Justia Professional Malpractice & Ethics Opinion Summaries

Jennings, who was not a medical professional, ran Results Weight Loss Clinic in Lombard, Illinois. Jennings paid Mikaitis, who was working full‐time for a hospital in Lockport, Illinois cash to secure a Drug Enforcement Agency registration number for the clinic and to review patient charts. Over the next two years, Jennings ordered over 530,000 diet pills (controlled substances) for over $84,000 using Mikaitis’s credit card and DEA number. Mikaitis appeared at Results weekly to get $1,750 cash and review four to eight charts. Results also gave drugs—in person and by mail— to many patients whose charts he never reviewed. A nurse practitioner who worked at the clinic later testified she noticed almost immediately that Jennings was unlawfully distributing drugs. Jennings paid Mikaitis about $98,000 cash, in addition to reimbursement for drug costs.Mikaitis was tried on 17 counts. He denied knowing about illegal activity. The district judge issued a deliberate avoidance (ostrich) instruction. Convicted, Mikaitis was sentenced to 30 months. The Seventh Circuit affirmed. Ample evidence demonstrated that Mikaitis subjectively believed that there was a high probability he was participating in criminal activity and that he took specific, deliberate actions to avoid learning that fact. Mikaitis was a medical professional with corresponding duties. The jury was free to conclude the red flags were obvious to him. View "United States v. Mikaitis" on Justia Law

Defendant was convicted of conspiracy and substantive health care fraud for fraudulently billing Medicare and Medicaid for millions of dollars for visits to nursing home patients that he never made. He challenged the convictions, sentence, restitution amount, and forfeiture amount on appeal.The co-conspirator pleaded guilty to conspiracy and agreed to cooperate with the government. Part of his plea agreement addressed his compensation during the conspiracy. Defendant contends that the district court erred in quashing his subpoena of the co-conspirator’s attorney. The court ruled that any erroneous exclusion of the attorney’s testimony was harmless beyond a reasonable doubt because his testimony would not have impeached the co-conspirator. He further argues that the district court erred in limiting how many character witnesses he could present. The court found that the district court did not err because defendant overstates the importance of character witness testimony in this case. He was not on trial for being uncaring or uncompassionate but for lying and billing Medicare for services he did not provide.Additionally, defendant contends that the district court improperly limited part of his counsel’s closing argument when he was discussing whether defendant had made a profit. The court found that the government does not have to prove a defendant profited to establish the elements of fraud. The court also found that the district court did not err in calculating the loss amount used to determine defendant's sentence or the amount of restitution ordered. View "USA v. Douglas Moss" on Justia Law

At issue in this post-conviction case was petitioner Steve Franke’s attempt to prove that his criminal trial counsel provided constitutionally inadequate and ineffective assistance by failing to object that an expert diagnosis of child sexual abuse was inadmissible in the absence of corroborating physical evidence. Although the objection would have been contrary to controlling Court of Appeals precedent at the time of petitioner’s 2001 criminal trial, the Oregon Supreme Court later held that the rules of evidence required exclusion of a diagnosis of sexual abuse if it was not based on physical evidence, effectively overruling the Court of Appeals precedent. To survive summary judgment, petitioner offered evidence that some criminal defense attorneys in 2001 viewed the Court of Appeals precedent as vulnerable, were raising the kind of challenge to sexual abuse diagnoses that ultimately succeeded, and were recommending that practice to other criminal defense attorneys. Petitioner contended the evidence would have allowed him to establish that the exercise of reasonable skill and judgment obligated his attorney to raise a similar objection, or at least that his attorney’s failure to raise the argument was the product of a failure to adequately prepare and familiarize himself with the state of the law. Both the post-conviction court and the Court of Appeals held that petitioner’s claim failed as a matter of law. The Supreme Court agreed with the Court of Appeals that the argument that ultimately succeeded in Southard was not so obviously correct in 2001 that the exercise of reasonable skill obligated attorneys to raise the argument, and petitioner’s evidence did not permit a different conclusion. But the Supreme Court disagreed that petitioner’s claim could be resolved on summary judgment; the evidence created genuine issues of material fact that, if resolved in petitioner’s favor, could establish the failure by petitioner’s attorney to raise a Southard-type challenge to the sexual abuse diagnosis was the product of an unreasonable failure to investigate and familiarize himself with the state of the law to the extent appropriate to the nature and complexity of the case. Accordingly, the Supreme Court reversed the lower courts' judgments and remanded for further proceedings. View "Jackson v. Franke" on Justia Law

