United States v. Irwin HalperUnited States v. Irwin Halper
On February 23, 1977, Irwin Halper was indicted on sixty-eight counts of making and causing to be made false claims against the United States,
THE MEDICAID FRAUD INDICTMENT
In 1953 Irwin Halper became the sole owner of Professional Diagnostic Laboratories (“PDL”), a medical laboratory located in the Bronx. The bulk of PDL’s business was originally from physicians who were serving private patients, but in 1968 PDL began to participate in the Medicaid program. Soon, a major portion of PDL’s business was devoted to performing clinical laboratory tests ordered by doctors treating patients eligible for Medicaid benefits.
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Two different procedures are involved: “culture” tests and “sensitivity” tests. Physicians treating Medicaid patients submit various specimens to PDL for laboratory analysis. Each specimen is accompanied by an invoice identifying the patient, indicating the diagnosis, and designating the specific test or tests to be performed by the laboratory. A culture test consists of taking the submitted specimens and “incubating” them in a nutrient medium to see if abnormal bacteria or pathogens are present. If the culture test is “positive,” i. e., if the test shows that abnormal bacteria or pathogens are present, then a sensitivity test is performed. This test consists of dropping on the culture tiny discs containing various antibiotics to determine the specific antibiotic to which the bacteria or pathogens are sensitive. The resulting information is then relayed to the physician who, in turn, can prescribe the correct antibiotic for treating the patient from whom the specimen came. As might be expected, a physician ordering a culture and sensitivity test would want the laboratory first to determine whether a culture test is positive or negative, and second, if the culture test is positive, to perform a sensitivity test. As might also be expected, if a culture test proved to be negative, a physician would not want a sensitivity test to be performed. It is at precisely this point that PDL’s testing and billing practices seem to have gone astray.
Although the path of Medicaid reimbursement is a relatively tangled one, the schedule of billing fees is reasonably straightforward. There are two billing categories that are directly relevant to this appeal. Billing Code L004 covers culture tests alone, and the designated fee for such a test is $4.80. Billing Code L006 covers culture and sensitivity tests (up to ten antibiotic discs), and the fee for the combined test is $8.00. The Medicaid fraud indictment charged, and the government presented evidence tending to show, that between 1968 and 1971 Halper trained his clerical employees to bill Medicaid for whatever tests a physician ordered, without regard to whether the tests were actually required or actually performed. The effects of this training, so the charge goes, lasted well into the 1970’s, with Halper continuing to supervise PDL’s billing procedures and failing to correct them. 4
For example, if a physician ordered a culture and sensitivity test, PDL would invariably charge Medicaid $8.00 under Billing Code L006 — even when the culture test proved negative.
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In addition, when a phy
Although the indictment concerned only the practices just described, 6 the government was allowed to introduce evidence of a variety of other PDL activities which, at least in the government’s estimation, was useful to the determination of whether Hal-per had committed the crimes charged. For example, the government showed that PDL was able to perform blood chemistry tests as well as culture and sensitivity tests, and could do so either manually or by means of what is known as an automated “SMA-12” analysis. 7 At the time, a laboratory was entitled to charge $10.00 for the automated analysis but $28.60 for comparable manual tests. 8 The government presented evidence that when a doctor requested an SMA-12 test, PDL charged Medicaid not $10.00 but $28.60, as if the tests had been performed manually rather than mechanically. Along these same lines, the government introduced evidence showing that in 1972 various Blue Cross officials questioned Halper regarding PDL’s practice of charging Medicare (not Medicaid) patients for blood tests at the higher manual rate instead of the lower automated rate. 9 Halper apparently agreed to charge Medicare patients the same amount that he would charge his private patients. The government also introduced evidence that Halper told his clerical staff to add “Drawing of Blood” and other similar notations to invoices accompanying blood specimens that Halper had picked up at various clinics throughout the City. Medicaid was charged an additional $1.00 on invoices bearing these notations. ' The Medicaid fee schedule allowed for such charges only when the blood was actually drawn at the laboratory doing the billing; very little blood was drawn at the PDL premises. 10
THE INCOME TAX EVASION INDICTMENT
