Justia Public Benefits Opinion Summaries

Nita and Kirtish Patel operated two companies that provided mobile diagnostic medical services. To obtain Medicare reimbursement for neurological testing, they falsely represented that a licensed neurologist would supervise the tests. In reality, Kirtish, who lacked a medical license, wrote the reports, and Nita forged a physician’s signature. Their fraudulent scheme generated over $4 million, including substantial Medicare payments.In 2014, a former employee filed a sealed qui tam action in the United States District Court for the District of New Jersey, alleging healthcare fraud and asserting claims under the False Claims Act. The Patels were subsequently arrested and each pleaded guilty to one count of healthcare fraud. Their plea agreements did not address or preclude future civil or administrative actions. After their guilty pleas, the Government intervened in the qui tam action and obtained summary judgment against the Patels, relying on collateral estoppel from their criminal admissions. The District Court trebled the Medicare loss and imposed civil penalties, resulting in a judgment exceeding $7 million. Nita appealed, and the United States Court of Appeals for the Third Circuit affirmed her liability under the False Claims Act.Both Patels later moved to vacate their criminal sentences under 28 U.S.C. § 2255, arguing ineffective assistance of counsel because their attorneys did not advise them that their guilty pleas could have collateral estoppel effects in the civil qui tam action. The District Court denied their motions, finding that counsel’s performance was not objectively unreasonable and that the Patels were aware their plea agreements did not preclude civil actions.On appeal, the United States Court of Appeals for the Third Circuit held that the Sixth Amendment does not require criminal defense counsel to advise clients of collateral consequences such as civil liability under the False Claims Act. The court affirmed the District Court’s judgment, concluding that Padilla v. Kentucky’s holding is limited to deportation consequences and does not extend to civil liability. View "Patel v. USA" on Justia Law

The defendant, who had been receiving disability insurance benefits due to a medical diagnosis, operated a jewelry business while collecting these benefits. The Social Security Administration (SSA) began investigating after suspecting that the defendant was earning income that could affect his eligibility. The SSA asked the defendant whether he had worked or received income since his diagnosis, to which he responded negatively. However, evidence showed that he had significant gross income from jewelry sales, and the SSA determined that his countable income likely exceeded regulatory caps, making him ineligible for benefits. The defendant was subsequently charged with taking government property and making false statements.The United States District Court for the District of New Mexico presided over the trial. The government presented evidence of substantial gross income and efforts by the defendant to conceal earnings. The defendant did not provide information about business expenses that could have reduced his countable income. The jury convicted him on multiple counts related to theft of government property and false statements. At sentencing, the district court calculated the loss amount, including benefits paid to the defendant’s children and payments made outside the charged period, resulting in a 15-month prison sentence.The United States Court of Appeals for the Tenth Circuit reviewed the case. The court held that the evidence was sufficient for a reasonable jury to find that the defendant’s countable income exceeded the regulatory caps, even without detailed expense information, given the high gross income and lack of contrary evidence. The court also found no reversible error in the jury instructions, as the defendant failed to timely challenge the district court’s reasoning. Regarding sentencing, the court held that it was proper to include reasonably foreseeable payments to the defendant’s children and payments outside the charged period in the loss calculation. Any error in including Medicare premiums was deemed harmless. The convictions and sentence were affirmed. View "United States v. Sandoval" on Justia Law

The defendant was cited for a third offense of driving under the influence (DUI) and for driving with a suspended license, both misdemeanors, in November 2021. He was initially convicted in Justice Court and then sought a trial de novo in the District Court. At trial, a jury found him guilty of both offenses. During sentencing, the defendant’s counsel informed the court that the defendant was on a limited income, receiving disability and social security, and requested that the court consider his financial situation when imposing fines and fees, including a request to waive the public defender fee.After the jury verdict in the Twenty-First Judicial District Court, the court sentenced the defendant to jail time, most of which was suspended, and imposed a $3,000 fine with statutory surcharges and a $250 public defender fee. The written judgment also included a $10 technology fee and $50 in prosecution costs, which were not mentioned in the oral pronouncement. The defendant appealed, arguing that the written judgment conflicted with the oral sentence and that the court failed to consider his ability to pay the fines and fees.The Supreme Court of the State of Montana reviewed the case. It held that when there is a conflict between the oral sentence and the written judgment, the oral sentence controls, and thus the $10 technology fee and $50 prosecution costs should not have been included. The court further held that the District Court erred by failing to inquire into the defendant’s ability to pay the public defender fee, the $3,000 fine, and the statutory surcharges, as required by Montana statutes. The Supreme Court reversed the sentence and remanded the case for a new sentencing hearing consistent with its opinion. View "State v. Post" on Justia Law

