United States v. Burgos ( 1998 )


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  •                     UNITED STATES COURT OF APPEALS
    FOR THE FIFTH CIRCUIT
    No. 97-10163
    UNITED STATES OF AMERICA,
    Plaintiff-Appellee,
    VERSUS
    HERNAN ENRIQUE BURGOS,
    Defendant-Appellant.
    Appeal from the United States District Court
    For the Northern District of Texas
    March 19, 1998
    Before DAVIS, WIENER and PARKER, Circuit Judges.
    PER CURIAM:
    Defendant-Appellant Hernan Enrique Burgos (“Burgos”) appeals
    his conviction and sentence for mail fraud.        We affirm.
    I. FACTS AND PROCEEDINGS
    A   fourteen    count   indictment      alleged     that   Burgos,   a
    psychiatrist, knowingly billed certain insurance companies for
    services that he did not provide to his patients who were insured
    by the companies.    The insurance industry standardizes its billing
    procedures through the use of five-digit codes.           The codes are a
    shorthand language used by the insurance industry and the medical
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    profession to describe a condition, treatment or procedure.               By
    placing a code on a claim form, a doctor tells the insurance
    company what type of service was rendered by the doctor.
    The indictment identified fourteen claims in which patients
    were hospitalized in the Psychiatric Institute of Fort Worth during
    1991 for periods ranging from ten days to six months.           The patients
    were billed daily, including weekends and vacations, by Burgos,
    using the code for individual psychotherapy, with the additional
    descriptive phrase “daily hospital care.”             However, the patients
    saw Burgos only a few times in the weeks or months during their
    hospitalization.
    The    jury   convicted    Burgos    on   all   fourteen   counts.   At
    sentencing, the district court determined that the amount of loss
    was more than $800,000 but not more than $1.5 million, which
    resulted in an eleven-level increase to his base offense level.
    The court found that Burgos abused a position of trust, resulting
    in a two level increase.       The court then found that, in addition to
    the insurance companies, Burgos’s patients were victims of his
    crime and that they were vulnerable victims, resulting in a two
    level increase.     Based on an offense level of 23 and a criminal
    history category of I, the district court sentenced Burgos at the
    bottom of the guideline range to 46 months imprisonment, three
    years supervised release and a $425,000 fine.
    II. VULNERABLE VICTIM UPWARD SENTENCE ADJUSTMENT
    Burgos challenges the upward adjustment to his total offense
    level because his victims were vulnerable.             Review of sentences
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    imposed under the guidelines is limited to a determination of
    whether the sentence was imposed in violation of law, as a result
    of an incorrect application of the guidelines, or was outside the
    applicable guideline range and was unreasonable.         United States v.
    Matovsky, 
    935 F.2d 719
    , 721 (5th Cir. 1991). Legal conclusions are
    reviewed de novo, and findings of fact are reviewed for clear
    error.   United States v. Fitzhugh, 
    984 F.2d 143
    , 146 (5th Cir.
    1993).
    The guidelines provide:
    If the defendant knew or should have known that a victim
    of the offense was unusually vulnerable due to age,
    physical or mental condition, or that a victim was
    otherwise particularly susceptible to the criminal
    conduct, increase by 2 levels.
    U.S.S.G. § 3A1.1(b). The determination that a victim is vulnerable
    is a factual finding which the district court is best suited to
    make.    United States v. Rocha, 
    916 F.2d 219
    , 244-45 (5th Cir.
    1990).
    a. Ex Post Facto
    Burgos first argues that the district court violated the Ex
    Post Facto Clause by applying the 1995 version of the Sentencing
    Guidelines rather than the 1991 version which was in effect when
    the last offense was completed.          He contends that the earlier
    version of the guidelines required the defendant to target his
    victim specifically based on the victim’s vulnerability.
    Pursuant to § 1B1.11(a) and 1B1.11(b)(1), p.s., and 
    18 U.S.C. § 3553
    (a)(4)(A), a district court should apply the Guidelines in
    effect   on   the   date   the   defendant   is   sentenced,   unless   the
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    application of such Guidelines would violate the Ex Post Facto
    Clause of the Constitution, in which event, the Guidelines in
    effect on the date of the offense should be used.
    Here, sentencing occurred after the effective date of the 1995
    Edition.    Amendment 521, effective November 1, 1995, redesignated
    the vulnerable victim provision of the Guidelines, but it did not
    change the text of the provision.        See U.S.S.G. App. C, amend. 521,
    at 428-30. The application notes to § 3A1.1, however, were amended
    to clarify the operation of § 3A1.1, specifically whether the
    victim must have been targeted by the defendant.          Id. at 429.