On November 18,1977, Halper was again indicted — by a different grand jury and for quite a different crime. This indictment charged that Halper attempted to evade almost $19,000 in personal income tax by filing a false and fraudulent individual income tax return on behalf of himself and his wife, in violation of
Halper retained an accountant named Benjamin Meisel in 1970. Meisel was responsible for doing the business accounting for PDL and for preparing Halper’s federal income tax returns for the years 1971 through 1974; he was not given the responsibility for doing Halper’s personal accounting. Because PDL was owned solely by Halper, its income and expenses were reported on a Schedule C form which was in turn appended to Halper’s personal income tax return. Meisel determined PDL’s taxable income by keeping track of the PDL business account, through which all PDL receipts and disbursements travelled. The government alleged that, other than some interest on savings accounts, Halper did not advise Meisel of personal income that was not registered in the PDL account, nor, according to the government, did Halper allow Meisel to examine personal checking accounts held by the Halpers. Halper disputed this, claiming that he showed Meisel his personal bank statements and that he had no intent to withhold information from Meisel; he also claimed that he told Meisel specifically of the eleven checks. Meisel testified that he questioned the Halpers about non-PDL income, but that he was not informed of the money represented by the eleven checks. A few days before the 1974 tax return was due, Meisel sent to Halper the prepared return, showing a taxable income of $147,521 and a tax due of $37,248.
Halper was apparently astonished by the amount of tax due; he paid Meisel for his services and sought a “second opinion,” retaining the David J. Internoscia Company
DISCUSSION
Halper argues on appeal that the district court committed reversible error by granting the government’s motion to try together the Medicaid fraud indictment and the income tax evasion indictment. For the reasons that follow, we agree with Halper on this point and, accordingly, reverse the judgments of conviction.
The court may order two or more indictments . . . to be tried together if the offenses . . could have been joined in a single indictment .
As is apparent from the wording of the rule, the decision to order two indictments tried together is one to be made in the district court’s discretion.
See United States
v.
Antonelli Fireworks Co.,
Two or more offenses may be charged in the same indictment or information in a separate count for each offense if the offenses charged, whether felonies or misdemeanors or both, are of the same or similar character or are based on the same act or transaction or on two or more acts or transactions connected together or constituting parts of a common scheme or plan.
See
8 Moore’s Federal Practice H 13.03, at 13-4 to 13-5; 1 Wright, Federal Practice and Procedure: Criminal § 212. Accordingly, two indictments may be tried together only if the offenses charged are (1) “of the same or similar character,” or (2) “based on the same act or transaction,” or (3) based “on two or more acts or transactions connected together or constituting parts of a common scheme or plan.” But even if the offenses could have been joined in a single indictment under
It is transparent that the Medicaid fraud indictment and the income tax evasion indictment are not based on the “same act or transaction.” The Medicaid fraud indictment arose from Halper’s alleged failure to ensure that PDL engaged in honest billing practices for culture and sensitivity tests at the laboratory; the income tax evasion indictment arose from Halper’s alleged failure to report taxable income on his 1974 personal return. The two indictments clearly do not arise from the same “act,” and, however broadly the term “transaction” may be interpreted,
see United States v. Isaacs,
The government does argue, however, that the indictments arose out of “connected” transactions. We cannot agree. Whatever connection exists here, it is entirely too speculative to justify joinder of indictments. The government argues that Halper’s scheme to defraud the Medicaid system produced the income which he then failed to report on his personal income tax returns. But the government concedes that the sums charged in the income tax evasion indictment were not the same funds embraced in the Medicaid fraud indictment, Government Brief at 26, and, at a pretrial hearing, the government acknowledged that it would be unable to trace the money “dollar-for-dollar.” The government did not prove at trial, indeed, it hardly attempted to prove, that the money “earned” in the alleged Medicaid fraud was the money that went unreported in the 1974 income tax return.
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In other words, no “connection” was shown sufficient to warrant the joinder of the indictments. Commission of one of the offenses neither depended upon nor necessarily led to the commission of the other; proof of the one act neither constituted nor depended upon proof of the other.
