Wednesday, August 21, 2013

11th Circuit Reverses Health Care Fraud Conviction

In an unpublished opinion by the 11th Circuit, the court  in United States v. Reddy reversed and remanded a conviction coming out of a 7 day trial that started with a 37 count Indictment and had convictions for all but five wire fraud counts.  This health care case included counts of mail fraud, wire fraud, health care fraud, and falsifying records in a federal investigation.  At the heart of the reversal is a Daubert claim. Looking at the proposed expert's qualifications, reliability of the methodology, and relevance, the cout found that the error was not harmless in that what the expert "had to say about his peer review and accuracy of the work performed by" the accused "was highly probative and would have likely been helpful to the jury."

The court did note that the Indictment should not have been dismissed premised upon another argument made by the defendant. The court said that Section 1347 is a federal offense and "the underlying conduct must have an interstate nexus or other 'jurisdictional hook.'"  But the court noted that the "Indictment's language generally tracks the statutory language" and therefore "is sufficient to withstand a motion to dismiss."

The defense in this case was handled by the Altanta, Georgia law firm of Kish and Lietz.

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http://lawprofessors.typepad.com/whitecollarcrime_blog/2013/08/11th-circuit-reverses-health-care-fraud-conviction.html

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