USA v. Carlos Alfredo Verdeza, No. 21-10461 (11th Cir. 2023)Annotate this Case
Defendant, a physician assistant, evaluated patients and prescribed their physical therapy. The clinics where Defendant worked then billed the patients' health insurance both for the evaluations and for the subsequent physical therapy. The problem—for Defendant and for the health-insurance company—was that the “patients” didn’t really need the physical therapy and didn’t actually receive any treatment. When the health insurance company grew suspicious of the abnormally high rate of physical-therapy prescriptions from the clinics, it cooperated with an FBI investigation into the clinics. That investigation led a grand jury to indict Defendant on eight healthcare fraud-related charges. After a trial, a jury convicted Defendant on three counts. On appeal, Defendant raised several challenges to his conviction—sufficiency, evidentiary, and instructional—and to his sentence.
The Eleventh Circuit affirmed. The court held that sufficient evidence allowed the jury to find beyond a reasonable doubt that Defendant knew the bills were fraudulent. Moreover, the court wrote that the minimal leading questions Defendant points to here do not allow Defendant to overcome the overwhelming evidence of his guilt at trial. Moreover, the court reasoned that here, the district court sentenced Defendant to 48 months— below his Guidelines range of 51–63 months. Given that Defendant had previously participated in very similar schemes, been investigated by the Florida regulatory board for similar conduct, and had attempted to defraud the victim of millions of dollars, the court could not say that the 48-month sentence the district court imposed—slightly below the Guidelines range—was an abuse of discretion.