Justia White Collar Crime Opinion Summaries

Defendants Farha, Behrens, Kale, and Clay appeal their convictions for charges related to Medicaid fraud on multiple grounds. Defendants were all high-level executives of WellCare or one of its Florida subsidiaries, Staywell and HealthEase. At trial, the government proved that together defendants participated in a fraudulent scheme to file false Medicaid expense reports that misrepresented and overstated the amounts Staywell and HealthEase spent on medical services for Medicaid patients, specifically outpatient behavioral health care services. The court concluded that the evidence was sufficient to convict Farha, Behrens, and Kale for health care fraud; there was sufficient evidence to convict Behrens for making false representations to AHCA; and there was sufficient evidence to convict Clay for making false statements to federal agents. The court rejected Farha, Behrens, and Kale's challenge to the jury instructions with regard to their fraud convictions. Finally, the court rejected defendants' claims of evidentiary error. Accordingly, the court affirmed the convictions. View "United States v. Clay" on Justia Law

Defendant, the CFO of Inno Vida, was convicted of two counts of conspiracy to commit wire fraud, one count of conspiracy to engage in financial transactions with criminally derived property, three counts of wire fraud, one count of major fraud against the United States, and three counts of making false statements to a federal agency. The government presented evidence that defendant maintained two sets of financial statements and used one set to mislead investors and the United States. The company's controller testified that, when the two sets of statements were prepared, he believed only the other set complied with Generally Accepted Accounting Principles. The court concluded that the district court did not abuse its discretion by admitting the controller's testimony under Federal Rule of Evidence 701 because the testimony was rationally based on his own personal experiences. The court also concluded that the government presented sufficient evidence to convict defendant of each charge. Accordingly, the court affirmed the judgment. View "United States v. Toll" on Justia Law