with an
    7
    intent fraudulently to secure” greater benefits or payments than
    are due or when no benefit or payment is authorized.               42 U.S.C.
    § 408(a)(4); 42 U.S.C. § 1320a-7b(a)(3).
    Count One of the indictment charged that Defendant, from
    about 1996 through about September 2009,
    having knowledge of the occurrence of any event
    affecting his initial or continued right to any
    payment under Subchapter II of Title 42 (Disability
    Insurance Benefits), did conceal and fail to disclose
    said events with intent to fraudulently secure payment
    in a greater amount than is due and when no payment is
    authorized; to wit, the defendant concealed and failed
    to disclose his employment and earnings to the Social
    Security Administration.
    J.A.   14.   Similarly,      Count   Two    charged   that   Defendant,   from
    about April 1998 through about September 2009,
    having knowledge of the occurrence of any event
    affecting his initial and continued right to any
    benefit and payment under a federal health care
    program, did conceal and fail to disclose said event
    with intent to fraudulently secure such payment and
    benefit in a greater amount and quantity than is due
    and when no such benefit and payment is authorized; to
    wit, the defendant concealed and failed to disclose
    his employment and earnings to Medicare.
    J.A. 15.
    Further, the indictment identified Defendant’s employment
    history, starting in 1996 and continuing through the charged
    time   period,   as    the   “event”    that    triggered    his   disclosure
    obligations and alleged that Defendant’s concealment and failure
    to disclose this employment constituted the criminal conduct.
    Specifically,    the    indictment         alleged    that   Defendant    “was
    8
    employed but did not report his employment to the SSA or to
    Medicare despite the fact that his employment would affect his
    eligibility       for,    and   the   amounts     he   was   eligible    to    receive
    from, these federal benefit programs.”                  J.A. 12.     The indictment
    also stated that Defendant “knew that employment is an event
    affecting his continued right to [Social Security Disability]
    and Medicare benefits and he concealed and failed to disclose
    such events with a fraudulent intent . . . .”                  J.A. 13.
    We agree with the district court that this indictment was
    sufficient to apprise Defendant of the charges against him and
    identify    the    essential      elements       of   the   crimes   charged.     The
    indictment    tracked       the    statutory      language,     provided      specific
    details    about    the    nature     of   the    charges,    and    identified   the
    “event”      triggering           Defendant’s          disclosure       obligations.
    Defendant has shown, and we have found, nothing requiring the
    government to list each specific job Defendant held during this
    period as a basis for charging him with these fraud crimes.
    Further, the government clarified any confusion by filing a bill
    of particulars providing Defendant with specific notice of each
    job within his employment history that served as the “event” in
    the indictment.          We therefore conclude that the indictment here
    was sufficiently specific to pass constitutional muster.
    9
    III.
    Defendant also argues that the government failed to allege
    specific intent to defraud, an essential element of each crime,
    for all the counts in the indictment.                 We review this issue de
    novo.    
    Woolfolk, 399 F.3d at 594
    .
    Defendant rightly notes that every essential element of an
    offense must be charged.             See 
    Kingrea, 573 F.3d at 191
    .              And
    intent to defraud is an element here.                 Fatally for Defendant’s
    argument, however, his indictment charges it.
    Specifically,     in    Count   One,    the    government      alleged    that
    Defendant “did conceal and fail to disclose said events with
    intent to fraudulently secure payment in a greater amount than
    is due and when no payment is authorized; to wit, the defendant
    concealed and failed to disclose his employment and earnings to
    the Social Security Administration.”                 J.A. 14.        Similarly, in
    Count Two, the government alleged that Defendant “did conceal
    and   fail   to   disclose    said    event   with    intent    to    fraudulently
    secure such payment and benefit . . . to wit, the defendant
    concealed and failed to disclose his employment and earnings to
    Medicare.”     J.A. 15.
    The other portions of the indictment provide details and
    allege    that    Defendant    knew    he     was    required   to     report   his
    employment, failed to do so, and received benefit payments and
    benefits     during   that    time.     In    Count    Three,   the     government
    10
    directly       charges     that       Defendant        “did     willfully        execute    and
    attempt to execute a scheme and artifice to defraud a federal
    health     care       benefit    programs        [sic],        that    is,      Medicare,    to
    obtain,        by      means      of     false         and      fraudulent         pretenses,
    representations and promises, money and property owned by and
    under the custody and control of Medicare, . . . .”                                   J.A. 16.
    These    allegations       plainly       charge        Defendant       with     the   specific
    intent to defraud that is required for the pertinent crimes.
    Defendant nevertheless presses that the indictment alleges
    only “passive non-disclosure of employment by a recipient of
    Social Security benefits” rather than affirmative concealment of
    material facts and that these allegations are insufficient to
    sustain the fraud charges.                   Appellant’s Br. at 32.               In support
    of     this    argument,        he     relies        heavily     on    United     States     v.
    Phillips,       
    600 F.2d 535
        (5th     Cir.       1979).       But      Defendant’s
    reliance on that case is misplaced—not least because Phillips is
    not about the sufficiency of an indictment, but is instead a
    challenge to the sufficiency of the evidence.                            There, the Fifth
    Circuit decided that the government had provided insufficient
    evidence of the defendant’s fraudulent intent by failing to show
    that    the    defendant        knew    he    was     not    entitled      to    benefits    or
    adducing       evidence    of     the    defendant’s           “devious”      behavior      such
    that     the     jury     could        infer     Phillips’s           fraudulent       intent.
    
