United States v. Matthew Kolodesh ( 2015 )


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  •                                     PRECEDENTIAL
    UNITED STATES COURT OF APPEALS
    FOR THE THIRD CIRCUIT
    _____________
    No. 14-2904
    _____________
    UNITED STATES OF AMERICA
    v.
    MATTHEW KOLODESH,
    a/k/a Matvei Kolodech,
    a/k/a Michael Kolodech,
    Appellant
    _______________
    On Appeal from the United States District Court
    for the Eastern District of Pennsylvania
    (D.C. No. 2-11-cr-00464-001)
    District Judge: Hon. Eduardo C. Robreno
    _______________
    Submitted Under Third Circuit L.A.R. 34.1(a)
    April 24, 2015
    Before: CHAGARES, JORDAN, and BARRY,
    Circuit Judges
    (Filed: May 28, 2015)
    Gary Green, Esq.
    Sidkoff, Pincus & Green
    1101 Market Street
    Suite 2700
    Philadelphia, PA 19107
    Jack J. McMahon, Jr., Esq.
    1500 Walnut Street
    Suite 1100
    Philadelphia, PA 19102
    Counsel for Appellant
    Zane David Memeger, Esq.
    Robert A. Zauzmer, Esq.
    Emily McKillip, Esq.
    Office of the United States Attorney
    615 Chestnut Street
    Suite 1250
    Philadelphia, PA 19106
    Counsel for Appellee
    _______________
    OPINION OF THE COURT
    _______________
    2
    JORDAN, Circuit Judge
    Matthew Kolodesh appeals from his conviction and
    sentence following a trial in the United States District Court
    for the Eastern District of Pennsylvania based on his
    involvement in a Medicare fraud scheme. We will affirm.
    I.     Background1
    Kolodesh owned a home-health services company
    called Community Home Health, Inc. Around 1999, he
    approached one of his employees, Alex Pugman, with the
    idea of starting a company to provide home-based hospice
    care. Pugman, who had a background in hospice care,
    agreed. Kolodesh funded the new company, which they
    named Home Care Hospice, Inc., and Pugman managed the
    day-to-day operations.       Kolodesh’s wife, Malvina
    Yakobashvili, and Pugman were listed as owning equal shares
    in the company; however, Kolodesh was intimately involved
    in forming and overseeing the management of Home Care
    Hospice.
    As early as 2000 or 2001, Kolodesh, Pugman, and
    Pugman’s wife, Svetlana Ganetsky, who was also employed
    1
    The following general background information is
    supplemented by additional facts as they relate to each
    argument raised on appeal. Because Kolodesh was convicted
    after a jury trial, “we must defer to the jury’s verdict and view
    the evidence in the light most favorable to the government.
    Therefore, we recount the government’s version of the facts.”
    United States v. Serafini, 
    233 F.3d 758
    , 763 n.4 (3d Cir.
    2000) (citation omitted).
    3
    by Home Care Hospice, began giving gifts and cash
    “kickbacks” to doctors in exchange for patient referrals.
    (App. at 979-82.) In addition, at Kolodesh’s suggestion,
    Pugman placed some doctors or their employees on the Home
    Care Hospice payroll with sham job titles. Those sham
    employees were then issued paychecks, in exchange for
    patient referrals.
    About 90% of the revenue generated by Home Care
    Hospice came from Medicare reimbursements. Medicare, as
    is well known, is a federal health benefits program providing
    financial assistance to senior and disabled citizens to cover
    medical costs. Fischer v. United States, 
    529 U.S. 667
    , 671
    (2000). “Medicare attains its objectives through an elaborate
    funding structure,” 
    id. at 673,
    one aspect of which involves
    reimbursement to health care providers for medical treatment
    costs incurred in furnishing services to Medicare recipients,
    
    id. at 677,
    680. Providers are reimbursed by the Centers for
    Medicare and Medicaid Services (“CMS”) through a “fiscal
    intermediary,” which is a private entity that contracts with
    CMS to help it administer the Medicare program by
    determining payment amounts and making payments. 42
    U.S.C. §§ 1395h(a), 1395kk-1(a); 42 C.F.R. § 405.902; see
    also 
    Fischer, 529 U.S. at 677
    .
    At some point, Home Care Hospice began to submit to
    CMS fraudulent claims for reimbursement.            Medicare
    provides reimbursement only for hospice patients certified as
    terminally ill and places time limits on the validity of such
    certifications, 42 C.F.R. §§ 418.21-.22, but, at Kolodesh’s
    suggestion, Home Care Hospice began submitting
    reimbursement claims for patients who did not qualify for
    hospice care. Kolodesh and Pugman had the employees of
    4
    Home Care Hospice falsify patient records to conceal the
    fraud. Home Care Hospice employees also falsified records
    to show patients as eligible for and receiving continuous care
    – a more time-intensive and thus more expensive level of care
    – when those patients were neither eligible for nor received
    such care.
    To surreptitiously extract value from Home Care
    Hospice, Kolodesh and Pugman would, among other things,
    have contractors, such as Alexy Drobot, the person who
    serviced the copy machine for the business, submit fake
    invoices that Home Care Hospice would pay, and then the
    contractor would give most of the money to Kolodesh and
    Pugman, while keeping a portion for himself.
    Kolodesh, Pugman, Ganetsky, and a number of others
    were charged for their roles in the scheme to defraud
    Medicare. Kolodesh in particular was charged with one count
    of conspiracy to defraud a health care benefit program, in
    violation of 18 U.S.C. § 1349, twenty-one counts of health-
    care fraud, in violation of 18 U.S.C. § 1347, two counts of
    mail fraud, in violation of 18 U.S.C. § 1341, and eleven
    counts of money laundering, in violation of 18 U.S.C. § 1957.
    At the conclusion of a five-week trial, in which Pugman and
    Ganetsky testified for the government after having pled
    guilty, the jury convicted Kolodesh on all counts. Kolodesh
    filed a motion for a new trial and, later, a supplemental
    motion for a new trial, both of which the District Court
    denied. On May 28, 2014, the District Court sentenced him
    to a total of 176 months’ imprisonment, with three years of
    supervised release. The Court also ordered restitution in the
    amount of $16.2 million. Kolodesh filed this timely appeal.
