United States v. Hugh Willett
2014 U.S. App. LEXIS 8351
| 5th Cir. | 2014Background
- Willett was convicted by a bench trial on one count of conspiracy to commit health-care fraud (18 U.S.C. §1349) and six counts of aiding and abetting health-care fraud (18 U.S.C. §1347 & §2); he received a 41-month sentence, bottom of the guidelines range.
- JS&H Orthopedic was a DME supplier; Willett was closely associated with ownership via appearances and signings, and TOPS was another entity joined to their scheme.
- The government alleged upcoding of three items (hip abduction pillow, walking boots, basic wrist braces) to obtain higher reimbursements, plus forged LMNs and similar fraud across JS&H and TOPS.
- Willett’s duties included delivering DME, handling delivery tickets, signing employer and Medicare documents, and depositing/reviewing checks, placing him in a position to know of the fraudulent codes and profits.
- Evidence relied on circumstantial proof: family/partnership ties, joint bank accounts, supervisory interactions, and Canady’s testimony showing Willett’s awareness and response to concerns about billing.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Sufficiency of knowledge for conspiracy and health-care fraud | Willett argues insufficient knowledge of Mrs. Willett’s coding | The government’s circumstantial evidence supports knowledge and intent | Evidence supports knowledge beyond a reasonable doubt |
| Exclusion of polygraph evidence under Rule 403 | Polygraph results were probative and harmless error analysis should apply | Exclusion prejudiced defense by restricting witness impressions | Exclusion was harmless error in light of total evidence |
| Abuse-of-trust enhancement under § 3B1.3 | Willett did occupy a position of trust but contends insufficiently to significantly facilitate | Willett’s position and actions significantly facilitated the fraud | District court properly applied the abuse-of-trust enhancement |
Key Cases Cited
- United States v. Grant, 683 F.3d 639 (5th Cir. 2012) (elements of conspiracy and knowledge inferred from circumstances)
- United States v. Delgado, 668 F.3d 219 (5th Cir. 2012) (conspiracy proof may be circumstantial)
- United States v. Imo, 739 F.3d 226 (5th Cir. 2014) (knowledge for health-care fraud may be inferred from circumstances)
- United States v. Girod, 646 F.3d 304 (5th Cir. 2011) (knowledge and intent required for §1347/1349 convictions)
- United States v. Read, 710 F.3d 219 (5th Cir. 2012) (ownership and control evidence supports conspiracy/fraud)