United States Ninth Circuit

Following defendants' convictions of conspiracy to commit health care fraud, health care fraud, and the submission of fraudulent bills to Medicare, the district court's findings regarding the amount of loss are reversed and the matter is remanded for resentencing, where: 1) in health care fraud cases, the amount billed to an insurer shall constitute prima facie evidence of intended loss for sentencing purposes, and if not rebutted, shall constitute sufficient evidence to establish the intended loss by a preponderance of the evidence, but the parties may introduce additional evidence to support arguments that the amount billed overestimates or understates the defendant's intent; 2) here, the record is uncertain as to what the district court understood the law to be; and 3) the evidence is sufficient to support the district court's finding that defendant Popov's bills to Medicare were foreseeable to defendant Prakash.

Appellate Information

• Decided 02/11/2014
• Published 02/11/2014

Judges

• LASNIK

Court

• United States Ninth Circuit

Counsel