    5
    II.   Discussion2
    The arguments on appeal focus on allegations of
    prosecutorial misconduct, certain evidentiary issues, and
    supposed errors in responding to a request from the jury and
    in sentencing.3 We address each in turn.
    2
    The District Court had original jurisdiction under 18
    U.S.C. § 3231; we have appellate jurisdiction pursuant to 28
    U.S.C. § 1291.
    3
    In support of the arguments raised in his opening
    brief, Kolodesh raises several new contentions in his reply
    brief. Those are waived and we do not address them further.
    See United States v. Pelullo, 
    399 F.3d 197
    , 222 (3d Cir. 2005)
    (“It is well settled that an appellant’s failure to identify or
    argue an issue in his opening brief constitutes waiver of that
    issue on appeal.”).
    6
    A.     Prosecutorial Misconduct4
    Kolodesh argues that the government committed
    prosecutorial misconduct in two ways. First, he says the
    prosecutor improperly introduced and repeatedly referred to
    an inaccurately transcribed, irrelevant, and unduly prejudicial
    portion of a recorded conversation between Kolodesh and
    Pugman. Second, he says the prosecutor improperly elicited
    testimony about Russian stereotypes, which undermined the
    fairness of the trial.
    1.      Transcript of Wiretapped Conversations
    At trial, the government relied heavily on transcripts of
    conversations that had been recorded through wiretaps that
    the FBI placed at Home Care Hospice.                One such
    4
    Kolodesh did not lodge a contemporaneous objection
    to the prosecutor’s conduct; rather, he raised the issue for the
    first time in his motion for a new trial. We therefore review
    the District Court proceedings for plain error insofar as this
    argument is concerned. United States v. Brennan, 
    326 F.3d 176
    , 188 (3d Cir. 2003). Under that standard, “an appellate
    court may, in its discretion, correct an error not raised at trial
    only where the appellant demonstrates that (1) there is an
    error; (2) the error is clear or obvious, rather than subject to
    reasonable dispute; (3) the error affected the appellant’s
    substantial rights, which in the ordinary case means it
    affected the outcome of the district court proceedings; and (4)
    the error seriously affect[s] the fairness, integrity or public
    reputation of judicial proceedings.” United States v. Marcus,
    
    560 U.S. 258
    , 262 (2010) (internal quotation marks omitted)
    (alteration in original).
    7
    conversation between Kolodesh and Pugman related to a
    letter that a Medicare fiscal intermediary, Cahaba
    Government Benefit Administrators, LLC (“Cahaba”), sent to
    Home Care Hospice. The letter requested patient data for the
    2006-2007 fiscal year to determine whether Home Care
    Hospice’s claims had exceeded the cap for new patients, the
    cap being a limit on the total annual amount CMS would
    reimburse for each hospice patient. The letter requested the
    number of new patients admitted during a defined period, but,
    depending on how the letter was interpreted, the period could
    be understood to be twelve or thirteen months. Knowing that
    they had overbilled Medicare, Kolodesh and Pugman decided
    to submit thirteen months of data and to misrepresent several
    patients as new when they had been previously discharged but
    since readmitted.     During the recorded conversation,
    Kolodesh said to Pugman, “We have to f*** them over this
    time, one more time and be smart about it … .” (App. at
    1261.) The government referred to this comment twice in its
    opening statement and four times in its closing argument.
    Kolodesh did not object to any of those references.5
    Calling his remark the “F*** Medicare Statement,”
    Kolodesh now argues that the translation and transcription of
    it, which was originally in Russian, was inaccurate. (Opening
    Br. at 19.) He also says that the government should have told
    the jury that the statement did not appear in the original
    transcription of the conversation. According to Kolodesh, the
    failure to get a good translation and the failure to tell the jury
    that his F*** Medicare Statement appeared only in the later
    5
    Kolodesh did object to questions to Pugman about
    what Kolodesh meant, but not to the admissibility of the
    statement itself or the government’s use of that statement.
    8
    transcription constitute prosecutorial misconduct. He seems
    to forget, however, that he stipulated at trial to the truth and
    accuracy of the transcripts. He thus invited any error and
    cannot complain now. United States v. Stewart, 
    185 F.3d 112
    , 127 (3d Cir. 1999) (limiting plain-error review to errors
    that were not invited); see also United States v. Console, 
    13 F.3d 641
    , 660 (3d Cir. 1993) (“A defendant cannot complain
    on appeal of alleged errors invited or induced by himself,
    particularly where, as here, it is not clear that the defendant
    was prejudiced thereby.” (internal quotation marks omitted)).
    Kolodesh also argues that the government’s reliance
    on the F*** Medicare Statement constitutes misconduct
    because it was irrelevant to the crimes charged in the
    indictment. On the contrary, though, his crude and concise
    comment was directly relevant to the twenty-one counts of
    health care fraud. It helped establish the fraudulent nature of
    the claims his company submitted and his mental state in
    causing those submissions.
    The statement was also relevant to the charged
    conspiracy. Among the overt acts supporting that charge, the
    indictment listed the obstruction of a Medicare audit in early
    2007. That 2007 audit was separate from the later inquiry by
    Cahaba that prompted the F*** Medicare Statement during
    the recorded conversation. In February 2007, Cahaba sent
    Home Care Hospice a letter notifying it that Cahaba would
    conduct a prepayment audit for twenty to forty claims
    covering a portion of the 2005-2006 fiscal year. Kolodesh
    directed Pugman to bring one of their field nurses into the
    office and pay her specifically to assist in changing patient
    records so that they would appear to be compliant. As a
    result, the audit led to the denial of only two claims out of
    9
    twenty. Kolodesh’s statement, “‘We have to f*** them over
    this time, one more time and be smart about it …’” (App. at
    1261 (emphasis added)), is relevant to establishing the
    fraudulent nature of Home Care Hospice’s response to the
    2007 audit, as well as being relevant to Kolodesh’s
    corresponding mental state and to the existence of an
    agreement to defraud Medicare. Thus, the District Court did
    not plainly err in permitting Kolodesh’s own words to be
    admitted against him and allowing the government to refer to
    them freely.6
    2.     Russian Stereotype Testimony
    Kolodesh argues that the government committed
    prosecutorial misconduct by repeatedly eliciting testimony
    from witnesses that Russians “game the system,” which
    6
    Kolodesh also makes reference to Rules 403 and
    404(a) of the Federal Rules of Evidence. Any argument
    based on improper character evidence under Rule 404(a) is
    waived due to the cursory nature of the reference to it in the
    brief. See United States v. Hoffecker, 
    530 F.3d 137
    , 162 (3d
    Cir. 2008) (noting parenthetically that “[a]n issue is waived
    unless a party raises it in its opening brief, and for those
    purposes a passing reference to an issue will not suffice to
    bring that issue before this court”); see also Fed. R. App. P.
