600 F. App'x 225
5th Cir.2015Background
- Elliott was convicted of health care fraud and conspiracy; district court sentenced him to 84 months and ordered restitution of $561,934.12.
- The jury convicted on seven counts, but did not adjudicate restitution or Medicare loss; restitution was set at sentencing.
- The district court found intended loss of $1,713,716 (the billed amount) to apply a 16-level sentencing enhancement.
- Elliott argues Sixth Amendment right to jury verdict on restitution amount and that intended loss should reflect Medicare’s actual payment, not billed amount.
- The panel cites Apprendi/Southern Union/Alleyne but follows Rosbottom and Read, holding Apprendi does not require jury findings for restitution in this circuit.
- Court affirms the district court’s loss determination and the resulting sentence.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Does restitution amount require a jury finding beyond a reasonable doubt? | Elliott (Elliott) argues jury must find restitution amount beyond a reasonable doubt. | Elliott contends Sixth Amendment applies; district court’s finding based on preponderance is improper. | No; Sixth Amendment does not require jury finding for restitution per circuit precedent. |
| Was the intended loss properly determined for the sentencing enhancement? | Elliott claims the intended loss should reflect Medicare’s actual reimbursement, not billed amounts. | Gov’t contends prima facie evidence from billed amounts supports intended loss; other evidence may rebut. | district court’s intended-loss finding was not clearly erroneous; reliance on billed amounts upheld. |
| Does Apprendi apply to restitution in this circuit after Rosbottom/Read? | Elliott relies on Apprendi to argue restitution must be jury-determined. | Rosbottom and Read control; Apprendi does not apply to restitution. | Restitution need not be jury-determined; Apprendi does not apply here. |
Key Cases Cited
- Apprendi v. New Jersey, 530 U.S. 466 (2000) (any fact increasing penalty beyond statutory maximum must be tried to a jury)
- Southern Union Co. v. United States, 132 S. Ct. 2344 (2012) (applies to fines and informs jury requirement to determine maximum penalties)
- Alleyne v. United States, 133 S. Ct. 2151 (2013) (extends Apprendi to mandatory-minimum enhancements)
- United States v. Rosbottom, 763 F.3d 408 (2014) (Apprendi does not apply to restitution; panel recognizes potential tension with Supreme Court dicta)
- United States v. Read, 710 F.3d 219 (2012) (Apprendi does not apply to restitution in this circuit)
- United States v. Valdez, 726 F.3d 684 (2013) (district court erred by ignoring evidence rebutting prima facie intended loss from billed amount)
- United States v. Usman, 460 F. App’x. 414 (2012) (no witness testified to defendant’s knowledge; reaffirmed use of billed amount as intended loss under certain evidence)
- United States v. Isiwele, 635 F.3d 196 (2011) (loss calculation under Guidelines; prima facie evidence standard for intended loss)
