UNITED STATES OF AMERICA v. PHILIP E. MICHAEL, II
No. 17-5626
UNITED STATES COURT OF APPEALS FOR THE SIXTH CIRCUIT
February 20, 2018
RECOMMENDED FOR FULL-TEXT PUBLICATION Pursuant to Sixth Circuit I.O.P. 32.1(b) File Name: 18a0033p.06
Argued: January 31, 2018
Decided and Filed: February 20, 2018
Before: SUHRHEINRICH, SUTTON, and BUSH, Circuit Judges.
COUNSEL
ARGUED: Terry M. Cushing, UNITED STATES ATTORNEY‘S OFFICE, Louisville, Kentucky, for Appellant. Nicole S. Elver, DRESSMAN BENZINGER LA VELLE PSC, Louisville, Kentucky, for Appellee. ON BRIEF: Terry M. Cushing, UNITED STATES ATTORNEY‘S OFFICE, Louisville, Kentucky, for Appellant. Nicole S. Elver, Kent Wicker, DRESSMAN BENZINGER LA VELLE PSC, Louisville, Kentucky, for Appellee.
OPINION
SUTTON, Circuit Judge. What does it mean to “use[]” someone else‘s “means of identification“?
I.
Michael worked as a licensed pharmacist at the Aracoma Pharmacy in Chapmanville, West Virginia. He separately co-owns another pharmacy in West Virginia and one in Pennsylvania. The government suspected that Michael used all three pharmacies to distribute on-demand prescription drugs, worth more than $4 million, over the Internet in violation of federal law.
A grand jury returned a multi-count indictment against Michael and several others for crimes arising out of the scheme. Two of the counts deserve mention. Count 7 charged him with committing health care fraud by “fraudulently submitt[ing] a claim for payment to Humana Insurance Company for dispensing medication . . . which was never dispensed.” R. 78 at 24; see
The government alleged that, in September 2013, Michael submitted a claim for payment to Humana indicating that A.S. (a doctor) had prescribed the drug Lovaza for P.R. (a patient). The submission included the doctor‘s National Provider Identifier and the patient‘s name and birth date. A.S. was not P.R.‘s doctor, however. In truth, A.S. did not issue this prescription for Lovaza, and P.R. did not ask Michael to fill a prescription for the drug. After discovering the fraudulent submission, Aracoma‘s management recalled the submission and fired Michael.
Before trial, Michael moved to dismiss Count 8. Even taking the government‘s allegations as true, he disclaimed “us[ing]” the “means of identification of another person” in violation of
The government appealed.
II.
That leaves this question: Did Michael “transfer[], possess[], or use[]” A.S. and P.R.‘s “means of identification” even though he did not pretend to be them?
“Use” has more than one meaning, and this is not the first time Congress has vexed the courts by using it. See Watson v. United States, 552 U.S. 74 (2007); Bailey v. United States, 516 U.S. 137 (1995); Smith v. United States, 508 U.S. 223 (1993). But context usually goes a long way to resolving these interpretive disputes, and it does just that here. The object of “use[]” is “a means of identification.”
Several cases adopt this meaning of “use” in construing criminal laws in a similar context. See, e.g., United States v. Castleman, 134 S. Ct. 1405, 1415 (2014) (
Measured by this reading of the statute, Michael‘s conduct violated it—or at least a jury could find he violated it. (We are at the indictment stage.) As alleged, Michael used A.S.‘s ID number and P.R.‘s name when he created and submitted a fraudulent prescription order to obtain reimbursement money from Humana. That, it seems to us, represents a natural interpretation of the provision, and a fair application of it here.
Sometimes the object of a verb limits the meaning of the verb, it is true. Saying a person “uses drugs” might suggest in context that the verb means “to consume . . . regularly.” Webster‘s New International Dictionary 2524 (3d ed. 2002). Other examples abound of ways in which the object of “use” might change the meaning of use. See, e.g., Oxford English Dictionary Online (3d ed. 2011) (“[t]o ingest or consume (a medicine) or avail oneself of (a treatment) in order to gain benefit“); id. (“[t]o employ (a weight, measure, or other abstract system) as a standard“).