The case concerns the fatal shooting of Brett Ness in Billings, Montana, following a series of drug-related disputes. Alexander Garrett LaForge III, along with several others, was involved in confrontations with Ness over an alleged shortfall in a methamphetamine transaction. After escalating tensions and threats, LaForge and a group of associates returned to Ness’s trailer, where LaForge shot Ness in the head with a .45 caliber pistol. Ness died later that day. Multiple co-defendants received plea deals in exchange for their testimony against LaForge.The Thirteenth Judicial District Court, Yellowstone County, presided over LaForge’s trial. LaForge requested a substitution of counsel shortly before trial, citing communication issues and dissatisfaction with his attorney’s preparation. The District Court conducted an inquiry and denied the request, finding no substantial breakdown in communication. During trial, LaForge also requested a cautionary jury instruction regarding the credibility of co-defendants’ testimony, which the District Court declined, instead providing standard witness credibility instructions and a specific instruction regarding one co-defendant’s accountability. The jury convicted LaForge of deliberate homicide. At sentencing, the court ordered LaForge to pay $72,000 in restitution to the victim’s mother for lost business income, based on her testimony about canceled jobs following her son’s death.The Supreme Court of the State of Montana reviewed the case. It held that the District Court did not abuse its discretion in denying LaForge’s request for substitute counsel or in its jury instructions regarding co-defendant testimony. However, the Supreme Court found that the $72,000 restitution award was not supported by sufficient evidence and that the record was unclear as to whether the victim’s mother, as a business representative, qualified as a “victim” under the restitution statutes. The Supreme Court affirmed the conviction and other aspects of the judgment, reversed the restitution award, and remanded for a new hearing to determine the proper amount and recipient of restitution. View "State v. LaForge" on Justia Law

Ronald Myers pleaded guilty in 2005 to possessing an implement for counterfeiting state securities and transporting a stolen motor vehicle across state lines. He was sentenced to 60 months in prison, 3 years of supervised release, and ordered to pay $40,406 in restitution. Myers completed his sentence in 2010 but was reincarcerated in 2013 on other charges. Since then, over $30,500 has been deposited into his inmate trust account, mostly from family and friends, with a smaller portion from prison wages. Myers still owes over $35,000 in restitution.The United States District Court for the Eastern District of Washington granted the government's motion to turn over funds from Myers's inmate trust account to apply to his restitution obligation. The court rejected Myers's request for an evidentiary hearing to determine which funds were prison wages, concluding that the government had provided sufficient evidence of the account's composition. The court held that the Mandatory Victims Restitution Act (MVRA), 18 U.S.C. § 3664(n), applies to substantial aggregated sums from multiple sources, not just one-time financial windfalls.The United States Court of Appeals for the Ninth Circuit affirmed the district court's order. The court held that § 3664(n) applies to substantial resources from any source, including gradual accumulations from family and friends, and not just to one-time windfalls. The court also found that the district court did not abuse its discretion in declining to hold an evidentiary hearing, as the existing documentary evidence was sufficient. The court concluded that the turnover order did not contravene the judgment's restitution provisions and was consistent with the MVRA's goal of ensuring prompt restitution to victims. View "United States v. Myers" on Justia Law

William Dexter Lucas was involved in schemes to fraudulently obtain small-business loans from the government and vehicle loans from private institutions. He pleaded guilty to conspiracy to commit bank and wire fraud and waived his right to appeal. His presentence investigation report (PSR) included details of his fraudulent activities and mentioned allegedly fraudulent social security benefits he had been receiving. At sentencing, the district court ordered Lucas to pay restitution to both the private institutions and the Social Security Administration (SSA). Lucas appealed his sentence, challenging the restitution orders for the vehicle loans and social security benefits.The United States District Court for the Southern District of Texas initially handled the case. Lucas objected to the PSR's restitution calculations, arguing that the vehicle loans restitution was ordered to the wrong victim and incorrectly calculated, and that the social security benefits restitution was improper because he was entitled to the benefits and the alleged fraud was not part of the same scheme as the offenses in his indictment. The district court recalculated the vehicle loans restitution but upheld the SSA restitution, finding that Lucas's statement to the SSA was fraudulent and that the SSA fraud was part of the same conduct as the fraud alleged in the indictment.The United States Court of Appeals for the Fifth Circuit reviewed the case. The court held that the SSA restitution was erroneous because the SSA fraud was not part of the same scheme or conspiracy as the offenses in the indictment. The court affirmed the vehicle loans restitution, finding that Lucas's challenge to the calculation was barred by his appeal waiver and that the dealerships were proper victims. The court affirmed the vehicle loans restitution but vacated the SSA restitution award. View "United States v. Lucas" on Justia Law

