Summary
This Fourth Circuit opinion affirms the conviction of Donald Booker for conspiracy to commit health care fraud, paying illegal kickbacks, and money laundering related to a scheme that billed North Carolina’s Medicaid program for medically unnecessary drug tests. The court rejected Booker’s challenges regarding the sufficiency of the evidence, the constitutionality of the Anti-Kickback Statute under the nondelegation doctrine, and alleged double jeopardy concerns under the money-laundering statute. Additionally, the appellate court upheld the district court’s evidentiary rulings concerning an administrative audit and its findings. The judgment of the district court was affirmed.
Topics
Practice areas
Questions Presented
- Whether sufficient evidence supported Booker's conspiracy conviction despite his arguments that he did not personally bill Medicaid, did not receive Medicaid payments directly, and was not linked to the medically unnecessary testing orders.
- Whether sufficient evidence supported Booker's five convictions for paying illegal kickbacks under the Anti-Kickback Statute.
- Whether the Anti-Kickback Statute violates the nondelegation doctrine.
- Whether Booker's concealment-money-laundering convictions presented a merger or double-jeopardy problem under United States v. Santos.
- Whether the district court abused its discretion or violated the Confrontation Clause by admitting evidence concerning an adverse administrative ruling and evidence of a $1 million transfer between United Youth's account and Booker's personal account.
- Whether the district court clearly erred in calculating the loss amount under U.S.S.G. § 2B1.1.
- Whether Booker's 200-month sentence was substantively unreasonable because of alleged disparities with his codefendants and his personal characteristics.
Holdings
- The evidence was sufficient for a rational jury to find that Booker knowingly joined and participated in a conspiracy to defraud the United States, commit health care fraud, and pay illegal kickbacks. A conspiracy defendant may be held responsible for fraudulent acts committed by coconspirators in furtherance of the common plot even if the defendant did not personally submit the claims.
- The evidence was sufficient to support Booker's convictions for paying illegal kickbacks to Legacy Housing.
- The Anti-Kickback Statute does not violate the nondelegation doctrine because Congress supplied an intelligible principle and standards guiding the Department of Health and Human Services' regulatory discretion.
- Booker's concealment-money-laundering convictions did not present the merger problem discussed in Santos. The amended money-laundering statute defines proceeds to include gross receipts, and Booker's concealment conduct was distinct from the conduct necessary to execute the Medicaid fraud scheme.
- The district court did not abuse its discretion in admitting evidence concerning the adverse administrative ruling or the $1 million bank transfer, and the admissions did not violate the Confrontation Clause.
- The district court did not clearly err in finding a loss exceeding $9.5 million. Under controlling Fourth Circuit precedent, loss may be based on intended loss, and the more than $12 million billed to Medicaid supported the enhancement; the actual amount paid by Medicaid independently supported the calculation.
- Booker's 200-month sentence was substantively reasonable. A disparity with codefendants does not establish unreasonableness when the codefendants were not similarly situated, and the district court adequately considered the statutory sentencing factors and Booker's personal characteristics.
Key quotations
“Even if Booker didn’t personally submit fraudulent Medicaid claims, it’s blackletter law that a conspiracy defendant is “responsible for the acts of his co-conspirators in pursuit of their common plot.”” (10)
“We therefore reject Booker’s argument that the Anti-Kickback Statute violates the nondelegation doctrine.” (13)
“We therefore reaffirm that the loss amount for which a defendant is sentenced can be based on “the amount of loss [a defendant] intended to cause,” which here was the just over $12 million United Youth billed to Medicaid for medically unnecessary tests.” (23)
“We conclude that Booker’s sentence is substantively reasonable.” (25)
Factual background
Donald Booker owned and operated United Youth Care Services and a related drug-testing laboratory that billed North Carolina Medicaid for medically unnecessary drug tests. Booker established protocols requiring beneficiaries to undergo uniform testing twice weekly regardless of individual medical need and arranged kickback payments to entities that recruited Medicaid beneficiaries or supplied urine samples. United Youth billed Medicaid millions of dollars, paid approximately $124,000 to Do It 4 the Hood and nearly $1.5 million to Legacy Housing, and used misleading check descriptions and payment structuring to conceal the kickbacks and avoid reporting requirements. The scheme generated more than $9.5 million in loss for sentencing purposes.
Procedural history
A grand jury indicted Booker in the Western District of North Carolina. After a trial at which Booker represented himself with standby counsel, the jury convicted him on all ten counts. The district court denied his post-verdict motion for judgment of acquittal, calculated a Guidelines range of 210 to 262 months, and imposed a downward-variant 200-month sentence. The Fourth Circuit affirmed.