United States v. John Natale
2013 U.S. App. LEXIS 11765
| 7th Cir. | 2013Background
- Natale, a vascular surgeon, was indicted for health care fraud, mail fraud, and false statements related to Medicare billing and operative reports.
- Government claimed Natale submitted higher-reimbursing codes for complex bifurcation grafts while performing simpler tube-graft repairs below the renal arteries.
- Government relied on CT-scan vs operative-report comparisons and expert testimony to show discrepancies between described procedures and actual grafts.
- Natale defended with the Rush Technique, a non-billed, non-CT-visible method, claiming it as a functional equivalent affecting how codes should be chosen.
- District court instructed jury on false statements counts in a manner that allowed conviction for statements not strictly tied to health-care benefits, and allowed demonstratives in deliberations.
- Jury acquitted Natale on health care fraud and mail-fraud counts but convicted on the false statements counts; court sentenced Natale, and appeal followed focusing on jury instructions and evidentiary rulings.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Was the § 1035 instruction missing the health care benefit program element reversible error? | Natale | Natale | Harmless error; conviction affirmed |
| Was the materiality element properly limited to the health care program in § 1035? | Natale | Natale | Harmless error; conviction affirmed |
| Must § 1035 false statements require specific intent to deceive? | Natale | Natale | No specific intent requirement |
| Did the district court's allowance of demonstratives in the jury room prejudice Natale? | Natale | Natale | No reversible prejudice; not abuse of discretion |
| Did exclusion of the HHS report require reversal? | Natale | Natale | Harmless error; no reversal |
Key Cases Cited
- Neder v. United States, 527 U.S. 1 (1999) (omission of element analyzed under harmless-error)
- United States v. Griggs, 569 F.3d 341 (7th Cir. 2009) (harmless error for omitted elements or misstatements)
- United States v. Olano, 507 U.S. 725 (1993) (waiver vs plain error standard)
- United States v. Ranum, 96 F.3d 1020 (7th Cir. 1996) (no specific intent to deceive in similar false-statements context)
- United States v. Yermian, 468 U.S. 68 (1984) (discussed intent vs. materiality in false statements)
- Kungys v. United States, 485 U.S. 759 (1988) (materiality in false statements linked to decision-making)
- United States v. Hunt, 521 F.3d 636 (6th Cir. 2008) (materiality tied to health-care program in § 1035 context)
- United States v. Klein, 543 F.3d 206 (5th Cir. 2008) (materiality requirements for health-care program statutes)