    28(a)(8).      Kolodesh’s Rule 403 argument – that the
    inflammatory nature of the single instance of profanity
    rendered the comment unfairly prejudicial – fails, particularly
    in light of its probative value. Cf. United States v. Pirani, 
    406 F.3d 543
    , 555 (8th Cir. 2005) (en banc) (concluding that tape
    recording where defendant was “swearing expressively” was
    not unfairly prejudicial).
    10
    testimony the government then used to “assert to the jury that
    Kolodesh must be guilty because … [he] was born in
    Russia.”7 (Opening Br. at 37.) He misstates the record.
    First, the prosecutors did not elicit a majority of the
    statements of which Kolodesh complains; rather, those
    references to Russians were offered by witnesses without any
    prompting by the government.8 And statements that arguably
    were elicited by the prosecutors are relatively innocuous in
    the context of this case. The nurses at Home Care Hospice
    7
    Kolodesh was originally from the Georgian Soviet
    Socialist Republic, but he casts his argument on appeal
    broadly to include not only “Russian ethnic stereotypes” but
    also stereotypes about “native Russians,” “Russian speakers,”
    and, more generically, the “Russian community” in the
    United States, with which Kolodesh was identified at trial.
    (Opening Br. at 37, 38.)
    8
    For example, one of the prosecutors engaged in the
    following exchange with Pugman:
    Q      Are you familiar with the concept of a
    continuous care schedule?
    A      Yes.
    Q      What is that?
    A      So, if Irina as coordinator on Russian
    team would come to me and by that time,
    let’s say, in the year 2007-2008,
    especially nurses on the Russian team,
    they loved continuous care. Continuous
    care meant a lot of money, of course,
    some work in terms of documenting, but
    then getting paid for this.
    (App. at 1016-17.)
    11
    were divided into a “Russian team” and an “English team,”
    with each team focusing on patients who spoke those
    respective languages. (App. at 956-58.) When asked which
    team was involved with most of the fraudulent claims,
    Pugman stated matter-of-factly that it was the Russian team,
    without elaborating on the reasons. When Ganetsky was
    asked whether any nurses refused to participate in the fraud,
    she responded, “None of the Russian nurses had a problem
    with fabricating charts.”        (App. at 2531.)       But she
    immediately followed with the statement that, “[o]n the
    English team, there was a nurse who refused to participate,”
    making it clear that participation in the fraudulent scheme did
    not break down strictly along ethnic, linguistic, or cultural
    lines.9 (Id.; see also 
    id. at 1031-32
    (Pugman testifying that “a
    couple of nurses” refused to participate, without specifying
    which team, and stating by way of illustration that if he
    approached a nurse on the English team who refused, he
    would simply approach another nurse on the English team
    and offer to pay her double to do it).) In another instance
    cited by Kolodesh, Pugman stated that Kolodesh told him
    “how the marketing is done in [the] Russian community.”
    (App. at 963.) When the prosecutor asked for further details,
    Pugman recounted Kolodesh’s explanation of how he would
    provide doctors cash kickbacks for referrals. Yet that
    testimony must be considered in the context of other
    evidence, such as Pugman’s testimony that both “Russian”
    and “American” doctors received kickbacks for giving
    referrals, though the former preferred cash kickbacks while
    9
    If the fraudulent activity had broken cleanly on such
    lines, that would be a matter of fact, not bias. That it did not
    do so simply reduces any force in the argument that there was
    a risk that the jury would succumb to prejudice.
    12
    the latter preferred to be placed on the payroll.10 (App. at
    1214.)
    The government did not invoke Russian stereotypes in
    its opening statement or closing argument to the jury. The
    only references to ethnicity or language groups came in
    closing argument and involved a reference to how each group
    of doctors – Russian speakers and English-only speakers –
    preferred to receive kickbacks and a reference to a statement
    by Ganetsky that she believed the co-conspirators would be
    suspected of fraud because they were Russians. The
    prosecutor used the latter statement not to prove that Russians
    were predisposed toward fraudulent activity, but to suggest
    that Ganetsky, Pugman, and Kolodesh believed that Home
    Care Hospice was about to come under closer scrutiny, and
    that their subsequent efforts to discharge large numbers of
    inappropriate patients indicated knowledge of the fraudulent
    nature of their actions. Thus, the government did not, as
    Kolodesh alleges, “broadcast” Russian stereotypes to the jury.
    (Opening Br. at 40.) Viewed in the context of the evidence
    presented at trial, the prosecutors’ questions and statements
    do not constitute misconduct, nor was it plain error for the
    District Court to permit them.11
    10
    The final statement Kolodesh cites that was actually
    elicited by the prosecutors was Kolodesh’s own comment that
    he is “savvy … like all Russians.” (App. at 1121.) But the
    context of Kolodesh’s statement indicates that he was
    referring to why he prefers the cash-basis accounting method
    to the accrual-basis method; he was not referring to fraudulent
    activity.
    11
    Kolodesh further argues that testimony concerning
    Russians was inappropriate because none of the witnesses
    13
    B.     Evidentiary Issues12
    Next, Kolodesh alleges a series of evidentiary errors;
    namely, the District Court’s exclusion of allegedly
    exculpatory medical evidence, its failure both to exclude
    evidence of uncharged wrongful acts and to allow Kolodesh
    to rebut that evidence, and its admission of conversations
    relating to his attempt to open an overseas bank account.
    were qualified “as expert witnesses on the propensity of
    Russian people to commit crimes.” (Opening Br. at 39.)