    The Comment in the 1991 edition provided, “This adjustment
    applies to offenses where an unusually vulnerable victim is made a
    target of criminal activity by the defendant.” § 3A1.1, comment.
    (n.1)(Nov. 1991). Amendment 521, inter alia, deleted that sentence
    and replaced it with “Subsection (b) applies to offenses involving
    an unusually vulnerable victim in which the defendant knows or
    should have known of the victim’s unusual vulnerability.” § 3A1.1,
    comment.   (n.2).    In   amending    the   commentary,   the    Sentencing
    Commission explained that there had been some inconsistency in the
    application of § 3A1.1 regarding whether the adjustment required
    proof that the defendant had targeted the victim on account of the
    victim’s vulnerability.    U.S.S.G. App. C, amend. 521, at 430.         The
    Commission stated that the amendment thus served to clarify the
    application of § 3A1.1 as to that issue.          Id.
    Relying on United States v. Stover, 
    93 F.3d 1379
    , 1386 (8th
    Cir.    1996),   Burgos   argues     that   the   amendment     effectuated
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    substantive changes which, if applied to Burgos, would violate the
    Ex Post Facto Clause.        Stover recognized that in the Eighth
    Circuit, prior to the amendment, the Government had to prove that
    the defendant had targeted an unusually vulnerable victim.            
    Id. at 1384
    .   Amendment 521 was a substantive change in that circuit
    because the Government no longer had to prove targeting.                 
    Id.
    Consequently, the amendment implicated the Ex Post Facto Clause.
    
    Id. at 1385-86
    .
    Although this circuit has used the “target” language in
    upholding the adjustment, see, e.g., United States v. Leonard, 
    61 F.3d 1181
    , 1188 (5th Cir. 1995); United States v. Scurlock, 
    52 F.3d 531
    , 541-42 (5th Cir. 1995), unlike the Eighth Circuit, we have not
    required a specific “targeting” of a vulnerable victim beyond the
    requirement that the defendant knew or should have known of the
    vulnerability.
    The Third Circuit, which had not addressed whether specific
    targeting was required, followed the First, Second, and Ninth
    Circuits   in    holding   that   §       3A1.1   contained   no   targeting
    requirement.     United States v. Cruz, 
    106 F.3d 1134
    , 1138-39 (3rd
    Cir. 1997); see also United States v. Hershkowitz, 
    968 F.2d 1503
    ,
    1506 (2d Cir. 1992)(declining to impose a specific targeting
    requirement); United States v. O’Brien, 
    50 F.3d 751
    , 755 (9th Cir.
    1995)(same); United States v. Gill, 
    99 F.3d 484
    , 488 (1st Cir.
    1996)(holding in a post-amendment case that the pre-amendment
    guideline did not contain a targeting requirement).
    We hold that the amendment does not implicate the Ex Post
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    Facto Clause because there is no authority requiring targeting in
    this circuit, see Cruz, 
    106 F.3d at 1139
    , and because Amendment 521
    clarified that the guideline language itself does not contain such
    a requirement.
    b. Who was Burgos’s vulnerable victim?
    Burgos argues that the district court clearly erred when it
    determined that the insurers were vulnerable victims.                     Burgos
    misconstrues the district court’s ruling.               The insurers are not,
    and could not have been found to be, vulnerable victims.             In making
    its findings, the district court stated, “I find that . . . the
    patients were victims along with the insurance companies and they
    were vulnerable victims.”      We understand the court to have found,
    first, that the victims of the offense included not only the
    insurers but also the patients, and second, that the patients were
    unusually vulnerable. The district court thus adopted the findings
    of the Presentence Report (“PSR”) that Burgos’s patients were
    unusually vulnerable because of their mental conditions.
    Burgos does not contest the finding that his patients were
    especially vulnerable or that he knew that they were vulnerable.
    Rather, his argument presumes that they were not the victims of his
    crimes.    However, a reasonable fact finder could conclude that the
    patients were the victims of Burgos’s fraudulent scheme. They were
    often admitted to the hospital needlessly or their stays in the
    hospital    were   extended   beyond       what   was   necessary   and   their
    insurance companies were billed for treatment not given.             Further,
    the patients’ treatment benefits were often exhausted by the time
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    of their discharge. In some cases, patient benefits were exhausted
    for a life-time; therefore, any future treatment needs would not be
    covered under their current policy. We therefore conclude that the
    district court did not clearly err in applying the vulnerable
    victim adjustment in calculating Burgos’s guideline range.
    CONCLUSION
    Having reviewed the record, relevant authority, the briefs and
    argument of counsel, we find no other error assigned by Burgos
    merits reversal.
    We therefore affirm Burgos’s conviction and sentence.
    AFFIRM.
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