    Phillips, 600 F.2d at 538-40
    .                    Here, the relevant question is
    11
    whether the government charged that Defendant committed fraud by
    intentionally concealing his employment.                           Phillips has minimal
    application      in    the     context      of     Defendant’s         challenge       to   his
    indictment.
    In sum, the indictment charged the requisite intent.                                   We,
    therefore,       reject      Defendant’s          argument        that    the     government
    failed to allege specific intent to defraud.
    IV.
    Defendant        also     argues      that    the       district     court    erred      in
    denying    his    motion      to    dismiss       the    indictment       as    time    barred
    under the statute of limitations.                      We review this issue de novo
    because    the     district        court’s      decision         depended      solely    on   a
    question of law.            United States v. United Med. & Surgical Supply
    Corp., 
    989 F.2d 1390
    , 1398 (4th Cir. 1993).
    It    is    undisputed        that    there        is   a    five-year      statute      of
    limitations for the fraud offenses at issue here.                              See 18 U.S.C.
    §   3282(a)       (setting         forth      general         five-year         statute       of
    limitations      for    non-capital         crimes).             The   Supreme    Court     has
    recognized that “‘[s]tatutes of limitations normally begin to
    run when the crime is complete.’”                      Toussie v. United States, 
    397 U.S. 112
    , 115 (1970) (quoting Pendergast v. United States, 
    317 U.S. 412
    , 418 (1943)).              “Criminal acts over an extended period,
    however,     may       be     treated      as      a     ‘continuing        offense’        for
    12
    limitations purposes when a criminal statute explicitly compels
    that result, or if ‘the nature of the crime involved is such
    that Congress must assuredly have intended that it be treated as
    a continuing one.’”             United States v. Smith, 
    373 F.3d 561
    , 563-
    64 (4th Cir. 2004) (per curiam) (quoting 
    Toussie, 397 U.S. at 115
    ).
    In this case, Defendant moved to dismiss the indictment,
    which was filed in March 2012, as time-barred because some of
    the charged conduct occurred before March 2007.                             The district
    court       denied     the   motion     and   ruled      that     “here     there    is   no
    limitations in this case . . . as to Counts 1 and 2, much of
    which charged is clearly within the five-year period, anyway,
    and    as    to     those    matters    before,     the     doctrine      of   continuing
    offenses       would    apply    with    respect      to    any   limitation        issue.”
    J.A.     85.         The     district     court      then    issued       a    memorandum
    reiterating that the charged offenses were continuing offenses
    and that “the defendant’s continued concealment constitutes a
    ‘course      of     conduct’    that    affects     his     remaining       rights   going
    forward, and the course of conduct—failing to report—is that act
    which constitutes the violation.”                  J.A. 131-33.
    Defendant does not challenge the determination that these
    crimes       are     continuing    offenses        for     statute     of      limitations
    purposes.          See Appellant’s Br. at 35 n.3 (“Perry accepts for the
    purposes of this discussion the district court’s determination
    13
    that the charged offenses are continuing offenses.”).                       Instead,
    Defendant contends, as he did in his post-trial Rule 29 motion,
    that the limitations period began to run not when the continuing
    offenses were complete, but instead in 1999 when the government
    knew of, or could have discovered, Defendant’s non-disclosure.
    Defendant has pointed to no binding precedent applying such
    a discovery rule in a case like this, nor have we found any.
    Instead, Defendant attempts to rely on a Fourth Circuit civil
    forfeiture case and some easily distinguishable out-of-circuit
    immigration offense cases.                  United States v. Kivanc, 
    714 F.3d 782
    , 789 (4th Cir. 2013) (involving civil forfeiture statute
    that states         that    the   action     must    be   commenced   within   “‘five
    years     after       the      time     when        the    alleged    offense       was
    discovered[.]’” (emphasis added) (quoting 19 U.S.C. § 1621));
    United States v. DiSantillo, 
    615 F.2d 128
    , 134-36 (3d Cir. 1980)
    (differentiating           between    the    crime   of   entry   through   “regular
    immigration service procedures” and the crime of “being found in
    the United States when the alien did not enter . . . through an
    INS     port   of     entry”      and   deeming      “illegal     entry   through     a
    recognized INS port” crime not a continuing offense); United
    States v. Gomez, 
    38 F.3d 1031
    , 1037-38 (8th Cir. 1994) (deeming
    crime of being “found in” the United States under 8 U.S.C. §
    1326 a continuing offense).                 Aside from the fact that this case
    involves a clearly different statute of limitations from the one
    14
    analyzed in Kivanc, both DiSantillo and Gomez focused on the
    government’s      ability       to    discover     a    defendant’s    entry    to    the
    United   States     as     the       basis   to    distinguish      illegal     reentry
    violations under 8 U.S.C. § 1326 and determine whether those
    violations are continuing offenses.                    We refuse to shoehorn these
    round    pegs     into    the    square      hole       that   is   this     case    and,
    accordingly, reject Defendant’s argument.
    V.
    Defendant challenges the sufficiency of the indictment on
    Count    Three.          The    parties      disagree      about    the    appropriate
    standard of review, with Defendant arguing for de novo and the
    government arguing for plain error.                     We need not resolve this
    dispute because Defendant cannot prevail, even under the de novo
    standard.
    Count Three charged Defendant with violating 18 U.S.C. §
