United States v. Shanin Moshiri
2017 U.S. App. LEXIS 9959
| 7th Cir. | 2017Background
- Dr. Shanin Moshiri, a podiatrist at Sacred Heart Hospital, was charged and convicted after a bench trial for receiving illegal remuneration in exchange for patient referrals in violation of the Anti‑Kickback Statute (42 U.S.C. § 1320a–7b(b)).
- Sacred Heart instituted "teaching" contracts (drafted by residency director Noorlag at the owner Novak’s direction) paying attending podiatrists monthly stipends ($2,000–$4,000/mo) while most other attendings performed similar teaching duties without extra pay.
- Moshiri’s contracts (2006 and 2008) paid $2,000 then $4,000 per month for duties he largely did not perform; program logs showed minimal teaching activity by Moshiri compared to other attendings.
- Recorded conversations with the hospital COO (Puorro) and Moshiri’s post‑arrest statement to an agent indicated Moshiri discussed bringing lists of referred patients and admitted the contract had “turned into basically paying for patients.”
- The district court convicted Moshiri on one count (payment received March 8, 2013), relying heavily on those recorded statements and finding the contract fell outside the regulatory safe harbor because it took referrals into account.
Issues
| Issue | Moshiri's Argument | Government's Argument | Held |
|---|---|---|---|
| Sufficiency: did evidence show contract fell outside safe harbor? | Govt failed to prove contract took referrals into account | Recorded statements, sparse teaching, and payment pattern showed referrals were a basis for compensation | Affirmed — evidence sufficient to show contract excluded from safe harbor |
| Mens rea: did Moshiri knowingly violate Anti‑Kickback Statute? | No proof he knew contract compensated referrals | Statements to Puorro and Agent, Medicare certification, and knowledge he didn’t perform duties show knowledge | Affirmed — sufficient evidence he knowingly received payment for referrals |
| Expert testimony: was CPME chair’s testimony admissible on industry norms? | Petrov unqualified; methodology insufficient to opine on stipend value | Petrov’s extensive CPME experience made testimony reliable; weight for cross‑examination | Affirmed — district court did not abuse discretion admitting Petrov’s testimony |
| Vagueness: is Anti‑Kickback Statute vague as applied; require "primary purpose" standard? | Statute vague; should require that referrals be primary purpose of payment | Precedent permits conviction when payments compensate past or induce future referrals | Affirmed — statute constitutional as applied; court declines to adopt "primary purpose" standard |
Key Cases Cited
- Jackson v. Virginia, 443 U.S. 307 (establishes standard for sufficiency of evidence review)
- Daubert v. Merrell Dow Pharm., 509 U.S. 579 (framework for admissibility of expert testimony)
- Kumho Tire Co. v. Carmichael, 526 U.S. 137 (trial court gatekeeping and discretion on expert testimony)
- Salinas, 763 F.3d 869 (7th Cir. 2014) (applies Jackson standard in circuit)
- Galati, 230 F.3d 254 (7th Cir. 2000) (credibility and evidence weighing principle)
- Metavante Corp. v. Emigrant Sav. Bank, 619 F.3d 748 (7th Cir. 2010) (experience‑based expert testimony can be admissible)
- Borassi, 639 F.3d 774 (7th Cir. 2011) (payment compensating past or inducing future referrals violates Anti‑Kickback Statute)