United States v. Richard Hogan, 785 F.3d 1052

New Century, a Flint, Michigan clinic founded by Glenn English, billed Medicare for psychotherapy sessions that were not provided; patients received prescription drugs in exchange for signing a sign-in binder and false progress notes.
Clinic staff (social workers) fabricated progress notes and stamped dates; billing included impossible entries (sessions on closed holidays, >24 hours a day, groups exceeding Medicare limits).
FBI raided the clinic; English (CEO) and Richard Hogan (Programs Director) were indicted; jury convicted English of Medicare fraud and both of conspiracy to commit Medicare fraud; sentences: English 96 months, Hogan 60 months.
At trial the government introduced evidence that English had participated in two prior Medicare-fraud schemes; English objected under Fed. R. Evid. 404(b).
Hogan challenged sufficiency of evidence, alleged a variance between indictment and proof (arguing proof showed drug-distribution conspiracy), and objected to admission of two hearsay statements; court rejected these challenges.

Issue	Plaintiff's Argument	Defendant's Argument	Held
Admissibility of prior-bad-acts evidence (English)	Gov: prior schemes show knowledge/intent, not propensity; admissible under Rule 404(b)	English: prejudicial propensity evidence; probative value outweighed by unfair prejudice	Admission proper under abuse-of-discretion review; probative of intent/knowledge; limiting instruction given; harmless at worst
Sufficiency of evidence (Hogan)	Gov: presented evidence Hogan recruited patients, directed prescriptions, helped create fake notes, and admitted knowledge to FBI	Hogan: record insufficient to show he knowingly joined conspiracy	Sufficient evidence supports conspiracy conviction; record not "devoid" of guilt evidence
Variance between indictment and proof (Hogan)	Gov: proved conspiracy to commit Medicare fraud charged in indictment	Hogan: proof focused on drug-distribution scheme, not only Medicare fraud	Variance not shown to have affected substantial rights; conviction stands
Admissibility of two hearsay statements (Hogan)	Gov: statements were admissible or harmless in light of other evidence	Hogan: patient’s statement about loan and employee’s statement about sign-in were hearsay and should be excluded	Even if erroneous, admission was harmless given overwhelming other evidence

General Elec. Co. v. Joiner, 522 U.S. 136 (1997) (standard for reviewing evidentiary rulings)
United States v. De Oleo, 697 F.3d 338 (6th Cir. 2012) (prior similar misconduct probative of intent/knowledge)
United States v. Childs, 539 F.3d 552 (6th Cir. 2008) (harmless-error analysis for evidentiary rulings)
United States v. Frazier, 595 F.3d 304 (6th Cir. 2010) (standard for reviewing sufficiency when not renewed at close of trial)
United States v. White, 492 F.3d 380 (6th Cir. 2007) (elements for conspiracy: knowing and voluntary joining)
United States v. Robinson, 547 F.3d 632 (6th Cir. 2008) (variance doctrine requires showing prejudice to substantial rights)
Griffin v. Finkbeiner, 689 F.3d 584 (6th Cir. 2012) (harmless-error standard for nonconstitutional errors affecting verdict)
United States v. Mack, 729 F.3d 594 (6th Cir. 2013) (three-step 404(b) admissibility analysis)
United States v. Johnson, 27 F.3d 1186 (6th Cir. 1994) (404(b) and intent as a permissible purpose; caution on propensity inference)
United States v. Marrero, 651 F.3d 453 (6th Cir. 2011) (intrinsic evidence exception to Rule 404(b))
United States v. Adams, 722 F.3d 788 (6th Cir. 2013) (scope of intrinsic evidence: single episode or integral acts)
United States v. Bell, 516 F.3d 432 (6th Cir. 2008) (forbidden propensity inference from prior bad acts)