Summary
The Fifth Circuit affirmed Kristal Glover-Wing’s convictions for conspiracy to commit healthcare fraud and three counts of healthcare fraud involving fraudulent Medicare hospice reimbursement claims. The court held that sufficient evidence supported the convictions, including evidence that Glover-Wing knew the patients were not terminally ill and participated in a scheme involving medical directors and hospice staff. The court also held that judicial estoppel did not apply because Glover-Wing failed to establish the doctrine’s requisite factors, while leaving unresolved whether the government may be judicially estopped in a criminal case.
Topics
Practice areas
Questions Presented
- Whether the evidence was sufficient to support Glover-Wing's three convictions for healthcare fraud under 18 U.S.C. § 1347.
- Whether the evidence was sufficient to support Glover-Wing's conviction for conspiracy to commit healthcare fraud under 18 U.S.C. § 1349, including whether the acquittal of her alleged codefendants precluded her conviction.
- Whether the government should have been judicially estopped from arguing that ACH employees could be considered coconspirators based on alleged earlier representations concerning the scope of the conspiracy.
Holdings
- The evidence was sufficient for a rational trier of fact to find beyond a reasonable doubt that Glover-Wing knew the three patients were not terminally ill and willfully sought hospice certifications and Medicare reimbursements for them.
- The evidence was sufficient to support Glover-Wing's conspiracy conviction because a rational juror could find an agreement between her and the physicians to participate in Medicare fraud; the acquittal of the other alleged conspirators did not preclude her conviction.
- The court declined to decide whether judicial estoppel applies to the government in a criminal case or what standard of review governs a preserved claim, but held that Glover-Wing failed to establish the doctrine's requisite factors.
Key quotations
“Instead, it must determine “whether, after viewing the evidence in the light most favorable to the prosecution, any rational trier of fact could have found the essential elements of the crime beyond a reasonable doubt.”” (6)
“We further conclude that because Glover-Wing fails to establish the requisite factors to invoke judicial estoppel against the government, the doctrine is inapplicable to her case.” (14)
Factual background
Kristal Glover-Wing founded and operated Angel Care Hospice, a Medicare provider in Louisiana. The evidence showed that she recruited and compensated medical directors who certified patients as terminally ill even when their conditions and daily activities contradicted those certifications, and that she directed staff to maximize hospice eligibility, manipulate records, and reenroll patients to obtain Medicare reimbursement. Three patients formed the basis of the substantive healthcare-fraud counts, while the broader arrangement formed the basis of the conspiracy count.
Procedural history
A federal grand jury indicted Glover-Wing and two physicians for conspiracy to commit healthcare fraud and three substantive healthcare-fraud counts. After trial, the jury convicted Glover-Wing on all four counts and acquitted the physicians. The district court denied Glover-Wing's post-verdict motion for judgment of acquittal and motion for a new trial based on judicial estoppel. The Fifth Circuit affirmed.