Florida Court Discusses Sentences in Medicaid Fraud Cases

Although white-collar crimes are not implicitly violent, they are often harshly penalized due to the financial losses they frequently cause. It is not uncommon for convictions for such offenses to result in years of imprisonment, as demonstrated in a recent Florida Medicaid theft case in which the court ultimately rejected the defendant’s challenge to his sentence. If you are accused of theft, it is prudent to talk to a Sarasota theft crime defense lawyer about your options for seeking a positive outcome.

 

History of the Case

 

Allegedly, the defendant worked for a company that provided medical billing and credentialing services, giving him access to financial, medical provider, and patient information. He was tasked with submitting claims to Florida Medicaid for services rendered by a specific physician. Between February 2017 and October 2018, the defendant allegedly submitted around 1,700 fraudulent claims, resulting in a payment of over $2.25 million. The defendant did not report or underreported these fraudulent earnings to the IRS, leading to a total tax loss of close to $800,000 over the tax years 2017-2019. Additionally, from April 2019 to September 2019, the defendant worked for another company, diverting over $55,000 into his personal account and underreporting this income on his 2019 tax return.

 

It is reported that the defendant was charged with and pleaded guilty to multiple counts of defrauding a healthcare benefits program, aggravated identity theft, and failing to file an income tax return, as well as a count of filing a fraudulent tax return. A presentence investigation report grouped his offenses into two main categories: healthcare fraud and tax offenses, with separate adjustments for each group’s offense level. The district court sentenced the defendant to a total of 65 months’ imprisonment, with a three-year term of supervised release and a set of standard conditions for supervised release, including Standard Condition 12, which the defendant did not object to initially. The defendant then appealed his sentence.

Sentences in Medicaid Fraud Cases

On appeal, the court affirmed the defendant’s sentence. The court first addressed the defendant’s argument that his fraud and tax offenses should have been grouped together under certain provisions of the sentencing guidelines, which he claimed would have resulted in a lower offense level. The court found that the language of the provision in question was ambiguous and referred to the guidelines’ commentary and previous case law to resolve this ambiguity.

In doing so, the court ultimately determined that the fraud and tax offenses were not of the same general type and involved different victims (Medicaid and the IRS, respectively) and that the offenses were factually distinct and involved independent behaviors. Therefore, the court upheld the district court’s decision not to group these offenses together.

The defendant also challenged Standard Condition 12 of his supervised release as an unconstitutional delegation of judicial authority, arguing it improperly allowed the probation officer to determine whether he must notify third parties of any risk he might pose. The appellate court reviewed this argument for plain error, given that the defendant did not object to this condition at sentencing.

The court found that the condition did not constitute an unconstitutional delegation because it merely allowed the probation officer to manage the details of notification rather than determine whether the defendant was subject to the condition itself. Thus, the appellate court found no plain error in the imposition of Standard Condition 12. Ultimately, the appellate court affirmed the district court’s judgment, upholding the sentencing and the conditions of supervised release imposed on the defendant.

Meet with an Experienced Sarasota Criminal Defense Attorney.

If you are charged with a theft crime, it is in your best interest to meet with an attorney to evaluate your potential defenses. The experienced Sarasota theft defense attorneys at Hanlon Law can evaluate your case and advise you of your options for seeking the best outcome available. You can reach Hanlon Law via our online form or by calling  941.462.1789 to set up a conference.