    1347.     That     statute       penalizes        health   care     fraud,    which   is
    committed by anyone who
    knowingly and willfully executes, or attempts to
    execute, a scheme or artifice-- (1) to defraud any
    health care benefit program; or (2) to obtain, by
    means    of    false     or    fraudulent   pretenses,
    representations, or promises, any of the money or
    property owned by, or under the custody or control of,
    any health care benefit program, . . . .
    18 U.S.C. § 1347(a).            As with Counts One and Two, the indictment
    tracked the language of the statute and directly alleged that
    15
    Defendant “execute[d] a scheme and artifice to defraud . . .
    Medicare[.]”        J.A. 16.
    The   government      premised         its   theory     regarding         Defendant’s
    “scheme       and    artifice      to        defraud”        on     three        particular
    allegations: 1) Defendant was employed at “the Social Security
    Administration, Hertz Corporation, L&J Cleaning, Macy’s . . .
    and other businesses while he was receiving [Social Security
    Disability] and Medicare benefits[;]” 2) Defendant “personally
    profited      from    the   scheme      to    defraud       Medicare       by    obtaining
    prescription drugs and not having to pay for the drugs and/or
    make a co-payment[;]” and 3) Defendant “made false statements in
    documents regarding his employment.”                    J.A. 16.          Throughout the
    indictment, the government alleged that Defendant “concealed and
    failed to disclose” his employment while continuing to accept
    benefits and payment.           J.A. 12-17.         Also, the government alleged
    that Defendant applied for and received the Low Income Subsidy
    to assist him in paying for his prescription drugs, in addition
    to his Medicare Part D prescription drug benefits.                              It further
    alleged that in his LIS application, despite being employed at
    the   time,    Defendant       stated    that      “I   expect       no   earnings      this
    year.”      J.A. 12.        Defendant points to nothing requiring the
    government      to    provide     further          factual        allegations      in   the
    indictment to support the alleged scheme and artifice to defraud
    16
    in Count Three.             And we find nothing.                   Accordingly, we reject
    this argument.
    VI.
    Finally,        Defendant           challenges         the     sufficiency    of     the
    government’s evidence on his healthcare fraud conviction.                                  The
    standard for reversing a jury verdict of guilty is a high one:
    the   Court    does        so    only     “where       the   prosecution’s       failure    is
    clear.”    United States v. Foster, 
    507 F.3d 233
    , 244–45 (4th Cir.
    2007) (quotation marks omitted).                       That is because “the appellate
    function   is       not    to     determine       whether      the    reviewing    court    is
    convinced of guilt beyond reasonable doubt, but, viewing the
    evidence and the reasonable inferences to be drawn therefrom in
    the   light        most     favorable       to        the    Government,    ‘whether       the
    evidence      adduced            at      trial     could       support     any     rational
    determination of guilty beyond a reasonable doubt.’”                                 United
    States v. Burgos, 
    94 F.3d 849
    , 863 (4th Cir. 1996) (en banc)
    (quoting United States v. Powell, 
    469 U.S. 57
    , 67 (1984)).                                 The
    “jury’s verdict must be upheld on appeal if there is substantial
    evidence      in     the        record    to     support      it,”     where   substantial
    evidence is “evidence that a reasonable finder of fact could
    accept as adequate and sufficient to support a conclusion of a
    defendant’s guilt beyond a reasonable doubt.”                            United States v.
    17
    Young,    
    609 F.3d 348
    ,      355        (4th    Cir.    2010)      (quotation       marks
    omitted).
    To convict Defendant for healthcare fraud, the government
    must prove that he “knowingly and willfully execute[d] . . . a
    scheme    or    artifice--         (1)      to    defraud       any   health       care     benefit
    program;       or    (2)   to    obtain,          by    means    of   false     or      fraudulent
    pretenses, representations, or promises, any of the money or
    property owned by . . . any health care benefit program . . . .”
    18 U.S.C. § 1347(a).               See also 
    Kivanc, 714 F.3d at 795
    (same).
    “[T]he    specific         intent      to    defraud       may     be      inferred      from    the
    totality of the circumstances and need not be proven by direct
    evidence.”          United States v. McLean, 
    715 F.3d 129
    , 138 (4th Cir.
    2013) (quotation marks omitted).
    In considering whether there existed a scheme to defraud,
    we must look to the “common-law understanding of fraud[,]” which
    we have interpreted to include “acts taken to conceal, create a
    false    impression,         mislead,        or        otherwise      deceive      in    order   to
    ‘prevent[]          the      other          [party]        from         acquiring         material
    information.’”            United States v. Colton, 
    231 F.3d 890
    , 898 (4th
    Cir. 2000) (quoting Restatement (Second) of Torts § 550 (1977))
    (interpreting the scope of a scheme or artifice to defraud under
    18   U.S.C.     §    1344,      the    bank       fraud    statute);         see   also      United
    States     v.       Beverly,     284        F.     App’x    36,       39    (4th     Cir.    2008)
    (unpublished but orally argued) (per curiam) (interpreting the
    18
    scope of a scheme or artifice to defraud under 18 U.S.C. § 1347,
    the health care fraud statute).
    “Although silence as to a material fact (nondisclosure),
    without an independent disclosure duty, usually does not give
    rise to an action for fraud, suppression of the truth with the
    intent to deceive (concealment) does.”                  
    Colton, 231 F.3d at 899
    .
    Almost    surely    for    this    reason,      the    Eighth    Circuit    upheld    a
    health care fraud guilty verdict in United States v. Phythian,
    
