UNITED STATES OF AMERICA, Appellant, v. DANTE RODRÍGUEZ-RIVERA; JAVIER EFRAÍN SIVERIO-ECHEVARRÍA; GEORGE D. ALCÁNTARA-CARDI; MARTHA NIEVES; JAVIER ANTONIO AGUIRRE-ESTRADA; CARLOS MALDONADO-LÓPEZ, Defendants, Appellees.
No. 17-1975
United States Court of Appeals For the First Circuit
March 11, 2019
Hon. Daniel R. Domínguez, U.S. District Judge
APPEAL FROM THE UNITED STATES DISTRICT COURT FOR THE DISTRICT OF PUERTO RICO
Before Howard, Chief Judge, Torruella and Kayatta, Circuit Judges.
Dennise N. Longo-Quinones, Assistant United States Attorney, with whom Rosa
Ignacio Fernández de Lahongrais for Dante Rodríguez-Rivera.
Juan R. Rodríguez, with whom Rodríguez Lopez Law Offices, P.S.C. was on brief, for Gеorge D. Alcántara-Cardi.
José R. Gaztambide Añeses on joint brief for Martha Nieves.
Leonardo M. Aldridge on joint brief for Javier Siverio-Echevarría.
KAYATTA, Circuit Judge. A United States grand jury indicted three doctors and three employees of a durable medical equipment (“DME“) supplier in Puerto Rico on counts of health care fraud and conspiracy to commit health care fraud, under
I.
The relevant portion of the indictment at issue identifies the events and conduct alleged to give rise to a crime as follows.
Medicare covers a bеneficiary‘s access to reusable DME that is medically necessary and that is ordered by a licensed medical doctor or other qualified health care provider. Examples of DME are mоtorized wheelchairs, hospital beds, oxygen concentrators, nebulizers, and surgical dressings. Medicare also covers certain DME accessories, such as adjustable wheelchair arm rests, safety belts, pelvic straps, reclining backs, seat cushions, and tire pressure tubes.
A DME supplier can submit a claim to Medicare in order to seek direct reimbursement for DME supplied to a beneficiary, but only if that beneficiary has assigned his or her right of payment to the DME supplier. When submitting a claim, the DME supplier must provide, among other things: (1) the beneficiary‘s name and Health Insurance Claim Number; (2) the name and identification of the physician or provider who ordered the DME; and (3) a description of the DME provided to the beneficiary.
The defendants are either physicians in Puerto Rico or emplоyees of Equipomed, a Puerto Rican DME supplier. According to the indictment, from 2007 to 2013, the defendants engaged in a scheme to defraud Medicare. The alleged scheme was straightforward: (1) the dеfendant doctors wrote fraudulent prescriptions or medical orders for DME without beneficiaries’ assent or knowledge and without even having examined the beneficiaries; (2) the Equipomed defendants then submitted fraudulent DME claims to Medicare; (3) Medicare paid the fraudulent claims; and (4) the defendants split the proceeds.
The defendants moved, presumably under
The district сourt granted the defendants’ motion and dismissed the section 1028A counts, holding that the defendants “submitted the reimbursement forms in their own names and for their own benefit” and did not submit the claim forms “as representatives of the beneficiaries nor for the benefit of the beneficiaries.” This interlocutory appeal followed.
II.
The indictment, however, is on its face adequate to state an offense. Unlike a civil complaint that need allege facts that “plausibly narrate a claim fоr relief,” Germanowski v. Harris, 854 F.3d 68, 71 (1st Cir. 2017) (quoting Schatz v. Republican State Leadership Comm., 669 F.3d 50, 55 (1st Cir. 2012), a criminal indictment need only “apprise the defendant of the charged offense,” United States v. Stepanets, 879 F.3d 367, 372 (1st Cir. 2018) (quoting United States v. Savarese, 686 F.3d 1, 7 (1st Cir. 2012)), “so that the defendant can prepare a defense and plead double jeopardy in any future prosecution for the same offense,” id. (quoting United States v. Guerrier, 669 F.3d 1, 3 (1st Cir. 2011)).
Such is just what the government‘s superseding indictment did in this case. It
In nevertheless dismissing the indictment, the district court did not question that § 1028A is a criminal offense, that the indictment recited its elements properly, or that the indictment identified the defendants’ conduct said to have constituted the offense. Instead, at the defendants’ behest and over the government‘s objection, the distriсt court undertook to determine whether the conduct identified in the indictment could, as a matter of law, support a conviction for the charged offense of aggravated identity theft. Among othеr things, the district court ruled that no facts were alleged showing that the defendants “submit[ted the] claim forms as representatives of the beneficiaries.”
That ruling presumes that a Rule 12(b) motion provides an occasion to force the government to defend the sufficiency of its evidence to be marshalled in support of proving the charged offense. It does not. As we said in Stepanets (issued after the district court‘s decision in this case), “the government need not recite all of its evidence in the indictment.” 879 F.3d at 372 (quoting United States v. Innamorati, 996 F.2d 456, 477 (1st Cir. 1993)); see also United States v. DeLaurentis, 230 F.3d 659, 661 (3d Cir. 2000) (“The government is entitled to marshal and present its evidence at trial, and have its sufficiency tested by a motiоn for acquittal . . . .“).
As this court recently held, under Rule 12(b)(1), “a district court may consider a pretrial motion to dismiss an indictment where the government does not dispute the ability of the court to reach the motion and proffers, stipulates, or otherwise does not dispute the pertinent facts.” United States v. Musso, 914 F.3d 26, 29-30 (1st Cir. 2019) (citing United States v. Weaver, 659 F.3d 353, 355 n* (4th Cir. 2011)). No circuit, though, allows such a review on an incomplete or disputed factual record. Nor do the defendants point us to any case in which a circuit court blessed a requirement that the government complete the factual record prior to trial.
The district court in this case apparently regarded the factual record as complete and undisputed. The government has never so conceded. The claim forms said to constitute the use of other persons’ names, dates of birth, and сlaim numbers are not in the record. Nor is there any evidence concerning how Medicare interprets such forms. The indictment alleges that the claim form must be read as a statement that the identified beneficiary has assigned his or her benefit claim to one of the defendants. Whether such a transfer of rights somehow also connotes permission to act on behalf of the assignor is unclear on the limited record as it now stands, as is whether the conduct alleged constitutes a requisite transfer or possession of the beneficiaries’ personal identifying information. We tender no opinion as to whether the prosecution will turn out to have enough evidence to secure a conviction. We do hold that the proceedings as they now stand provide no occasion for determining
III.
For the foregoing reasons, we reverse the district court‘s dismissal of the section 1028A aggravated identify theft counts, and remand for further proceedings in accordance with this opinion.
