Justia White Collar Crime Opinion Summaries

Joseph Scott Gray, a decorated U.S. Army veteran, was convicted of defrauding the Department of Veterans Affairs (VA) by lying about his health to obtain benefits. After leaving the military in 2003, Gray falsely claimed severe disabilities to receive increased benefits, including "individual unemployability" and "aid and attendance" benefits. His fraudulent activities were exposed when investigators videotaped him performing daily activities without assistance, contradicting his claims of severe disability.The United States District Court for the Western District of Michigan convicted Gray of several fraud-related offenses. The jury found him guilty, and the district court sentenced him to five years in prison and ordered him to pay $264,631 in restitution, covering benefits received from 2004 onward. Gray appealed, challenging the exclusion of an expert witness, the calculation of his criminal history score, the reasonableness of his sentence, and the restitution order.The United States Court of Appeals for the Sixth Circuit reviewed the case. The court upheld the exclusion of Gray's expert witness, Dr. Ennis Berker, as the proposed testimony was deemed irrelevant to the issues at trial. The court also found no procedural error in the calculation of Gray's criminal history score and deemed the five-year sentence substantively reasonable, considering the severity and duration of his fraudulent conduct.However, the court vacated the restitution order, ruling that it should not cover losses before January 2015, as the indictment only charged Gray with a conspiracy beginning in 2015. The case was remanded for recalculation of the restitution amount, limited to the period specified in the indictment. View "United States v. Joseph Gray" on Justia Law

Kay Ellison, co-founder of a charter airline, was convicted of federal wire fraud, bank fraud, and conspiracy. The airline, Direct Air, faced cash flow issues and Ellison siphoned millions from an escrow account through fictitious reservations and falsified records. She was charged alongside Judy Tull and chose not to testify or present a defense at trial. The jury convicted her on all counts, and she was sentenced to ninety-four months in prison and ordered to pay over $19 million in restitution. Her convictions were affirmed on direct appeal.Ellison filed a motion to vacate her sentence under 28 U.S.C. § 2255, claiming ineffective assistance of counsel. She argued her attorney incorrectly advised her that if she did not testify, she could not present other evidence, which she claimed prejudiced her defense. The United States District Court for the District of New Jersey denied her motion without an evidentiary hearing, concluding that even if her counsel was ineffective, she could not show prejudice because there was no reasonable probability that the jury would have acquitted her if she had testified or presented other witnesses.The United States Court of Appeals for the Third Circuit reviewed the case and affirmed the District Court's decision. The Third Circuit applied the Strickland v. Washington standard, which requires showing a reasonable probability that the result of the proceeding would have been different but for the attorney's errors. The court found that Ellison failed to demonstrate such a probability, as her proposed testimony and that of her witnesses would not have likely changed the jury's verdict given the strong evidence against her. Thus, the denial of her habeas corpus petition was upheld. View "Ellison v. USA" on Justia Law

The case involves Amaka Oji and Oji Fit World, LLC (OFW), who were approved as Medicaid providers by the D.C. Department of Health Care Finance (DHCF) in 2011. Between 2012 and 2015, they submitted over 24,000 claims for reimbursement for wellness services provided to Medicaid beneficiaries. Investigations by DHCF, the Office of the Inspector General for the Centers for Medicare and Medicaid Services, and the FBI revealed that Oji and OFW regularly overbilled Medicaid, often charging for a full hour of service regardless of the actual time spent or whether the service was provided at all.The District of Columbia filed a lawsuit in April 2021 under the D.C. False Claims Act and the common law doctrine of unjust enrichment. The Superior Court of the District of Columbia granted summary judgment in favor of the District, finding that Oji and OFW had submitted false claims and falsified records. The court awarded the District $1,001,362.50 in treble damages and $497,000 in civil penalties. Oji and OFW's various procedural defenses, including claims of laches and statute of limitations, were deemed waived due to their failure to raise them in a timely manner.The District of Columbia Court of Appeals reviewed the case and affirmed the summary judgment order. However, the court remanded the case for further consideration of the damages and penalties. The appellate court found that the Superior Court had not provided sufficient explanation or analysis for the awarded amounts, making it difficult to review the decision. The appellate court emphasized the need for the trial court to explain its reasoning in detail to permit adequate appellate review. View "Oji Fit World, LLC v. District of Columbia" on Justia Law

