United States v. Mesquias, No. 20-40869 (5th Cir. 2022)Annotate this Case
The Fifth Circuit affirmed defendants' convictions and sentences for multiple counts of health care fraud and conspiracy stemming from their involvement in a scheme to falsely certify that patients were eligible for home health or hospice services. The court concluded that sufficient evidence supports defendants' convictions for health care fraud and conspiracy to commit that fraud. The court rejected defendants' contention that the government offered no proof that they knew the patients were ineligible for home health and hospice, and that the government did not prove the ineligibility of the six patients whose claims were listed as the substantive fraud counts. Rather, the record shows that defendants were intimately involved with the fraud, and that the certifications for all six patients were either outright lies or based on fabricated medical records.
The court also concluded that the district court properly calculated the loss amount when sentencing defendants. In this case, the district court found that defendants' fraud was pervasive and thus treated the entire amount that they billed to Medicare as the intended loss, enhancing defendants' offense levels by 24 points, resulting in an advisory Sentencing Guidelines range of life in prison pursuant to USSG 2B1.1.