Burkhart, the CEO of ASC, a private company that operates Indiana nursing homes and long-term care facilities, orchestrated an extensive conspiracy exploiting the company’s operations and business relationships for personal gain. Most of the funds involved in the scheme came from Medicare and Medicaid. After other defendants pled guilty and Burkhart’s brother agreed to testify against him, Burkhart pled guilty to conspiracy to commit mail, wire, and healthcare fraud (18 U.S.C. 1349); conspiracy to violate the AntiKickback Statute (18 U.S.C. 371); and money laundering (18 U.S.C. 1956(a)(1)(B)(i)). With a Guidelines range of 121-151 months, Burkhart was sentenced to 114 months’ imprisonment.Burkhart later filed a habeas action, contending that his defense counsel, Barnes & Thornburg provided constitutionally deficient representation because the firm also represented Health and Hospital Corporation of Marion County, a victim of the fraudulent scheme. The Seventh Circuit affirmed the denial of relief. While the firm labored under an actual conflict of interest, that conflict did not adversely affect Burkhart’s representation. Nothing in the record shows that the firm improperly shaded its advice to induce Burkhart to plead guilty; the advice reflected a reasonable response to the “dire circumstances” facing Burkhart. The evidence of Burkhart’s guilt was overwhelming. View "Burkhart v. United States" on Justia Law

Following a preliminary hearing, petitioner Dr. Sanjoy Banerjee was charged in an information with two counts of presenting a false or fraudulent health care claim to an insurer (a form of insurance fraud, counts 1-2), and three counts of perjury (counts 3-5). The superior court denied Banerjee’s motion to dismiss the information as unsupported by reasonable or probable cause. Banerjee petitioned for a writ of prohibition to direct the superior court to vacate its order denying his Penal Code section 995 motion and to issue an order setting aside the information. The Court of Appeal issued an order to show cause and an order staying further proceedings on the information, pending the Court's resolution of the merits of Banerjee’s petition. The State filed a return, and Banerjee filed a traverse. The State argued the evidence supported a strong suspicion that Banerjee committed two counts of insurance fraud and three counts of perjury, based on his violations of Labor Code section 139.3(a) between 2014 and 2016. During that period, Banerjee billed a workers’ compensation insurer for services he rendered to patients through his professional corporation and through two other legal entities he owned and controlled. The insurance fraud charges are based on Banerjee’s 2014-2016 billings to the insurer through the two other entities. The perjury charges were based on three instances in which Banerjee signed doctor’s reports, certifying under penalty of perjury that he had not violated “section 139.3.” Banerjee argued: (1) the evidence showed he did not violate the statute's referral prohibition; (2) even if he did not comply with section 139.3(e), the “physician’s office” exception to the referral prohibition applied to all of his referrals to his two other legal entities; and (3) the patient disclosure requirement of section 139.3(e), the referral prohibition of section 139.3(a), and the physician’s office exception to the referral prohibition were unconstitutionally vague. The Court of Appeal concluded: (1) Banerjee did not violate section 139.3(a) by referring his patients to his two other legal entities; and (2) the evidence supported a strong suspicion that Banerjee specifically intended to present false and fraudulent claims for health care benefits, in violation of Penal Code section 550(a)(6), by billing the workers’ compensation insurer substantially higher amounts through his two other legal entities than he previously and customarily billed the insurer for the same services he formerly rendered through his professional corporation and his former group practice. Thus, the Court granted the writ as to the perjury charges but denied it as to the insurance fraud charges. View "Banerjee v. Super. Ct." on Justia Law

Defendant Bennie Anderson was employed by Jersey City in the Tax Assessor’s office. His position gave him the opportunity to alter property tax descriptions without the property owner filing a formal application with the Zoning Board. In December 2012, defendant accepted a $300 bribe in exchange for altering the tax description of a property from a two-unit dwelling to a three-unit dwelling. Defendant retired from his position in March 2017 and was granted an early service retirement pension. In November 2017, defendant pled guilty in federal court to violating 18 U.S.C. 1951(a), interference with commerce by extortion under color of official right. Defendant was sentenced to two years of probation and ordered to pay a fine. Based on defendant’s conviction, the Employees’ Retirement System of Jersey City reduced his pension. The State filed an action in state court to compel the total forfeiture of defendant’s pension pursuant to N.J.S.A. 43:1-3.1. The trial court entered summary judgment for the State, finding that the forfeiture of defendant’s pension did not implicate the constitutional prohibitions against excessive fines because the forfeiture of pension benefits did not constitute a fine. The Appellate Division affirmed the grant of summary judgment to the State, but on different grounds, concluding the forfeiture of defendant’s pension was a fine, but that requiring defendant to forfeit his pension was not excessive. The New Jersey Supreme Court concluded forfeiture of defendant’s pension under N.J.S.A. 43:1-3.1 did not constitute a fine for purposes of an excessive-fine analysis under the Federal or New Jersey State Constitutions. Because the forfeiture was not a fine, the Court did not reach the constitutional analysis for excessiveness. View "New Jersey v. Anderson" on Justia Law