See McElroy v. United States,
The more difficult question is whether the two indictments charge offenses that are “of the same or similar character” for purposes of
When all that can be said of two separate offenses is that they are of the “same or similar character,” the customary justifications for joinder (efficiency and economy) largely disappear. Whereas the joinder of offenses “based on the same act or transaction” or of offenses based “on two or more acts or transactions connected together or constituting parts of a common scheme or plan” is reasonable and desirable both from the government’s and the defendant’s perspective, the same cannot be said for joinder of offenses of the “same ■ or similar character.” In the former situations, the government should not be put to the task of proving what is essentially the same set of facts more than once, and the defendant should be spared the task of defending more than once against what are essentially the same, or at least connected, charges.
See United States v. McGrath, supra,
The disadvantage to which a defendant is put and the potential danger to which a defendant is exposed by joinder of offenses of “same or similar character” are easily understood. As explained by the Court of Appeals for the District of Columbia Circuit:
(1) [the defendant] may become embarrassed or confounded in presenting separate defenses; (2) the jury may use the evidence of one of the crimes charged to infer a criminal disposition on the part of the defendant from which is found his guilt of the other crime or crimes charged; or (3) the jury may cumulate the evidence of the various crimes charged and find guilt when, if considered separately, it would not so find. A less tangible, but perhaps equally persuasive, element of prejudice may reside in a latent feeling of hostility engendered by the charging of several crimes as distinct from only one.
Drew v. United States,
There is indeed always a danger when several crimes are tried together, that thejury may use the evidence cumulatively; that is, that, although so much as would be admissible upon any one of the charges might not have persuaded them of the accused’s guilt, the sum of it will convince them as to all. This possibility violates the doctrine that only direct evidence of the transaction charged will ordinarily be accepted, and that the accused is not to be convicted because of his criminal disposition.
And in
United States v. Smith, supra,
Despite these realities, joinder of offenses under the
Applying these principles to the case at hand, we hold that the trying together of the two indictments against Halper was prejudicial error. Whatever the writers of
Nor do we believe that evidence of one of the offenses would be admissible as to the other under
From this, we think it is clear that, on the record as it now stands, evidence of the Medicaid fraud alleged in the indictment could not be used in a separate trial on the income tax evasion indictment; nor could the allegations in the income tax evasion indictment be used in a separate trial on the Medicaid fraud indictment. We think it is just as clear that similar act evidence relating to PDL’s billing practices, although it might be admissible in a trial on the Medicaid fraud indictment, would not be admissible as similar act evidence in a trial on the income tax evasion indictment. Halper’s main defense at trial was that the allegedly fraudulent Medicaid invoices and the allegedly false income tax return were the products of mistakes of which he had no knowledge and in which he did not participate. He argued that whatever mistakes were made were made by those he employed to perform the relevant tasks. He denied any intent to defraud the Medicaid program or the Internal Revenue System. We fail to see, and the government has failed to demonstrate, how the alleged submission of a false income tax return is at all relevant to the question whether Halper knowingly intended to defraud the Medicaid program by allowing,his clerical personnel to submit inaccurate laboratory test invoices; nor can we understand how the wealth of evidence purportedly relating to the Medicaid fraud indictment was relevant to the question whether Halper knowingly intended to submit a false personal income tax return. The most that the government argues in this regard is that “the totality of Halper’s deceitful practices evidenced his intent to enrich himself by submitting false documents to Government agencies. As such, proof of those practices was relevant both to the Medicaid fraud and the income tax evasion indictments.” Government Brief at 35. Given the policies and the realities surrounding the joinder of indictments, this is not enough. 15
Thus, there was error. It is true that there are cases where misjoinder has been found to be harmless error.
See, e. g., United States v. Turbide,
Notes
. See
. Judge Conner sentenced Halper to concurrent one-year terms of imprisonment on each count of the Medicaid fraud indictment of which Hal-per had been convicted and on the income tax evasion indictment, and imposed a $10,000 committed fine on Halper on the income tax evasion indictment. Halper is free on bail pending disposition of this appeal.
. As explained by the government, the Medicaid program in New York City is administered under federal guidelines by the New York City Department of Social Services and supervised by the New York State Department of Social Services.