    That argument is frivolous. When Ganetsky attempted to
    testify as to how business was conducted at “other Russian
    agencies,” Kolodesh objected and that objection was
    sustained. (App. at 2532.) Otherwise, the testimony
    Kolodesh cites all involved witnesses explaining the facts of
    this case based on personal knowledge. See Fed. R. Evid. 701
    (stating that opinion testimony of a lay witness is permitted if,
    among other things, it is “rationally based on the witness’s
    perception”). Kolodesh also mentions a litany of other
    evidentiary rules that were supposedly violated by admitting
    testimony that he says involved Russian stereotypes. Those
    arguments are not meaningfully briefed and are thus waived.
    Fed. R. App. P. 28(a)(8); 
    Hoffecker, 530 F.3d at 162
    .
    12
    “Generally, we review evidentiary rulings for abuse
    of discretion, but when no objection is made at trial we
    review for plain error only.” United States v. Brink, 
    39 F.3d 419
    , 425 (3d Cir. 1994) (citation omitted).
    14
    1.      Exclusion of Evidence of Medical
    Condition
    Kolodesh argues that the District Court abused its
    discretion by preventing him from countering Pugman’s
    testimony that Kolodesh met him at the office almost daily.
    Kolodesh says he had evidence that he was homebound due
    to illness from 2003 to 2005. He contends that, because the
    illegal activity began in earnest in 2003, the excluded
    evidence would have provided “exculpatory alibi testimony”
    showing that he “was physically too ill to be involved in the
    operation of [Home Care Hospice]” at that time. (Opening
    Br. at 42.) If the Court erred in this respect – and it appears it
    did – the error was harmless.
    Kolodesh called his wife, Yakobashvili, as a witness
    and attempted to have her testify as to his health. The District
    Court ruled that Yakobashvili had personal knowledge to
    testify as to “whether he got up in the morning and went or
    left the house,” but testimony that illness was the reason he
    could not go to work would be hearsay. (App. at 4275.)
    When Yakobashvili repeatedly ignored the scope of defense
    counsel’s questions and testified not only that Kolodesh was
    “[n]ot really” going into work at Community Home Health,
    but that the reason was that he was “very sick,” the District
    Court cut off questioning and ordered defense counsel to
    move on. (App. at 4276.)
    “Testimony that conveys a witness’s personal
    knowledge about a matter is not hearsay.” United States v.
    Vosburgh, 
    602 F.3d 512
    , 539 n.27 (3d Cir. 2010). The
    proffered testimony could be understood to establish that
    Yakobashvili had personal knowledge that her husband was
    15
    ill in some way and that the illness had an effect on his ability
    to work. That testimony could certainly have been subjected
    to close scrutiny under cross-examination, but her
    impressions of her husband’s health and capacity to work
    were not hearsay.13 However, even if Kolodesh had been
    allowed to pursue that line of questioning, it would not have
    affected the outcome of the trial. We are quite sure of that.
    See United States v. Zehrbach, 
    47 F.3d 1252
    , 1265 (3d Cir.
    1995) (en banc) (stating that an error is harmless “when it is
    highly probable that the error did not contribute to the
    judgment,” which “requires that the court possess a sure
    conviction that the error did not prejudice the defendant”
    (emphasis and internal quotation marks omitted)).
    Kolodesh wanted Yakobashvili to testify as to his
    health between 2003 and 2005. The incriminating evidence
    that Kolodesh identifies as being undermined by such
    testimony, however, refers to Kolodesh’s almost-daily office
    visits with Pugman during 2000 and 2006. Elsewhere,
    Pugman testified that he and Kolodesh had “always” been in
    “communication” on a daily basis, including in 2003 (App. at
    1051), and that some of their conversations took place over
    the phone. Furthermore, Pugman testified that, starting
    sometime in 2004, he and Kolodesh began having meetings
    after business hours in Kolodesh’s home, though “rarely” in
    Pugman’s home because Kolodesh “was more comfortable”
    in his own house. (App. at 967.) While Pugman also testified
    that he and Kolodesh “[s]ometimes, [but] not that often,” met
    13
    Yakobashvili’s attempt to identify the particular
    illness that her husband had may be another matter. But the
    District Court could have limited that testimony without
    excluding all reference to Kolodesh’s health.
    16
    at Community Home Health during 2004 (App. at 968), that
    testimony comports with Yakobashvili’s testimony that in
    2004 – in the midst of the period that she testified her
    husband was ill – Kolodesh had a meeting with Pugman,
    Ganetsky, and Yakobashvili at Community Home Health.14
    Because Yakobashvili’s proffered testimony did not
    demonstrate that Kolodesh was not involved in the operation
    of Home Care Hospice during 2003 to 2005, it failed to
    contradict Pugman’s testimony or to materially weaken his
    credibility. The decision to exclude Yakobashvili’s testimony
    about Kolodesh’s illness was, therefore, harmless.
    2.     Other-Acts Evidence Regarding
    Community Home Health
    Kolodesh argues that the District Court erred in not
    sua sponte excluding testimony by Pugman and Ganetsky that
    employees at Community Home Health engaged in certain
    uncharged acts of fraud. Pugman testified that he learned
    how to fraudulently alter charts in preparation for an audit
    while working at Community Home Health. He said that the
    director of nursing would instruct him to “fix[]” the charts,
    but if, for example, he refused to come in on the weekend to
    do so when he had other plans, he would get a call from
    Kolodesh urging him to come in and help. (App. at 1047.)
    14
    Kolodesh also claims that Pugman testified that
    Kolodesh “regularly came to [Home Care Hospice] to review
    the books.” (Opening Br. at 41.) But what Pugman actually
    said is that Kolodesh came to Home Care Hospice to review
    the company’s books “[o]n [an] as-needed basis.” (App. at
    978.) Furthermore, Pugman provided no timeframe for that
    statement.
    17
    Similarly, Ganetsky testified that, when she was working at
    Community Home Health, Kolodesh instructed her “on
    several occasions” to fabricate records for his mother-in-law,
    indicating that she received services that were, in fact, never
    provided.15 (App. at 2605.) Ganetsky also testified that
    Kolodesh told Pugman that he had “several ghost employees”
    on the payroll at Community Home Health, and that the same
    kind of fraud should be undertaken at Home Care Hospice.
    (App. at 2507.)
