United States v. Lopez-Diaz
940 F. Supp. 2d 39
D.P.R.2013Background
- Dec. 21, 2011 grand jury returned a superseding indictment charging JLD and CLD with health care fraud, conspiracy, and aggravated identity theft, plus a forfeiture allegation.
- May 14, 2012 trial began; at close of government case CLD and JLD moved for acquittal under Rule 29; motions renewed after evidence ended.
- June 14, 2012 jury found JLD and CLD guilty of conspiracy and multiple health care fraud and identity theft counts; JLD also faced 28 health care fraud counts.
- September–October 2012, defendants filed Rule 29 and Rule 33 motions challenging the verdict and requesting new trials.
- Court analyzed sufficiency of evidence for health care fraud and conspiracy, then addressed aggrav. identity theft, aiding and abetting, and Rule 404(b) issues, denying motions.
- Court concluded the government presented sufficient evidence to sustain convictions and denied motions for acquittal and new trial.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Sufficiency of evidence for health care fraud (counts 2–9, 10–19, 21–29) | Government: evidence shows false Medicare claims and intent to defraud. | JLD; CLD: insufficient evidence of billing or intent. | Sufficiency established; convictions upheld. |
| Conspiracy to commit health care fraud (count 1) | There was a valid agreement and overt acts. | Arguments about requires enrichment or failed agreement. | Sufficient evidence of agreement and overt acts; conspiracy upheld. |
| Aggravated identity theft and aiding and abetting | Evidence shows use of patient identifiers to bill Medicare. | CLD/JLD lacked direct participation or knowledge; forced to rely on association. | Sufficient evidence for both liability theories; convictions affirmed. |
| Rule 404(b) admissibility of family-treatment acts | Evidence of treating family members shows common scheme to defraud. | Acts improperly character evidence. | Admissible as part of common scheme to defraud; denial of motions preserved. |
| Exhibit list and trial preparation fairness | Discovery and designations provided; no ambush. | Defendants lacked certain documents; argued trial ambush. | No reversible error; motions denied. |
Key Cases Cited
- United States v. Lara, 181 F.3d 183 (1st Cir.1999) (standards for reviewing sufficiency of evidence)
- United States v. Savarese, 686 F.3d 1 (1st Cir.2012) (favorable-view of evidence for government)
- United States v. Soler, 275 F.3d 146 (1st Cir.2002) (standard for sufficiency after credibility assessments)
- United States v. Aviles-Colon, 536 F.3d 1 (1st Cir.2008) (admissible evidence considerations on Rule 29/33)
- United States v. Merlino, 592 F.3d 22 (1st Cir.) (standard for granting Rule 33 new trials; weight of evidence)
- United States v. Turn, 707 F.3d 68 (1st Cir.2013) (conspiracy requires agreement and overt acts; may be proved by circumstantial evidence)
- United States v. Rodriguez-De Jesus, 202 F.3d 482 (1st Cir.2000) (rare use of new trial to prevent miscarriage of justice)
- United States v. Gonzalez-Gonzalez, 136 F.3d 6 (1st Cir.1998) (new trial rarely granted; heavy weight against verdict must be shown)
- Valerio v. United States, 676 F.3d 237 (1st Cir.2012) (knowledge element may be proven by circumstantial evidence)