Michael thinks that the statutory object of the sentence, using a “means of identification” for fraudulent purposes, does something similar: that it confines the coverage of the law only to impersonations. We don‘t see it. The provision increases the sentence for anyone convicted of health care fraud who “uses” the “means of identification” of someone else.
The Supreme Court rejected a similar argument in another case about “uses.” See Smith v. United States, 508 U.S. 223 (1993). That statute imposed mandatory minimum sentences for anyone who “uses . . . a firearm” “during and in relation to . . . [a] drug trafficking crime.”
Smith was a strong candidate for allowing an object to limit its verb in that context, as the dissent pointed out. See 508 U.S. at 242 (Scalia, J., dissenting). But the argument failed. This case offers a far weaker claim. Pairing “uses” with “a means of identification” does not point us to any specialized definition, much less one that suggests “uses” refers only to assuming an identity or passing oneself off as a particular person.
Our precedent supports this interpretation. In United States v. Miller, 734 F.3d 530, 541 (6th Cir. 2013), we ruled for a defendant who argued that “uses” includes “act[ing] on [someone else‘s] behalf.” In United States v. Medlock, 792 F.3d 700, 706 (6th Cir. 2015), we pointed to our Pattern Jury Instructions for
The definitions noted in Miller and Medlock cover the conduct alleged in this case. A jury readily could find that a pharmacist who files a claim with a patient‘s insurer to recoup costs the patient would otherwise have to pay “refer[s] to means of identification as such” and “acts on [that patient‘s] behalf.” And White rejected a cramped reading of “uses,” showing that it covers more than assuming another person‘s identity. Otherwise, that conviction would have been reversed, not affirmed.
Michael prefers another reading of these decisions. He points to Miller‘s statement that
What of Medlock? The defendants operated an ambulance company and transported patients to hospitals for routine dialysis treatment. 792 F.3d at 703. When they requested reimbursement from Medicaid, the defendants mischaracterized the nature of the transports, saying that the patients had required stretchers when they had not. Id. at 705. The court held, quite correctly, that submitting false reimbursement requests about the nature of a service provided did not constitute “use” of another‘s “means of identification” but that forging a doctor‘s signature to bolster those submissions satisfied the statute. Id. at 708, 712. The lie in the first instance turned on the nature of the service being provided to a person—lying about what kind of service someone did or did not provide—not whether the person received a service. The lie in the second instance turned on whether a doctor had actually approved the submissions—again about something more than what kind of service was, or was not, provided.
Michael insists that the statute did not cover the conduct in Medlock because the defendants merely lied about “what they were entitled to,” and he at most did the same thing
When, then, is lying about what one is entitled to covered by the statute? And when not? The answer turns on causation, or at least causation often helps to answer the question. The salient point is whether the defendant used the means of identification to further or facilitate the health care fraud. Consistent with the words of the statute, the question is whether the defendant used the means of identification “during and in relation to” the predicate felony.
Think of that distinction here. Had Michael, in the course of dispensing drugs to a patient under a doctor‘s prescription, only inflated the amount of drugs he dispensed, the means of identification of the doctor and patient would not have facilitated the fraud. See id. at 707–08. But that is not what he did. He used A.S. and P.R.‘s identifying information to fashion a fraudulent submission out of whole cloth, making the misuse of these means of identification “during and in relation to“—indeed integral to—the predicate act of healthcare fraud.
Michael also invokes
Michael insists, last of all, that allowing
We have nothing to say about whether the government will be able to make the requisite showings at trial. All that matters is that the indictment “contains the elements of the offense charged.” Hamling v. United States, 418 U.S. 87, 117–19 (1974).
We reverse the district court‘s decision and remand for proceedings consistent with this opinion.