State Farm Mutual Automobile Insurance Company and State Farm Fire and Casualty Insurance Company (collectively, “State Farm”) provide automobile insurance in New York and are required to reimburse individuals injured in automobile accidents for necessary health expenses under New York’s No-Fault Act. State Farm alleges that several health care providers and related entities engaged in a scheme to fraudulently obtain No-Fault benefits by providing unnecessary treatments and services, and then pursued baseless arbitrations and state-court proceedings to seek reimbursement for unpaid bills.The United States District Court for the Eastern District of New York granted State Farm’s motion for a preliminary injunction in part, enjoining the defendants from proceeding with pending arbitrations and from initiating new arbitrations and state-court proceedings, but denied an injunction of the pending state-court proceedings. The district court found that State Farm demonstrated irreparable harm due to the fragmented nature of the proceedings, which obscured the alleged fraud, and the risk of inconsistent judgments and preclusive effects.The United States Court of Appeals for the Second Circuit reviewed the case and affirmed the district court’s decision to grant the preliminary injunction in part. The appellate court held that the district court did not abuse its discretion in finding that State Farm demonstrated irreparable harm, serious questions going to the merits, a balance of hardships tipping in its favor, and that the injunction was in the public interest. The court also concluded that the Federal Arbitration Act did not bar the injunction of the arbitrations because the arbitrations would prevent State Farm from effectively vindicating its RICO claims.Additionally, the appellate court reversed the district court’s decision not to enjoin the pending state-court proceedings, finding that the Anti-Injunction Act’s “expressly-authorized” exception applied. The court determined that the state-court proceedings were part of a pattern of baseless, repetitive claims that furthered the alleged RICO violation, and that enjoining these proceedings was necessary to give RICO its intended scope. The case was remanded for further proceedings consistent with this opinion. View "State Farm Mutual v. Tri-Borough" on Justia Law

The case involves James Peperno, Jr., who was found guilty by a jury of nine counts of conspiracy to commit bribery and wire fraud, among other related charges. Peperno devised a scheme to solicit bribes from Walter Stocki, who was involved in zoning litigation with the borough of Old Forge, Pennsylvania. Peperno, along with Robert Semenza, Jr., the Old Forge Borough Council President, planned to influence the litigation in Stocki's favor in exchange for bribes. Peperno initially approached Stocki in January 2019, asking for a $20,000 upfront payment and a monthly retainer. Stocki recorded their conversations and later contacted the FBI, which led to further recorded interactions and payments facilitated by the FBI.The United States District Court for the Middle District of Pennsylvania presided over the case. At trial, Peperno was found guilty on all counts except for two counts of money laundering. The Presentence Report (PSR) recommended sentencing enhancements for multiple bribes and for the total value of the bribes exceeding $15,000. Peperno objected to these enhancements, but the District Court overruled his objections, finding the recommendations supported by the evidence. The court sentenced Peperno to 72 months’ imprisonment, considering his intent and financial motivations.The United States Court of Appeals for the Third Circuit reviewed the case. Peperno appealed, arguing that the District Court erred in denying his request for a jury instruction on entrapment and in applying the sentencing enhancements. The Third Circuit held that the District Court correctly denied the entrapment instruction, as Peperno failed to show government inducement or lack of predisposition. The court also upheld the sentencing enhancements, agreeing that the evidence supported the finding of multiple bribes and that the total value of the bribes exceeded $15,000. The Third Circuit affirmed the District Court’s judgment of sentence. View "USA v. Peperno" on Justia Law

The plaintiffs alleged that the defendants marketed fraudulent franchise opportunities to foreign nationals seeking to invest in the United States to obtain residency visas. The complaint included claims under the Racketeer Influenced and Corrupt Organizations Act (RICO) and state-law claims for fraud, breach of contract, and malpractice. The plaintiffs claimed that the defendants misrepresented the nature of the investment opportunities, leading the plaintiffs to believe they were purchasing franchises that would qualify them for E-2 or EB-5 visas. Instead, they received licenses that did not meet visa requirements, resulting in financial losses and visa application issues.The United States District Court for the Southern District of Texas dismissed the case for failure to state a claim. The court found that the plaintiffs did not adequately allege a cognizable enterprise under RICO and failed to meet the heightened pleading standards for fraud under Federal Rule of Civil Procedure 9(b). The district court also denied the plaintiffs leave to amend their complaint, citing undue delay and the plaintiffs' failure to provide a proposed amended complaint or additional facts that would cure the deficiencies.The United States Court of Appeals for the Fifth Circuit reviewed the case and affirmed the district court's decision. The appellate court agreed that the plaintiffs failed to plead a RICO enterprise, as the complaint did not provide sufficient factual detail to support the existence of an association-in-fact enterprise. The court also upheld the dismissal of the fraud and fraudulent inducement claims, finding that the plaintiffs did not meet the particularity requirements of Rule 9(b). Additionally, the court found no abuse of discretion in the district court's denial of leave to amend the complaint and the dismissal of claims against certain defendants for failure to effect timely service of process. View "Crosswell v. Rodriguez" on Justia Law

The case involves Sam Sarkis Solakyan, who owned multiple medical-imaging companies. Solakyan conspired with physicians and medical schedulers to route unsuspecting patients to his companies for unnecessary MRI scans and other medical services, generating $263 million in claims. The scheme involved bribery and kickbacks to physicians who referred patients to Solakyan’s companies, violating California’s anti-kickback statutes.The United States District Court for the Southern District of California presided over the initial trial. Solakyan was charged with conspiracy to commit honest-services mail fraud and health-care fraud, as well as substantive counts of honest-services mail fraud and aiding and abetting. After a seven-day trial, the jury found Solakyan guilty on all counts. The district court sentenced him to 60 months in prison and ordered him to pay $27,937,175 in restitution to the affected insurers.The United States Court of Appeals for the Ninth Circuit reviewed the case. The court affirmed Solakyan’s conviction, holding that honest-services mail fraud under 18 U.S.C. §§ 1341 and 1346 includes bribery and kickback schemes that deprive patients of their right to honest services from their physicians. The court also held that actual or intended tangible harm is not an element of honest-services fraud. The indictment was found sufficient in alleging willful misconduct for health-care fraud. The court did not find any abuse of discretion in the jury instructions regarding the mens rea for the conspiracy charges or the use of mails in the fraud scheme. However, the court vacated the restitution order, remanding the case for further proceedings to determine if the restitution amount should be reduced by the cost of medically necessary MRIs that insurers would have paid for absent the fraud. View "USA V. SOLAKYAN" on Justia Law

