Summary
The Eleventh Circuit affirmed Lawrence Alexander’s conviction for making a materially false statement relating to a health care matter under 18 U.S.C. § 1035. The court upheld the rulings on venue, the sufficiency of the indictment and evidence, aiding and abetting, jury instructions, and forfeiture. It vacated the restitution order and remanded for further proceedings concerning restitution.
Topics
Practice areas
Questions Presented
- Whether venue was proper in the Southern District of Florida.
- Whether the indictment adequately stated an offense under 18 U.S.C. § 1035(a)(2).
- Whether the evidence was sufficient to support Alexander's conviction under § 1035.
- Whether the evidence was sufficient to support conviction under an aiding-and-abetting theory.
- Whether the district court's materiality and deliberate-ignorance jury instructions constituted reversible error.
- Whether the district court's $125,000 forfeiture order was procedurally and evidentiary valid.
- Whether the district court's $315,704.52 restitution order was supported by proof that Alexander's offense actually and proximately caused Medicare's losses.
Holdings
- Venue was proper in the Southern District of Florida because circumstantial evidence showed by a preponderance of the evidence that the charged offense took place there.
- Count 19 of the indictment was legally and facially sufficient under 18 U.S.C. § 1035(a)(2).
- The evidence was sufficient for a reasonable jury to find that the false ownership information was material to Medicare under § 1035.
- The evidence was sufficient to convict Alexander under an aiding-and-abetting theory.
- Alexander's challenge to the materiality instruction was waived by invited error, and his deliberate-ignorance challenge was waived because it was raised for the first time in his reply brief.
- The $125,000 forfeiture order was valid despite the district court's failure to enter a preliminary forfeiture order before sentencing.
- The $315,704.52 restitution order was unsupported because the government failed to prove that Alexander's false statement actually and proximately caused Medicare's claimed losses.
Key quotations
“Under the MVRA, sentencing courts must order restitution for a victim’s “actual loss directly and proximately caused by the defendant’s offense of conviction.”” (23-24)
“But the chance of reliance is not equivalent to reliance itself.” (27)
“The evidence to support a § 1035 conviction is not necessarily sufficient to support an order of restitution.” (27)
Factual background
Lawrence Alexander, an orthopedic surgeon, partnered with Jeremy Waxman to create Silent Hill Bracing and Orthopedic Supplies, a durable medical equipment company that billed Medicare. Alexander suggested listing his mother, Susan Alexander, as the company's owner even though she had no ownership or management role, and provided her identifying information and signature materials. Silent Hill submitted a January 2019 CMS Form 855S containing false ownership information and later ceased operations after Medicare suspected fraud. The district court ordered forfeiture and restitution based on payments made to Silent Hill, but the appellate court found insufficient evidence that Medicare actually relied on the January 2019 form in making later payments.
Procedural history
A grand jury indicted Alexander on conspiracy to defraud the United States and pay health care kickbacks and on making a false statement relating to health care matters under 18 U.S.C. § 1035. After a nine-day trial, the jury acquitted him of conspiracy and convicted him on the false-statement count. The district court denied his motions for judgment of acquittal, sentenced him to thirty-three months' imprisonment and three years of supervised release, ordered $315,704.52 in restitution, and ordered forfeiture of $125,000. The Eleventh Circuit affirmed on all issues except restitution, which it vacated and remanded.
Remand instructions
Vacate the restitution award and conduct further proceedings consistent with the opinion. The judgment is affirmed in all other respects, including the conviction, sentence, and forfeiture order.