    529 F.3d 807
    (8th Cir. 2008).                   In that case, which we find
    illuminating,       the        government’s      evidence       showed      that   the
    defendant had worked, that SSA had advised the defendant of her
    duty to report any work, and that the defendant nevertheless
    failed to report her work while continuing to receive benefits.
    Based on these facts, the Eighth Circuit held that “[r]eviewing
    the   evidence     in    the    light    most   favorable       to   the   verdict,   a
    reasonable   jury       could    readily      find    [that   Defendant]     Phythian
    violated § 408a(4).”           
    Id. at 812.
    Here, the jury had notably more evidence to support its
    verdict    than    did    the     jury   in     Phythian.        Specifically,     the
    government’s evidence showed that Defendant knew he had a duty
    to report any employment to SSA.                Indeed, in his application for
    benefits that reflected, Defendant agreed to “promptly notify
    Social Security if my medical condition improves so that I would
    be able to work . . . [or] I go to work whether as an employee
    19
    or a self-employed person.”              J.A. 453-54.        See also, e.g., J.A.
    630 (reflecting that SSA’s letter to Defendant explicitly stated
    that “if you have applied for or are receiving Social Security
    benefits,    you    are   responsible        for    immediately     notifying     your
    local Social Security Office of your employment because your
    income may affect your benefits”).
    The   government         showed      the    materiality     of     Defendant’s
    employment status as it related to his Social Security benefits—
    i.e., that Defendant’s benefits would have been affected and
    likely   terminated       had    he   informed      SSA    about   his    employment.
    Further, the government presented evidence that Defendant’s job
    with the SSA as benefits technical examiner included training on
    the receipt and termination of benefits, including that benefits
    may be reduced, suspended, or terminated upon employment and
    receipt of income.
    At trial, Defendant’s SSA supervisor agreed that Defendant
    worked on cases involving people who were working and receiving
    disability      payments.         J.A.      738.     And     the   government    sent
    Defendant    several      documents      requesting        employment     information
    and    reiterating     Defendant’s          disclosure      obligations     in   1999,
    2006, and 2008, but Defendant failed to disclose any of his
    employment until returning a work activity report in July 2008.
    This   report      corroborated       the    fact    that    Defendant     had   been
    employed while receiving benefits and supported SSA’s decision
    20
    to terminate his benefits.       Further, the response was incomplete
    because Defendant omitted from his work history employment for
    which there were no tax records.            Compare S.J.A. 1-14 (work
    activity report) with J.A. 801 (Defendant’s reference to Carla
    and Company position in 2002 credit application), S.J.A. 16, 18
    (Defendant’s reference to L&J Services position in 2005 Hertz
    application and resume).
    In addition, the evidence showed that Defendant continued
    receiving the LIS to supplement his Medicare prescription drug
    benefits in 2007 and 2008 while he was employed with SSA.             He
    received over four thousand dollars worth of LIS benefits during
    that time.      And, while working at SSA, Defendant continued to
    cash government disability checks totaling “a little bit less
    than $15,000.”    J.A. 795-97.
    In sum, the government presented sufficient evidence for a
    rational jury to find that Defendant engaged in a health care
    fraud scheme.    Accordingly, his conviction must be affirmed.
    VII.
    For the foregoing reasons, we hold that the district court
    properly denied Defendant’s motion to dismiss the indictment and
    motion   for   judgment   of   acquittal.    Therefore,   the   district
    court’s judgment is
    AFFIRMED.
    21
    