See generally
. Norma DiGregorio worked at PDL from 1968 until early 1971. Among her duties was the preparation of Medicaid invoices for billing. Halper gave DiGregorio a typed list of prices and billing codes, apparently an abbreviated form of the fee schedule issued by the City. The list did not include a code for culture tests alone. Halper taught DiGregorio how to do her job and supervised her in her work. Laverne Chappelle worked at PDL during 1971 as a billing clerk. Chappelle was trained by both Halper and DiGregorio. These same billing responsibilities were subsequently passed on to three other clerical workers. The government charged that Halper either instructed these employees to complete the invoices incorrectly or failed to correct the billing practices when he should have. None of the employees was made aware of the test results from the laboratory, nor were they made aware of the difference between a culture and a sensitivity test. Each of them testified at trial.
. Eight doctors testified that they ordered culture and sensitivity tests of various specimens and that in every case they received test result slips reporting negative results. But the invoices submitted to the City by PDL for these tests contained claims for either colony counts or combined culture and sensitivity tests (L006) or both. These eight doctors submitted the 68
. Counts 1 through 68 of the Medicaid fraud indictment charged that on 68 separate invoices Halper charged Medicaid $8.00 for a culture and sensitivity test (L006) when he should have billed only $4.80 for a culture test (L004), this being in violation of
. As explained by the government, an SMA-12 test is “a 12-component Sequential Multiple Analysis, done on auto-analytic equipment which in a matter of seconds performs 12 blood chemistry tests on a given specimen.”
. This discrepancy in billable amounts was eliminated from the Medicaid system in New York in late 1971.
. Halper obtained the machine to do these tests in June of 1971. The government alleged that Halper used the machine during July and August of that year but billed at the manual rates. Halper contended that the machine operated only occasionally during that period — to some extent, at least, the record bears him out on this point.
. Some of these blood samples had been drawn at the San Juan Medical Center in the Bronx, operated by Dr. Richard Izquierdo. The government was allowed to introduce evidence that Halper paid Izquierdo over $22,000 between March of 1971 and January of 1973 for the rental of a small laboratory at the San Juan Center. The government also showed that neither Halper nor any of his employees ever drew blood at the Center or used the rented laboratory in any way, the obvious implication being that the payment of “rent” was somehow relat
. The indictment charged that Halper’s return for 1974 listed taxable income as $130,413.94 with tax due being $36,834.22, and that the income should have been listed as $173,586.30 with the tax due being $55,827.02.
. The Medicaid fraud indictment itself charged only that between $250 and $450 had been obtained by PDL as a result of the allegedly false and fraudulent invoices, but the government made it clear that this was a “representative sampling of claims.” Using this theory as a basis for arguing that the Medicaid and income tax acts and transactions were “connected” for purposes of the rule, the government urges on appeal that “[s]ince the fraudulent tests were submitted every month throughout 1974, each of the 11 monthly checks that Hal-per failed to report as income in 1974 necessarily reflected substantial amounts obtained by fraud.” Government Brief at 27. Neither the government nor the district court relied on this “connection” as the basis for trying the indictments together. Instead, the purported mutual admissibility of the offenses and evidence relating to the offenses as “similar acts” was relied upon. See note 13, infra, and accompanying text.
. It was on this basis that the district court ordered the joinder of the two indictments against Halper.
. The text of the rule is as follows:
Other crimes, wrongs, or acts. Evidence of other crimes, wrongs, or acts is not admissible to prove the character of a person in order to show that he acted in conformity therewith. It may, however, be admissible for other purposes, such as proof of motive, opportunity, intent, preparation, plan, knowledge, identity, or absence of mistake or accident.
. Given the length óf the trial, the number of the witnesses, and the variety of documents and exhibits, we cannot say that the proof of the two offenses was “simple and distinct”
. Because we are ordering new trials on these indictments, we comment here briefly on a matter that may again arise. During the investigation of the Medicaid case, a grand jury subpoena was issued calling for the production of certain books and records of PDL. The grand jury concluded its term before taking any action. Halper requested the return of PDL records even though a subsequent grand jury had already begun considering the case, and that request was denied. Halper argues on this appeal that he was entitled to the return of these records, and that the failure to return them deprived him of his right to exercise his privilege against self-incrimination before the successor grand jury as to the previously submitted documents. But even if Halper were correct in this regard,
compare United States v. Thompson,