Com. v. Usanga, P.
Com. v. Usanga, P. No. 2349 EDA 2015
Pa. Super. Ct.Aug 16, 2017Background
- Patrick Usanga, a U.S. citizen with a foreign medical degree, incorporated Northeast Behavioral Medicine and operated a psychiatric clinic without a valid Pennsylvania license; he was the facility’s sole provider.
- Usanga billed insurers (Aetna, Blue Cross) using psychotherapy CPT codes for services he was not licensed to provide; insurers paid tens of thousands of dollars which Usanga deposited into his bank account.
- During the same period Usanga collected unemployment benefits ($52,000 determined overpaid) and Social Security disability payments (about $16,108 later reduced), despite representing he was unable to work.
- DPW revoked his clinic license after finding the facility failed to meet statutory staffing and psychiatrist-hour requirements.
- Criminal information charged Usanga with multiple counts including insurance fraud, tampering with public records, theft by deception, attempted theft, harassment, and making a false statement on an unemployment claim; a jury convicted him on most counts.
- Sentenced to an aggregate 6–12 years’ imprisonment plus five years’ probation, Usanga appealed raising: (1) denial of severance of harassment counts; (2) denial of mistrial for references to post-arrest silence; (3) improper admission of unauthenticated documents; and (4) excessive sentence outside guidelines.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether trial court erred in denying severance of harassment counts | Commonwealth: harassment evidence was admissible and probative of the insurance-fraud scheme | Usanga: harassment counts were unrelated and prejudicial if tried with economic crimes | Denial affirmed—harassment evidence relevant to billing claim, separable by jury, no undue prejudice |
| Whether mistrial was required for Commonwealth references to post-arrest silence | Commonwealth: references were brief, not exploited, and cured by instruction | Usanga: references violated Fifth Amendment and warranted mistrial | Denial affirmed for one preserved reference (Scott); curative instruction cured any prejudice; other reference not preserved on appeal |
| Whether certain exhibits were improperly admitted without authentication | Commonwealth: custodial witnesses and statutory filing provisions authenticated insurer and unemployment records | Usanga: witnesses lacked firsthand knowledge of document creation so exhibits were unauthenticated | Denial affirmed—Aetna and Blue Cross employees and Detective testimony sufficiently authenticated insurer records; unemployment records authenticated under statutory filing rule |
| Whether sentence was excessive and unreasonable outside guideline ranges | Usanga: court failed to adequately explain deviation from sentencing guidelines | Commonwealth: court stated reasons tied to public protection, number/seriousness of offenses, lack of remorse and judicial disrespect | Denial affirmed—trial court provided detailed, on-record reasons (egregious conduct, ongoing risk, harm to public/patients), not an abuse of discretion |
Key Cases Cited
- Jordan v. Commonwealth, 65 A.3d 318 (Pa. 2013) (test for admissibility/severance of joined offenses)
- Moury v. Commonwealth, 992 A.2d 162 (Pa. Super. 2010) (factors for assessing whether curative instructions can cure references to post-arrest silence)
- Windslowe v. Commonwealth, 158 A.3d 698 (Pa. Super. 2017) (appellate standard of review for evidentiary rulings)
- McLaine v. Commonwealth, 150 A.3d 70 (Pa. Super. 2016) (sentencing court may deviate from guidelines but must state factual basis and reasons on the record)