Kenneth Pontz was convicted by a jury of violating a federal embezzlement statute, 18 U.S.C. § 641, by misrepresenting his financial situation to obtain public benefits over an eight-year period. The government presented evidence that Pontz had received Supplemental Security Income (SSI) benefits by falsely claiming he lived alone, while he actually lived with his wife, who received Social Security Disability Insurance (SSDI) benefits. Pontz's misrepresentations allegedly began in 2004 and continued until 2020.The United States District Court for the District of Massachusetts denied Pontz's motion to dismiss the indictment, which argued that the statute of limitations barred charges for conduct occurring before June 16, 2017. The district court ruled that § 641 embezzlement was a "continuing offense," allowing the government to charge Pontz for conduct dating back to 2014. At trial, the court admitted testimony from an SSA employee, Luis Aguayo, as lay opinion under Federal Rule of Evidence 701, despite Pontz's objections that it was based on technical knowledge requiring expert testimony.The United States Court of Appeals for the First Circuit reviewed the case and held that § 641 embezzlement is not a continuing offense under the standard established in Toussie v. United States. The court found that the nature of embezzlement does not involve a renewed, daily threat of harm once the elements of the crime are complete. Consequently, the government could not charge Pontz for embezzlement occurring more than five years before his indictment. The court vacated the restitution and forfeiture orders and remanded to the district court to determine the appropriate remedy for the statute-of-limitations error. The court upheld the district court's evidentiary rulings regarding Aguayo's testimony. View "United States v. Pontz" on Justia Law

Rhonda and Robert Notgrass fraudulently obtained benefits from the Pandemic Unemployment Assistance program by falsely claiming unemployment due to the COVID-19 pandemic. Robert, a minister, and Rhonda, his wife, were ineligible for these benefits as Robert was fired for reasons unrelated to the pandemic, and Rhonda had not lost her job. They both pleaded guilty to misdemeanors and were sentenced to probation by the district court.The United States District Court for the Southern District of West Virginia sentenced the Notgrasses to five years of probation, including several conditions. The Notgrasses appealed four of these conditions: obtaining permission before leaving their judicial district, prohibition on possessing dangerous weapons, registering with an unemployment agency, and Robert's participation in a supervised mental-health treatment program. They argued that these conditions were both procedurally and substantively unreasonable.The United States Court of Appeals for the Fourth Circuit reviewed the case. The court first determined that the Notgrasses' appellate waiver did not cover challenges to probation conditions, allowing the appeal to proceed. On the merits, the court found that the district court had adequately explained the conditions in light of the Notgrasses' objections. The travel-permission and weapons prohibition conditions were standard and self-evident, while the unemployment registration and mental-health treatment conditions were tailored to the Notgrasses' specific circumstances. The court held that all four conditions were reasonably related to the § 3553(a) sentencing factors and were not an abuse of discretion.The Fourth Circuit affirmed the district court's sentences, finding the probation conditions both procedurally and substantively reasonable. View "US v. Notgrass" on Justia Law

Montreal Morgan participated in a home invasion robbery that resulted in the death of Fabian Alvarez. Following the incident, the Department of Labor and Industries (L&I) paid $10,480 in benefits under Washington’s Crime Victims Compensation Act (CVCA) for Alvarez’s medical and funeral expenses. Morgan pleaded guilty to conspiracy to commit murder in the second degree and unlawful possession of a firearm in the second degree. At his restitution hearing, Morgan requested a reduction in the restitution amount due to mitigating factors, but the trial court believed it lacked discretion under RCW 9.94A.753(7) and ordered the full amount of restitution requested by the State.The trial court’s decision was affirmed by the Court of Appeals, which agreed that RCW 9.94A.753(7) does not afford trial courts discretion to impose less restitution than the amount of CVCA benefits paid. Morgan then petitioned for review, which was granted by the Supreme Court of the State of Washington.The Supreme Court of the State of Washington held that RCW 9.94A.753(7) does not allow a trial court discretion to modify the amount of restitution owed to L&I for CVCA benefits. The court emphasized that the statutory language is unambiguous and requires the court to order restitution in the amount of benefits paid by L&I. The court affirmed the Court of Appeals' decision and upheld Morgan’s restitution order, concluding that the trial court correctly interpreted the statute as mandating full restitution for CVCA benefits without discretion for reduction based on mitigating factors. View "State v. Morgan" on Justia Law

Four elderly sisters were accused of defrauding the United States by falsely claiming benefits under two federal programs. Each sister pled guilty to one count of conspiracy, preserving the right to appeal two pretrial rulings: the denial of a motion to suppress evidence and the denial of a motion to dismiss the indictment for untimeliness.The United States District Court for the Eastern District of Arkansas denied the motion to suppress, ruling that the sisters lacked standing to challenge the search of a property because they had no possessory interest in it. The court also found that even if the search was unconstitutional, the affidavits supporting the search warrants still provided probable cause. The motion to dismiss the indictment was denied because the court held that the statute of limitations for mail fraud begins on the date of mailing, not the date of the last overt act.The United States Court of Appeals for the Eighth Circuit reviewed the case. The court affirmed the district court's denial of the motion to suppress, agreeing that the affidavits were sufficient to support the search warrants even without the contested information. The court also affirmed the denial of the motion to dismiss, stating that the aiding and abetting mail fraud charges were filed within the five-year limitations period. Additionally, the court found no abuse of discretion in the district court's decision not to hold an evidentiary hearing on the motions, as the alleged disputes of fact were immaterial to the legal conclusions.The Eighth Circuit affirmed the district court's rulings, upholding the convictions and sentences of the four sisters. View "United States v. Charles" on Justia Law