    Evidence of uncharged acts is admissible if the
    following requirements are met: “First, the evidence must be
    offered for a proper purpose under Rule 404(b)[ of the
    Federal Rules of Evidence]; second, the evidence must be
    relevant under Rule 402; and third, the probative value of the
    evidence must outweigh its potential for unfair prejudice
    under Rule 403.” United States v. Ciavarella, 
    716 F.3d 705
    ,
    15
    Kolodesh further complains of testimony that, on
    behalf of Home Care Hospice, Ganetsky entered into
    unlawful kickback arrangements with Community Home
    Health staff. That testimony, though, refers to illegal actions
    that are part of the crimes charged – the indictment
    specifically mentions the kickback scheme as a method of
    enrolling inappropriate hospice patients in Home Care
    Hospice. Such testimony does not, therefore, relate to
    evidence of uncharged wrongs, and, even if it did, it would be
    intrinsic to the charged offense. United States v. Gibbs, 
    190 F.3d 188
    , 217 (3d Cir. 1999) (“Rule 404(b), which proscribes
    the admission of evidence of other crimes when offered to
    prove bad character, does not apply to evidence of uncharged
    offenses committed by a defendant when those acts are
    intrinsic to the proof of the charged offense.”).
    18
    728 (3d Cir. 2013). The District Court did not plainly err in
    admitting the testimony of Pugman’s and Ganetsky’s
    experiences at Community Home Health. The testimony was
    not offered as evidence of Kolodesh’s character as a
    defrauder in order to show that he acted in accordance with
    that character at Home Care Hospice. See Fed. R. Evid.
    404(b)(1). Rather, it was offered as circumstantial evidence
    of Kolodesh’s knowledge of the fraudulent activity at Home
    Care Hospice. In his opening statement, defense counsel
    asserted that Kolodesh was unaware of the fraudulent
    practices at Home Care Hospice, and that the scheme was
    concocted and executed by Ganetsky and Pugman. Counsel
    asserted that, in contrast, Kolodesh ran Community Home
    Health as a legal, legitimate business. In light of the defense
    theory of the case, the relevance of the government’s
    evidence is clear: Kolodesh knew what fraudulent practices
    looked like – indeed, he taught them to Pugman and Ganetsky
    – and if Kolodesh was as intimately involved in Home Care
    Hospice as Pugman testified, he certainly would have known
    of the fraudulent conduct. Given the relevance of the
    complained-of evidence, we cannot say it was unfairly
    prejudicial, especially when seen through the lens of plain-
    error review.
    Kolodesh also argues that he should have been allowed
    to rebut that evidence by offering testimony about how he
    operated Community Home Health after Pugman left that
    company in 2001. At trial, Kolodesh sought to call three
    witnesses who worked at Community Home Health to
    counter the government’s evidence that he had instructed
    employees to fabricate records. The District Court allowed
    him to call the witnesses but limited their testimony to events
    “up to 2001,” when Pugman left to work full time at Home
    19
    Care Hospice, because the government’s evidence had been
    similarly limited. (App. at 4111.) The Court stated, however,
    that it would revisit its ruling if Kolodesh could demonstrate
    that the government’s evidence relative to Community Home
    Health went beyond 2001. Defense counsel responded that
    Ganetsky testified about her experience at Community Home
    Health up until about 2003 or 2004 , but he agreed to put on
    his witnesses and limit their testimony to 2001 and earlier,
    and then bring the witnesses back later “if [he felt] it’s that
    essential to bring them back.”16 (App. at 4114.) The
    witnesses then testified that, during the 1999-2001 time
    period, Kolodesh never instructed them to fabricate records.
    Defense counsel also followed up with the first of the three
    witnesses in a way that extended the testimony beyond 2001:
    Q     And that was the whole time that you
    worked there, right?
    A     Yes.
    Q     And you still work there now, right?
    A     Yes.
    (App. at 4141.) The government did not object, though it
    objected to a similarly broad question posed to the second
    witness.
    16
    Defense counsel also added, “[I]n reality, I don’t
    think it makes a whole lot of difference.” (App. at 4114.)
    However, it is unclear whether that statement was a
    concession as to the value of additional testimony or a
    reference to the logistical matter of whether to put witnesses
    on then or after having had an opportunity to review
    Pugman’s and Ganetsky’s testimony.
    20
    The District Court acted well within its discretion by
    allowing Kolodesh to rebut the government’s evidence while
    partially limiting the temporal scope of the testimony. To
    prevent the trial about fraudulent practices at Home Care
    Hospice from devolving into a side trial about fraudulent
    practices at Community Home Health, the Court’s ruling was
    entirely reasonable. But, even if we were to conclude that the
    District Court abused its discretion, its ruling was harmless.
    Kolodesh’s witnesses testified that he never asked them to
    doctor any charts, and one witness testified to that fact well
    beyond the 2001 limit. We are fully persuaded that the
    admission of additional testimony about Kolodesh’s practices
    at Community Home Health after 2001 would not have
    affected the outcome of the case. See 
    Zehrbach, 47 F.3d at 1265
    (setting forth test for harmless error).
    3.     Relevance of Conversations Regarding
    Overseas Bank Accounts
    The final evidentiary challenge Kolodesh advances is
    to the relevance and prejudicial effect of extensive recorded
    conversations that referred to his opening a Swiss bank
    account.     Kolodesh argues that evidence of foreign
    investments is “generally inadmissible” because of the
    negative perception in the public’s mind linking such
    accounts to criminal activity. (Opening Br. at 47.) Yet the
    case Kolodesh cites for that proposition does not support it.
    Rather, the case simply applied the standard rules relating to
    relevance and unfair prejudice, with the result being the
    approval of admission of evidence of a secret Swiss bank
    account. United States v. Friedland, 
    660 F.2d 919
    , 929 (3d
    Cir. 1981); cf. United States v. Udeozor, 
    515 F.3d 260
    , 264-
    65 (4th Cir. 2008) (“Rule 403 is a rule of inclusion, generally
    21
    favoring admissibility … .” (brackets and internal quotation
    marks omitted)). Here, Pugman testified that he, Ganetsky,
    and Kolodesh discussed the possibility of moving money
    overseas “to protect our money … from the government,”
    after they had received a letter from Cahaba requiring Home
    Care Hospice to repay over $2.6 million in reimbursements
    that had exceeded the per-patient cap for the 2006-2007 fiscal
    year. (App. at 1280.) Although Cahaba retracted the letter
    and at trial the government conceded that the letter was
    prompted by “a bookkeeping error” (App. at 4399), which
    Home Care Hospice corrected, the government argued – and
    the testimony supports – that the letter prompted Kolodesh
    and his co-conspirators to discharge several patients and
    discuss the possibility of moving money overseas because
    they were aware of fraudulent activity that would be detected
    if Cahaba continued to scrutinize Home Care Hospice. In one
    of the recorded conversations, Kolodesh indicated that he
    wanted to put money in a Swiss bank account, but he wanted
    to avoid one particular bank because “[it] reports everything
    to the American government.” (App. at 1284.)
