United States v. Sharon Iglehart
687 F. App'x 333
| 5th Cir. | 2017Background
- Sharon Iglehart, a psychiatrist and medical director at two Riverside partial hospitalization programs (PHPs), was convicted of conspiracy, health-care fraud, and false statements for fraudulent Medicare/Medicaid billing.
- Riverside billed approximately $22.7 million fraudulently; Medicare/Medicaid reimbursed about $6.4 million.
- Evidence showed Iglehart billed for patient encounters while physically in San Diego attending a Texas Medical Board (TMB)–ordered recordkeeping course following a prior TMB investigation.
- At trial the government introduced testimony about the TMB investigation and Iglehart’s mandatory training; Iglehart testified and defended on grounds of poor recordkeeping.
- The district court applied Guidelines enhancements for intended loss (U.S.S.G. §§ 2B1.1(b)(1)(K), (b)(7)(B)(ii)); sentenced Iglehart to 144 months after some adjustments and a downward variance.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Admission of TMB investigation testimony (Rule 404(b)) | Testimony about the TMB investigation was inadmissible character evidence and prejudicial; motion in limine preserved the objection | Testimony was offered to prove absence of mistake and to explain why Iglehart was in San Diego; admissible under Rule 404(b) | Plain-error review applied; any error was not clear or did not affect substantial rights; admission not reversible |
| Whether court definitively ruled on admissibility at motion in limine (preservation) | The court’s statement “I’ll deny the motion” definitively ruled and preserved the objection | The court reserved final ruling pending the government’s offer; no contemporaneous objection was later made | Court concluded the ruling was not definitive; issue forfeited and reviewed for plain error |
| Calculation of "intended loss" under U.S.S.G. § 2B1.1 and burden-shifting (Valdez/Isiwele) | Prima facie billed amount was rebutted by actual payments ($6.4M); court should have required government to prove subjective intent beyond that amount | Court properly treated billed amount as prima facie, found it overstated intent, considered Iglehart’s subjective knowledge, and made plausible factual findings supporting $9.5M–$20M intended loss | Court reviewed de novo (or plain error) and held the district court’s loss-range finding was plausible and the enhancements were properly applied |
Key Cases Cited
- United States v. Valdez, 726 F.3d 684 (5th Cir.) (describing burden-shifting for intended loss in health-care fraud)
- United States v. Isiwele, 635 F.3d 196 (5th Cir.) (billed amount is prima facie evidence but may be rebutted; courts may consider additional evidence)
- United States v. Beechum, 582 F.2d 898 (5th Cir. en banc) (two‑prong Rule 404(b) admissibility test: non‑character relevance and probative vs. prejudicial)
- Puckett v. United States, 556 U.S. 129 (Supreme Court) (plain‑error review requires clear error affecting substantial rights and discretionary correction)
- United States v. Jones, 475 F.3d 701 (5th Cir.) (courts have wide latitude in determining amount of loss)