United States v. Kathy Medlock, 792 F.3d 700

Medlocks owned Murfreesboro Ambulance Service (MAS) and billed Medicare for non-emergency transports to dialysis patients; Medicare requires a CMN and physician-backed medical necessity for reimbursement, plus run sheets reviewed by a Medicare contractor; investigations (AdvanceMed audit and OIG surveillance) revealed missing or forged CMNs and run tickets; defendants were indicted on conspiracy, health-care fraud, false statements, wire fraud, and aggravated identity theft counts; Kathy forged a physician's signature (CMNs) to obtain reimbursement for allegedly unnecessary transports; district court rejected some defense jury instructions and the Medlocks were convicted on most counts with some aggravated identity-theft counts later reversed on appeal; the court sentenced Woody to 75 months and Kathy to 70 months; on appeal the court reverses some convictions and affirms others, culminating in an amended opinion identifying Count 42 as Kathy’s aggravated identity-theft conviction that is affirmed; the hypothetical and statutory interpretations center on whether the misrepresentations about stretchers constituted “use” of identities and whether materiality and severance issues warrant reversal

Issue	Plaintiff's Argument	Defendant's Argument	Held
Does misrepresenting stretcher use constitute ‘use’ of identification under §1028A	Medlocks: no use since they transported the patients themselves	Government: misrepresentation uses names/numbers to obtain reimbursement	No use; reversed aggravated identity theft convictions for counts 40-41; Count 42 affirmed for Kathy
Should jury instructions require Medicare as the decision-maker for materiality	Medlocks urged materiality to Medicare, not a prudent person	Government urged standard materiality; no reversible error	No reversible error; materiality supported by trial evidence; instructions affirmed
Are the Medlocks guilty as a matter of law because Medicare would reimburse anyway	Medlocks claim CMN or medical necessity suffices; misrepresentations immaterial	Government argues misrepresentations were material to Medicare	Materiality found; convictions sustained apart from reversed ID theft counts
Was there sufficient evidence to support each remaining conviction			Sufficient evidence for false statements, health-care fraud, wire fraud, conspiracy; ID-theft counts reversed on appeal
Did the district court abuse its discretion by denying severance	Woody: sever counts to prevent prejudice from Kathy’s forgeries	Government: severance not warranted; evidence admissible against all	No abuse of discretion; no compelling prejudice shown

United States v. Miller, 734 F.3d 530 (6th Cir. 2013) (limits ‘use’ of means of identification under §1028A; signing in own name not sufficient)
United States v. Tevis, 593 F. App’x 473 (6th Cir. 2014) (unpublished; sufficiency discussion on use of third-party SSN; not controlling on meaning of ‘use’)
Abdelshafi v. United States, 592 F.3d 602 (4th Cir. 2010) (referred to as approving broader interpretation of ‘without lawful authority’)
Flores-Figueroa v. United States, 556 U.S. 646 (U.S. 2009) (clarified mens rea and scope of §1028A in fraud vs. theft context)
United States v. Lumbard, 706 F.3d 716 (6th Cir. 2013) (interpreted Flores-Figueroa; held ‘without lawful authority’ not limited to theft; discusses lawful authority)
Williams v. Taylor, 529 U.S. 362 (2000) (statutory construction principle: give effect to every clause)