    The recorded conversations were thus relevant as
    circumstantial evidence of Kolodesh’s knowledge that his
    actions were fraudulent and that he risked losing his money as
    a result. They were also relevant as circumstantial evidence
    of knowledge regarding the money laundering charges.
    Although the discussions about possibly putting money into
    Swiss accounts was not part of those charged offenses, the
    conversations provided evidence of Kolodesh’s intent to
    maintain access to criminally derived property and conceal
    such transactions from the government. The mere possibility
    of a negative inference regarding Swiss bank accounts did not
    22
    substantially outweigh the probative value of the recordings.
    Thus, the District Court did not plainly err in admitting them.
    C.     Response to Jury’s Request17
    Kolodesh argues that the District Court erred in failing
    to provide the jury with transcripts of testimony that the jury
    requested and, further, in failing to suspend jury deliberations
    until those transcripts could be provided. After the jury began
    deliberating, it sent a note asking for a transcript of Pugman’s
    testimony, “both direct and cross,” and noting that, “[i]f
    possible,” the transcript “may be edited to cover only
    testimony regarding continuous care.” (App. at 4611.) The
    jury requested the same for Ganetsky’s testimony and a full
    transcript for the testimony of Cecilia Wiley, Home Care
    Hospice’s office manager. After obtaining the agreement of
    counsel, the District Court instructed the jury that it would not
    be possible to provide only the portions of the transcript
    relating to continuous care. The Court also noted the length
    of the full testimony for Pugman and Ganetsky and told the
    jury it had two options: it could either rely on its recollection
    of the testimony or “request the entire transcript of Ganetsky
    and Pugman or either one or both.” (App. at 4622.) The
    Court then sent the jury back to decide what it wanted to do.
    The record is not entirely clear, but the jury may have sent a
    note back requesting the full transcript of Pugman’s and
    Wiley’s testimonies, though not Ganetsky’s. (See App. at
    17
    Because Kolodesh failed to raise a contemporaneous
    objection, we review for plain error. United States v.
    Salahuddin, 
    765 F.3d 329
    , 337 (3d Cir. 2014), petition for
    cert. filed, 
    83 U.S.L.W. 3558
    (U.S. Dec. 2, 2014) (No. 14-
    654).
    23
    4623-26 (defense counsel discussing all three witnesses and
    indicating that the jury had requested Wiley’s testimony
    twice); 
    id. at 4630
    (District Court stating when jury returned,
    “I have received your request for the transcripts of Alex
    Pugman and Cecilia Wiley”).) In any event, after discussing
    the matter further with counsel, the District Court instructed
    the jury that a transcript of Wiley’s testimony was not
    available but that the jury could rely on its recollection or
    come back into court and have the audio recording of the
    testimony played in its entirety. “As to Alex Pugman’s
    transcript,” the Court explained, “that is available and it will
    be delivered to you. It may take a little bit of time because it
    has to be edited to take the sidebars out of the transcript that
    has been developed.” (App. at 4631.) Before sending the
    jury back to the jury room, the District Court summarized,
    “So if possible, continue your deliberation on these and other
    issues as you wish while the Pugman transcript is being
    edited, and as far as Wiley is concerned, those are the choices
    that you have.” (Id.) Just over two hours later, the jury
    returned a verdict.
    As the foregoing record indicates, the District Court
    did not fail to make the transcript or recordings available to
    the jury; it expressly told the jury that it had a choice as to
    how to proceed regarding the Wiley testimony, that the
    Pugman transcript would be given as soon as it was available,
    and that it was free to continue deliberation as it wished.18
    18
    We reject Kolodesh’s contention that, by failing to
    mention Ganetsky’s testimony when the jury returned, the
    District Court tacitly rejected the jury’s request for her
    testimony. As noted above, the jury appears to have
    withdrawn that request. But even if that reading of the record
    24
    That the jury ultimately chose to rely on its recollection of the
    witnesses’ testimonies does not indicate that the Court should
    have halted proceedings. The handling of such matters is
    within the “broad discretion” of the trial court, United States
    v. Bertoli, 
    40 F.3d 1384
    , 1400 (3d Cir. 1994) (internal
    quotation marks omitted), and how the Court proceeded in
    this instance was not in any way an abuse of that discretion,
    let alone a problem rising to the level of plain error.
    D.     Sentencing
    Finally, Kolodesh challenges the procedural and
    substantive reasonableness of his sentence, including the
    District Court’s restitution order.
    is inaccurate, we do not believe the jury would have
    interpreted the District Court’s comments as a reversal of the
    earlier instruction to the jury that it could rely on its own
    recollection of Ganetsky’s testimony or request a full
    transcript.
    25
    1.     Alleged Procedural Error19
    First, Kolodesh argues that the government did not
    establish that the health care fraud in this case resulted in a
    $16.2 million loss, and, therefore, the twenty-level loss-
    enhancement imposed under the U.S. Sentencing Guidelines
    was inappropriate. See U.S.S.G. § 2B1.1(b)(1)(K). An agent
    who worked on the case testified at sentencing that he
    calculated the loss based on Pugman’s and Ganetsky’s
    testimony as to the percentage of continuous care claims that
    were fraudulent, 90-99.5%, and the percentage of patients
    who did not qualify even for non-continuous hospice care,
    30-33%. Using the lower estimates, the agent multiplied
    those percentages by the respective dollar amounts of claims
    submitted between 2003 and 2008, $1.7 million for
    19
    In United States v. Flores-Mejia, 
    759 F.3d 253
    (3d
    Cir. 2014) (en banc), we concluded that a defendant must
    object after a sentence is pronounced to preserve a claim
    based on “failure to give meaningful consideration” to the
    defendant’s objections. 
    Id. at 256.
    That rule, however, does
    not apply to sentences such as Kolodesh’s that were entered
    before Flores-Mejia was decided. 
