United States v. Delgado
2012 U.S. App. LEXIS 1100
| 5th Cir. | 2012Background
- Delgado, a medical-billing expert, owned Med Comp Electronic Billing and helped form Synergy in 2002 with Rael and Dr. Solis to provide group psychotherapy billed to Medicaid/Medicare.
- Dr. Solis supervised care but did not conduct or supervise the group sessions; Rael conducted sessions and used Solis's billing numbers; Delgado handled billing and split proceeds.
- Rael received 70% of proceeds and Delgado 30%; Medicaid/Medicare paid about $1.4 million for Synergy therapy from 2002–2005.
- The 'therapy' billed as group therapy was ineligible; sessions were often basic activities, and Delgado learned to circumvent limits using a billing modifier to bill multiple sessions per day.
- Delgado was involved in organizational control, lineage of staff decisions, and challenged investigators; after investigation, a ten-count indictment followed, and she was convicted on all counts with a sentence of 51 months and restitution; she appealed on multiple grounds.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Sufficiency of the evidence | Delgado argues the evidence is insufficient for fraud, conspiracy, and false statements. | Delgado contends the government failed to prove mens rea and elements. | Evidence sufficient to sustain conviction on all counts. |
| Admission of newsletters and manuals | Delgado argues manuals/newsletters were irrelevant and prejudicial. | Government argues materials were relevant to knowledge and regulatory violations and properly limited. | Not reversible error; admission deemed harmless with limiting instruction. |
| Deliberate indifference instruction | Delgado claims instruction relieved government of proving actual knowledge. | Delgado relied on lack of knowledge defense; evidence supports deliberate indifference. | Instruction upheld; supported by trial record. |
| Obstruction of justice enhancement | Delgado challenges enhancement for contacting a juror. | Government contends willful contact demonstrated obstruction. | Enhancement affirmed; not clearly erroneous. |
| Denial of post-trial juror contact | Delgado appeals denial of post-trial juror contact under Sixth Amendment. | Judge acted within discretion; no juror misconduct shown. | Denial affirmed; court did not err. |
Key Cases Cited
- United States v. Stephens, 571 F.3d 401 (5th Cir. 2009) (standard for reviewing sufficiency of evidence)
- United States v. Holmes, 406 F.3d 337 (5th Cir. 2005) (evidence need not preclude all innocence)
- United States v. Ferguson, 211 F.3d 878 (5th Cir. 2000) (free to choose among reasonable inferences)
- United States v. Garza-Robles, 627 F.3d 161 (5th Cir. 2010) (conspiracy may be inferred from circumstantial evidence)
- United States v. Mitchell, 484 F.3d 762 (5th Cir. 2007) (direct evidence not required; infer from circumstances)
- United States v. Moreno, 185 F.3d 465 (5th Cir. 1999) (deliberate ignorance instruction appropriate with sufficient facts)
- United States v. Nguyen, 493 F.3d 613 (5th Cir. 2007) (standard for evaluating jury instructions)
- Salinas v. Rodriguez, 963 F.2d 791 (5th Cir. 1992) (post-trial juror contact considerations; discretion)