Kenneth Bryan Ritchey, the defendant, operated Gulf Coast Pharmaceuticals Plus, LLC, a wholesale distributor of pharmaceutical products. During the COVID-19 pandemic, Ritchey directed his employees to acquire large quantities of personal protective equipment (PPE) and resell them at inflated prices to various healthcare providers, including the Department of Veterans Affairs (VA). The VA was charged significantly higher prices than the market value, resulting in Ritchey and his company receiving over $2 million, including more than $270,000 from the VA.Ritchey was charged with six counts, including conspiracy to defraud the United States. He pled guilty to violating 18 U.S.C. § 371, and the remaining counts were dismissed. The United States District Court for the Southern District of Mississippi calculated Ritchey’s offense level based on the estimated pecuniary loss caused by his actions, which included a significant enhancement for the amount of loss. The court determined the fair market value (FMV) of the PPE based on pre-pandemic prices and 3M’s pricing, leading to a higher offense level and a 60-month prison sentence.The United States Court of Appeals for the Fifth Circuit reviewed the case. The court found that the district court erred in calculating the FMV by relying on pre-pandemic prices and 3M’s pricing, which did not reflect the actual market conditions during the pandemic. The appellate court held that the district court’s method of determining the FMV was not based on a realistic economic approach. Consequently, the Fifth Circuit vacated Ritchey’s sentence and remanded the case for resentencing, emphasizing the need for a more accurate calculation of the FMV that reflects the market conditions at the time of the transactions. View "United States v. Ritchey" on Justia Law

In this case, the defendant was involved in a scheme to defraud the City of West Haven, Connecticut, of COVID-19 relief funds. The defendant, along with co-conspirators, submitted fraudulent invoices for equipment and services that were never provided. The City paid over $400,000 based on these false invoices. The defendant was the only one among his co-defendants to go to trial, while the others pled guilty.The United States District Court for the District of Connecticut convicted the defendant of wire fraud and conspiracy to commit wire fraud. The court sentenced him to 96 months in prison, which was above the recommended guidelines range. The defendant appealed, challenging the sentence as substantively unreasonable, the sufficiency of the evidence, and the district court’s evidentiary rulings.The United States Court of Appeals for the Second Circuit reviewed the case. The court found that the district court had provided a detailed explanation for the above-guidelines sentence, emphasizing the severity of the crime, the defendant’s financial gains, and the need for deterrence. The court also noted that the defendant did not receive a trial penalty, as the district court had explicitly stated that the sentence was not influenced by the defendant’s decision to go to trial. The court further found that the evidentiary rulings were not erroneous and that the evidence presented at trial was sufficient to support the conviction.The Second Circuit concluded that none of the defendant’s challenges had merit and affirmed the judgment of the district court. View "United States v. Trasacco" on Justia Law

Josephine Perez-Gorda was convicted of fraud after she and her husband, Justin, misrepresented his medical condition to the U.S. Department of Veterans Affairs. Justin, who suffered a brain injury while on duty, and Perez-Gorda claimed he was unable to walk or care for himself, leading to the receipt of various government benefits, including a new home, car, and caregiver stipend. However, evidence showed Justin was more mobile and self-sufficient than they had represented. After Justin's death in 2022, Perez-Gorda was indicted on multiple counts of wire fraud, mail fraud, health care fraud, conspiracy to commit health care fraud, and aiding and abetting offenses.The United States District Court for the Western District of Texas convicted Perez-Gorda on all counts, and she was sentenced to forty-six months in prison. Perez-Gorda appealed, arguing that the jury instructions on wire and mail fraud were erroneous based on intervening circuit precedent. She did not object to these instructions at trial. The Fifth Circuit reviewed the instructions for plain error and found them erroneous but concluded that the error did not affect Perez-Gorda’s substantial rights, as there was no reasonable probability that the jury would have acquitted her under the correct instructions.Perez-Gorda also challenged statements made during the grand jury proceedings and the sufficiency of the evidence supporting the jury verdicts. The Fifth Circuit found that the statements did not influence the grand jury’s decision and that a rational jury could have found her guilty beyond a reasonable doubt. Additionally, Perez-Gorda contested her sentence, specifically the two-level upward adjustment for her role as an organizer or leader. The Fifth Circuit reviewed this factual finding for clear error and upheld it, noting evidence that Perez-Gorda supervised Justin in the fraudulent activities. The Fifth Circuit affirmed the district court’s judgment. View "USA v. Perez-Gorda" on Justia Law