    Id. at 259.
    Furthermore,
    Kolodesh does not challenge the adequacy of the District
    Court’s consideration of the objections he raised. He instead
    challenges the District Court’s application of the Sentencing
    Guidelines, and in particular the Court’s factual findings in
    support of the Guidelines calculations it made. Therefore, our
    review is for abuse of discretion. United States v. Wise, 
    515 F.3d 207
    , 217 (3d Cir. 2008). “[A] district court will be held
    to have abused its discretion if its decision was based on a
    clearly erroneous factual conclusion or an erroneous legal
    conclusion.” 
    Id. 26 continuous
    care and $48.9 million for non-continuous care,
    resulting in a total loss of $16.2 million. Kolodesh argues
    that Pugman and Ganetsky were not competent to testify as to
    the percentage of fraudulent claims and that the government
    provided no foundation for their testimonies. He says that,
    based on expert testimony he advanced at the sentencing
    hearing, statistical sampling was needed to establish an
    accurate estimate of loss in this case.
    The District Court did not clearly err in concluding
    that the government proved a $16.2 million loss. Pugman and
    Ganetsky each testified extensively at trial regarding their
    intimate involvement in the management of Home Care
    Hospice and, together with Kolodesh, their direction of the
    company’s fraudulent activities. It is difficult to imagine who
    would have been more competent to testify based on personal
    knowledge as to the loss involved in this case. Furthermore,
    “[t]here is no rule that a district court must rely upon
    statistical analysis in a situation such as this to determine the
    amount of loss pursuant to section 2B1.1.” United States v.
    Jones, 
    641 F.3d 706
    , 712 (6th Cir. 2011) (making that
    statement as a general proposition in a health care fraud case,
    but reversing because the district court relied solely on a
    flawed statistical analysis). And as the application notes to
    the Sentencing Guidelines indicate, “[t]he court need only
    make a reasonable estimate of the loss.” U.S.S.G. § 2B1.1
    app. n.3(C). We find no error in the District Court’s
    application of the loss enhancement.
    Next, Kolodesh argues that the District Court erred in
    applying a four-level enhancement based on his role as an
    organizer or leader of the fraudulent activity. See U.S.S.G.
    § 3B1.1(a). He points to evidence adduced at trial indicating
    27
    that he had no control over the fraud and instead was, at most,
    “a passive, silent partner” in Home Care Hospice. (Opening
    Br. at 56.) Although he acknowledges the existence of
    damning testimony by Pugman and Ganetsky, he argues that
    they were “simply not credible.” (Opening Br. at 57.) We
    decline Kolodesh’s invitation to reweigh the evidence or
    reassess the witnesses’ credibility. Pugman and Ganetsky
    repeatedly testified at trial that Kolodesh was intimately
    involved in directing the fraudulent scheme. Although the
    jury could have chosen to reject Pugman’s and Ganetsky’s
    testimony and believe Kolodesh’s version of events, it did
    not. The District Court’s finding that Kolodesh was an
    organizer or leader of the fraudulent activity is in line with the
    jury’s verdict, and Kolodesh has pointed to nothing in the
    record that would make the District Court’s finding clearly
    erroneous. See United States v. Igbonwa, 
    120 F.3d 437
    , 440-
    41 (3d Cir. 1997) (stating that under the clearly erroneous
    standard, the reviewing court does not “conduct a de novo
    review of the evidence” but considers “whether there is
    enough evidence in the record to support the factual findings
    of the district court,” or, in the context of credibility
    determinations, whether “the district court’s decision is based
    on testimony that is coherent and plausible, not internally
    inconsistent and not contradicted by external evidence”).
    Kolodesh’s final procedural challenge relates to the
    District Court’s imposition of a two-level sentencing
    enhancement for obstruction of justice.       See U.S.S.G.
    § 3C1.1. During trial, Alexy Drobot – a witness for the
    government who, as noted earlier, had contracted with Home
    Care Hospice to service its copy machine – testified that
    Kolodesh came to his office shortly before Drobot was
    28
    scheduled to testify.20 Drobot was not there, but Kolodesh
    had Drobot’s secretary call and ask him to meet Kolodesh at
    Community Home Health. When Drobot refused, Kolodesh
    proposed a meeting at Starbucks. Drobot agreed and they met
    over coffee for about fifteen minutes. The only thing they
    discussed was Drobot’s upcoming testimony. Kolodesh
    mentioned that Drobot would probably get called as a witness
    the following week, and Kolodesh said, “don’t bury me.”
    (App. at 2977.) Drobot responded that he would not perjure
    himself but would “tell the truth and be done with this.”
    (App. at 2978.) Drobot acknowledged on cross-examination
    that Kolodesh did not threaten him or ask him to lie or to
    change his testimony.
    Again, Kolodesh is simply rearguing the weight of the
    evidence, without pointing to anything that shows the District
    Court clearly erred in finding that he willfully attempted to
    obstruct or impede the administration of justice. We
    conclude, therefore, that the District Court did not commit
    procedural error in applying the challenged enhancements.
    20
    Drobot testified at trial about the agreement he had
    with Kolodesh and Pugman to provide them with fake
    invoices in return for a portion of the funds used to pay those
    invoices.
    29
    2.     Substantive Reasonableness21
    Kolodesh challenges the substantive reasonableness of
    his sentence by arguing that he “did not orchestrate the fraud
    committed by [Home Care Hospice]” and that he “suffers
    from several physical and emotional conditions” that will
    prevent him from committing further crimes and make him an
    inappropriate candidate for a long term of incarceration.
    (Opening Br. at 62, 63.) He also says that the imposition of a
    large sentence and large restitution amount renders the
    sentence doubly harsh. We have already disposed of
    Kolodesh’s challenge to his role in the fraudulent scheme.
    See supra p. 24. As to Kolodesh’s physical condition, the
    District Court concluded that the Bureau of Prisons was “fully
    equipped and … well positioned to provide appropriate
    medical attention to Mr. Kolodesh’s ailments.” (Supp. App.
    at 12.) Kolodesh recites his ailments but does nothing to
    challenge the Court’s conclusion or to show why his ailments
    are so incapacitating that he could not commit any further
    offenses. Finally, the combination of a lengthy imprisonment
    term with a large restitution order does not render a sentence
    unreasonable. Cf., e.g., United States v. Lewis, 
    557 F.3d 601
    ,
    613-15 (8th Cir. 2009) (upholding the substantive
    reasonableness of a sentence of 204 months’ imprisonment in
    a case involving a restitution order of $39 million, although
    21
    We review the substantive reasonableness of a
    sentence for abuse of discretion. 
