Summary
The Fifth Circuit affirmed Shiva Akula’s convictions on twenty-three counts of health care fraud arising from fraudulent Medicare billing by his hospice company. The court rejected challenges concerning expert testimony, sufficiency of the evidence, and the constitutional and substantive reasonableness of his 240-month sentence.
Topics
Practice areas
Questions Presented
- Whether the district court abused its discretion or committed reversible error by declining to qualify Dr. Gregg Davis as an expert in Medicare billing and coding.
- Whether sufficient evidence established that Akula knowingly and willfully committed health care fraud.
- Whether Akula's 240-month upward-variance sentence was grossly disproportionate under the Eighth Amendment.
- Whether the above-Guidelines sentence was substantively unreasonable because the district court allegedly relied impermissibly on Akula's pretrial conduct, lack of remorse, failure to accept responsibility, and the amount of loss.
Holdings
- Any error in refusing to qualify Dr. Davis as an expert in Medicare billing and coding was harmless because there was no reasonable probability that the exclusion contributed to Akula's conviction.
- The evidence was sufficient for a rational jury to find beyond a reasonable doubt that Akula knowingly and willfully defrauded Medicare.
- Akula's 240-month sentence was not grossly disproportionate to the gravity of his health care fraud and therefore did not constitute clear or obvious Eighth Amendment error.
- The district court did not abuse its discretion in imposing a 52-month upward variance and a 240-month sentence because it adequately considered and explained the relevant 18 U.S.C. § 3553(a) factors.
Key quotations
“it is not the reviewing court’s role to ‘ask itself whether it believes that the evidence at the trial established guilt beyond a reasonable doubt,’” (10)
“Successful Eighth Amendment challenges are rare.” (13)
“it is not for the Court of Appeals to decide de novo whether the justification for a variance is sufficient or the sentence reasonable” (15)
Factual background
Akula owned and operated Canon Healthcare, LLC, a hospice company that billed Medicare for hospice services. Canon routinely billed patients at the higher general-inpatient-care rate and submitted additional claims under CPT codes for services allegedly not separately provided or already covered by hospice per diem payments. After Medicare audits in 2015 and 2017 identified pervasive billing failures and overpayments, Akula continued Canon's billing practices. Trial evidence showed that Akula controlled Canon's operations and billing personnel, received notice of the audit findings, and failed to correct the practices.
Procedural history
A federal grand jury indicted Shiva Akula on twenty-three counts of health care fraud under 18 U.S.C. § 1347. After a five-day jury trial, the jury convicted Akula on all counts. The district court denied his motions for judgment of acquittal and a new trial, imposed a 240-month above-Guidelines sentence, ordered restitution, and imposed supervised release. Akula appealed, challenging the exclusion of proposed expert testimony, the sufficiency of the evidence, and the sentence.