Wednesday, February 21, 2007

Medicare Fraud and Loss Amounts

United States v. Austin, No. 05-30602 (5th Cir. Feb. 13, 2007) (Garza, Prado, Owen)

If you enjoy reading opinions about Medicare fraud and associated loss amount calculations, then you'll love Austin. Here's the court's summary:
In this Medicare fraud case, the defendant pleaded guilty to violating 18 U.S.C. ยง 1347. He was sentenced to 27 months imprisonment and restitution of more than $2 million. The principal issues on appeal are (1) whether assets pledged after the offense was discovered should be credited in calculating the amount of loss; (2) the effect of payments made and assets pledged as a result of bankruptcy proceedings filed before discovery of the offense; and (3) whether $643,388 representing pension plan benefits that were funded before the loss was discovered should have been credited in determining the amount of loss. Weconclude that the district court properly construed and applied the Guidelines, except for the failure to credit $643,388 in calculating the loss. We accordingly vacate the order of restitution and remand for resentencing.

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