    Wise, 515 F.3d at 218
    . “[I]f
    the district court’s sentence is procedurally sound, we will
    affirm it unless no reasonable sentencing court would have
    imposed the same sentence on that particular defendant for
    the reasons the district court provided.” United States v.
    Tomko, 
    562 F.3d 558
    , 568 (3d Cir. 2009) (en banc).
    30
    the defendant there did not argue that the length of
    imprisonment and size of restitution combined to render the
    sentence unreasonable). Rather, we must “take into account
    the totality of the circumstances” as we consider the
    reasonableness of the sentence under the facts of each case.
    Gall v. United States, 
    552 U.S. 38
    , 51 (2007).
    Under a common understanding of the term, restitution
    is just what its name denotes: a restoring of victims to their
    state before the crime, as nearly as possible.22 Viewed that
    way, it is akin to compensatory damages in a civil suit rather
    than punitive damages. The Supreme Court, however, has
    stated that there is a punitive aspect to restitution orders in a
    criminal case, see Paroline v. United States, 
    134 S. Ct. 1710
    ,
    1726 (2014) (“The primary goal of restitution is remedial or
    compensatory, but it also serves punitive purposes.” (citation
    omitted)), and we are bound to follow that. Yet even though
    restitution has been deemed to serve “punitive purposes,” its
    “primary goal” is still “remedial or compensatory,” 
    id., and we
    see no reason why imposing restitution in an amount
    22
    See Merriam-Webster’s Collegiate Dictionary 996
    (10th ed. 2002) (defining “restitution” as “1: an act of
    restoring or a condition of being restored: as a: a restoration
    of something to its rightful owner b: a making good of or
    giving an equivalent for some injury 2: a legal action serving
    to cause restoration of a previous state,” defining “restitute”
    as “1: to restore to a former state or position 2: GIVE BACK;
    esp: REFUND,” and defining “restore” as “1: GIVE BACK,
    RETURN 2: to put or bring back into existence or use 3: to
    bring back to or put back into a former or original state:
    RENEW 4: to put again in possession of something”
    (emphases omitted)).
    31
    equal to the loss actually caused by Kolodesh and his co-
    conspirators would, when coupled with a lengthy term of
    imprisonment that is otherwise reasonable, render the
    sentence substantively unreasonable. Moreover, the District
    Court here granted a downward departure,23 imposing a
    sentence of 176 months’ imprisonment in the face of a
    guidelines range of 188 to 235 months. The justifications
    given for the sentence are reasonable.
    3.     Restitution24
    Kolodesh argues that the government did not
    adequately prove the amount of loss and that, in any event,
    the District Court erred by holding him jointly and severally
    liable for the full amount of loss rather than for the portion he
    caused. Kolodesh’s first argument is answered by our
    already-stated conclusion regarding the District Court’s
    factual findings on the loss amount. See supra pp. 22-23. His
    second argument is foreclosed by the very language of the
    statute authorizing restitution, which explicitly provides for
    joint and several liability in the full amount:
    If the court finds that more than 1 defendant has
    contributed to the loss of a victim, the court
    may make each defendant liable for payment of
    23
    The Court granted the downward departure based on
    its conclusion that the lower sentence “will satisfy the factors
    under 3553.” (Supp. App. at 12.)
    24
    “We review the legality of a restitution order de
    novo and review specific awards for abuse of discretion.”
    United States v. Turner, 
    718 F.3d 226
    , 235 (3d Cir. 2013).
    32
    the full amount of restitution or may apportion
    liability among the defendants to reflect the
    level of contribution to the victim’s loss and
    economic circumstances of each defendant.
    18 U.S.C. § 3664(h).
    Kolodesh relies on the Supreme Court’s recent
    decision in Paroline, but that case cannot serve him in these
    circumstances. Paroline interpreted 18 U.S.C. § 2259, a
    mandatory restitution statute specific to Chapter 110 of the
    United States criminal code, which covers sexual exploitation
    and other abuse of 
    children. 134 S. Ct. at 1716
    . The opinion
    was specifically concerned with the application of § 2259 to
    the crime of possessing child pornography. 
    Id. The Supreme
    Court vacated an en banc decision of the United States Court
    of Appeals for the Fifth Circuit that had “held that § 2259 did
    not limit restitution to losses proximately caused by the
    defendant, and each defendant who possessed the victim’s
    images should be made liable for the victim’s entire losses
    from the trade in her images, even though other offenders
    played a role in causing those losses.” 
    Id. at 1718.
    While the
    Supreme Court held that “a court applying § 2259 should
    order restitution in an amount that comports with the
    defendant’s relative role in the causal process that underlies
    the victim’s general losses,” it explicitly limited that holding
    to the “special context” at issue in the case. 
    Id. at 1727.
    Regardless of whether the words “special context” refer only
    to possession-of-child-pornography offenses or, more
    broadly, to any offense which might involve an “atypical
    causal process” underlying the victim’s losses, 
    id. at 1722,
    no
    such special context exists here.          This case involves
    straightforward consideration of moneys obtained by fraud.
    33
    Paroline does not alter the long-standing availability of joint-
    and-several liability in circumstances such as this.25 The
    District Court’s restitution order is thoroughly sound.
    III.   Conclusion
    For the foregoing reasons, we will affirm Kolodesh’s
    conviction and sentence.
    25
    Section 2259, the statute at issue in Paroline,
    incorporates the enforcement procedures of § 3664. See 18
    U.S.C. § 2259(b)(2) (“An order of restitution under this
    section shall be issued and enforced in accordance with
    section 3664 in the same manner as an order under section
    3663A[, which governs mandatory restitution to victims of
    certain crimes].”). As noted above, § 3664 grants the district
    court discretion to impose joint and several liability or to
    apportion liability. 
    Id. § 3664(h).
    Again, nothing in Paroline
    suggests that the Court was foreclosing the statutorily
    authorized imposition of joint and several liability in the
    typical case.
    34