Document Info

Docket Number: 13-4012

Citation Numbers: 757 F.3d 166, 2014 U.S. App. LEXIS 12405, 2014 WL 2937086

Judges: Duncan, Agee, Wynn

Filed Date: 7/1/2014

Precedential Status: Precedential

Modified Date: 11/5/2024

Authorities (20)

United States v. Resendiz-Ponce , 127 S. Ct. 782 ( 2007 )

United States v. Javier Dario Gomez , 38 F.3d 1031 ( 1994 )

United States v. Alfred Smith , 373 F.3d 561 ( 2004 )

Pendergast v. United States , 63 S. Ct. 268 ( 1943 )

United States v. Frank Kahled Burgos, United States of ... , 94 F.3d 849 ( 1996 )

United States v. Kingrea , 573 F.3d 186 ( 2009 )

fed-sec-l-rep-p-97402-38-fed-r-evid-serv-462-united-states-of , 989 F.2d 1390 ( 1993 )

United States v. Disantillo, Michele Romeo , 59 A.L.R. Fed. 176 ( 1980 )

United States v. George Phillips , 600 F.2d 535 ( 1979 )

United States v. Phythian , 529 F.3d 807 ( 2008 )

United States v. Clifford J. Quinn, United States of ... , 359 F.3d 666 ( 2004 )

United States v. Foster , 507 F.3d 233 ( 2007 )

United States v. Carll , 26 L. Ed. 1135 ( 1882 )

United States v. Powell , 105 S. Ct. 471 ( 1984 )

United States v. Young , 609 F.3d 348 ( 2010 )

United States v. Curtis Delmont Woolfolk , 399 F.3d 590 ( 2005 )

United States v. Florence Lockhart, A/K/A Florence Rebecca ... , 382 F.3d 447 ( 2004 )

United States v. Daniel I. Colton, United States of America ... , 231 F.3d 890 ( 2000 )

Russell v. United States , 82 S. Ct. 1038 ( 1962 )

Toussie v. United States , 90 S. Ct. 858 ( 1970 )

View All Authorities »