MIRAN, MICHAEL, PEOPLE v
KA 12-01189
N.Y. App. Div.Apr 26, 2013Background
- AG investigated defendants for Medicaid and Medicare false billing and fraud claims.
- DOH Commissioner referred Medicaid fraud investigation to the AG under Exec Law §63(3) (1978 and 2002 referrals).
- Attorney General pursued a 31-count indictment charging Medicaid/Medicare fraud based on dual-eligible patients and false billing practices.
- Defendants pled guilty: Miran to offering a false instrument for filing in the second degree; Esta Miran to offering a false instrument for filing in the first degree; Corporation to grand larceny in the second degree with restitution.
- FBI/OIG involvement; AG continued as Medicaid Fraud Control Unit (MFCU) under OIG permission; convictions upheld on appeal.
- Court held that AG authority under Exec Law §63(3) extends to Medicare fraud connected to an authorized Medicaid investigation, and that §63(3) is not preempted by 42 U.S.C. §1396b(q)(3).
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether Exec. Law §63(3) authorizes AG to prosecute Medicare fraud arising from Medicaid investigation | People argues §63(3) permits broader investigation/prosecution. | Miran argues §63(3) prevents Medicare offenses within Medicaid investigations. | Yes; AG authorized to prosecute Medicare fraud connected to Medicaid investigation. |
| Whether §63(3) is expressly preempted by 42 U.S.C. §1396b(q)(3) | People contends no express preemption; permit use of Medicaid/MFCU power. | Miran contends express preemption exists. | No express preemption. |
| Whether conflict preemption defeats the AG’s prosecutorial authority | People maintains no conflict; authority remains. | Miran argues conflict preemption applies. | Impossibility form does not apply; impediment form does not apply; §63(3) coexists with §1396b(q)(3). |
| Whether the Impossibility form of conflict preemption applies | Not argued separately; court should consider. | N/A | Not applicable; compliance with both laws possible. |
| Whether the Impediment form of conflict preemption applies | N/A | N/A | Not applicable; §63(3) supports federal objectives and does not impede Congress’s purposes. |
Key Cases Cited
- People v Gilmour, 98 N.Y.2d 126 (N.Y. 2002) (prosecutorial authority limitations of the Attorney General)
- People v Cuttita, 7 N.Y.3d 500 (N.Y. 2006) (statutory authority to prosecute under specific statutes)
- Matter of Mann Judd Landau v Hynes, 49 N.Y.2d 128 (N.Y. 1979) (broad construction of Exec. Law §63(3))
- People v Zarro, 66 A.D.3d 1050 (1st Dep’t 2010) (interpretation of §63(3) aris[ing] out of" language)
- People v Young, 220 A.D.2d 872 (2d Dep’t 1995) (definition of 'arising out of' in §63(3))
- Arizona v United States, 567 U.S. 387 (2012) (Supremacy Clause preemption framework; general principle about preemption)
- Smith v Dunham-Bush, Inc., 959 F.2d 6 (2d Cir. 1992) (preemption analysis guidance among federal/state laws)
- Allis-Chalmers Corp. v. Lueck, 471 U.S. 202 (1985) (preemption principles; starting presumption against preemption)
- Cipollone v. Liggett Group, Inc., 505 U.S. 504 (1992) (preemption analysis framework)
- Bates v Dow AgroSciences LLC, 544 U.S. 431 (2005) (statutory interpretation and preemption considerations)
