United States v. Rose Essien
530 F. App'x 291
5th Cir.2013Background
- Rose Essien served as Logic World’s office administrator, overseeing records and Medicaid billing.
- Logic World billed Medicaid for diapers at maximum quantities; records and signatures were suspect or forged.
- Essien helped establish General Medtronics and later Roben Medical, seeking licenses and continuing billing.
- Evidence included Rose’s role in calls to Medicaid and signing/processing forms used to submit claims.
- In 2011, Rose was convicted on 11 health care fraud counts and 5 aggravated identity theft counts; acquitted on conspiracy and two fraud counts.
- Judgment ordered restitution totaling $1,455,837.91 jointly and severally with co-defendants.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Sufficiency of evidence for conviction | Essien asserts insufficient evidence of personal billing involvement. | Essien contends no active participation in fraud scheme. | Evidence sufficient; circumstantial proof supports convictions. |
| Involvement in Roben counts (Counts 11–13) | Essien argues lack of evidence of Roben participation. | Essien argues overarching scheme shows knowing involvement. | Sufficient circumstantial evidence of knowing involvement. |
| Plain error in restitution | Essien contends restitution exceeded acquitted scope. | Essien contends error should reverse restitution amount. | No plain error; restitution affirmed. |
| Scope of restitution under Maturin | Essien challenges broad scope given convictions | Essien relies on Maturin to limit scope. | Conviction of scheme element supports broad restitution. |
Key Cases Cited
- United States v. Pennington, 20 F.3d 593 (5th Cir. 1994) (sufficiency standard: review in light of Government evidence)
- United States v. Ismoila, 100 F.3d 380 (5th Cir. 1996) (circumstantial evidence supports fraud intent)
- United States v. Keller, 14 F.3d 1051 (5th Cir. 1994) (intent may be inferred from circumstances)
- United States v. Hickman, 331 F.3d 439 (5th Cir. 2003) (defining fraud schemes and intent)
- United States v. Adams, 363 F.3d 363 (5th Cir. 2004) (scope of restitution when fraud verdict exists)
- United States v. Maturin, 488 F.3d 657 (5th Cir. 2007) (restoration scope tied to scheme element under 18 U.S.C. § 3663A)
- United States v. Olano, 507 U.S. 725 (U.S. 1993) (plain-error standard in appellate review)
- United States v. Frady, 456 U.S. 152 (U.S. 1982) (plain-error standard explained)
- Flores-Figueroa v. United States, 556 U.S. 646 (U.S. 2009) (means of identification knowledge requirement)