Jensen was charged as a coconspirator in a felony indictment alleging a scheme under which members of the Santa Clara County Sheriff’s Department issued hard-to-obtain concealed firearms permits in exchange for substantial donations to an independent expenditure committee supporting the reelection campaign of Sheriff Smith. Jensen is a sheriff’s department captain identified as the individual within the sheriff’s department who facilitated the conspiracy. Jensen unsuccessfully moved to disqualify the Santa Clara County District Attorney’s Office from prosecuting him, alleging that that office leaked grand jury transcripts to the press days before the transcripts became public which created a conflict of interest requiring disqualification. He also joined in codefendant Schumb’s motion to disqualify the office due to Schumb’s friendship with District Attorney Rosen and Rosen’s chief assistant, Boyarsky.The court of appeal rejected Jensen’s arguments for finding a conflict of interest requiring disqualification: the grand jury transcript leak, Schumb’s relationships with Rosen and Boyarsky, and a dispute between Rosen and Sheriff Smith about access to recordings of county jail inmate phone calls. The trial court could reasonably conclude Jensen did not demonstrate that the district attorney’s office was the source of the leak. Jensen himself does not have a personal relationship with Rosen or Boyarsky. The trial court could reasonably conclude that Jensen did not establish a conflict of interest based on the existence of a dispute between the district attorney and the elected official with supervisory power over Jensen. View "Jensen v. Superior Court" on Justia Law

Schumb was charged as a coconspirator in a felony indictment alleging a quid pro quo scheme in which members of the Santa Clara County Sheriff’s Department issued hard-to-obtain concealed firearms permits in exchange for substantial monetary donations to the reelection campaign of Sheriff Smith. Schumb is an attorney with a history of fundraising for elected officials; he accepted the donations as a treasurer of an independent expenditure committee supporting Sheriff Smith’s reelection. Schumb is a friend of Rosen, the elected Santa Clara County District Attorney, and previously raised funds for Rosen’s campaigns.Schumb unsuccessfully moved to disqualify the Santa Clara County District Attorney’s Office from prosecuting him, arguing that his friendships with Rosen and Rosen’s chief assistant, Boyarsky, created a conflict of interest making it unlikely Schumb would receive a fair trial. Schumb asserted that he intends to call Rosen and Boyarsky as both fact and character witnesses at trial and. despite their personal connections to the case, neither Rosen nor Boyarsky made any effort to create an ethical wall between themselves and the attorneys prosecuting the case. The court of appeal vacated and directed the lower court to enter a new order disqualifying the Santa Clara County District Attorney’s Office in Schumb's prosecution. View "Schumb v. Superior Court" on Justia Law

Sommer, a psychologist at a mental health clinic on a military base, sexually assaulted three patients under the guise of using “exposure therapy.” A jury convicted Sommer of several felonies, including sexual battery by fraudulent representation (Pen. Code, 243.4(c)). The trial court sentenced him to state prison.The court of appeal affirmed. Sufficient evidence supports the sexual battery by fraud conviction. Confusion is not surprising when a professional unexpectedly touches the sexual parts of the victim’s body during purported professional treatment. Confusion or doubt about the purpose of the touching does not preclude a conviction as long as the jury finds beyond a reasonable doubt that the victim allowed the touching to occur because of the defendant’s fraudulent misrepresentation of a professional purpose. The prosecutor did not misstate the law during his closing argument by saying: “Confusion is unconsciousness.” The court properly instructed the jury with CALCRIM No. 1191B, regarding consideration of charged sex offenses. The court did not err by refusing to release portions of the victims’ sealed mental health records; the undisclosed information “was not material to the defense.” View "People v. Sommer" on Justia Law

Dat was born in a Kenyan refugee camp in 1993. Admitted to the U.S. around 1994, he became a lawful permanent resident. Dat pled guilty to robbery, 18 U.S.C. 1951, and was sentenced to 78 months' imprisonment. Dat’s robbery conviction is a deportable offense, 8 U.S.C. 1227(a)(2)(A)(iii). Dat moved to vacate his guilty plea, claiming that his attorney, Allen, assured him that his immigration status would not be affected by his plea. Allen testified that she repeatedly told Dat the charges were “deportable offenses,” that she never told him, his mother, or his fiancée that he would not be deported. that she encouraged Dat to hire an immigration attorney, and that they reviewed the Plea Petition, which says that non-citizens would be permanently removed from the U.S. if found guilty of most felony offenses. The Plea Agreement refers to immigration consequences. Dat and Allen also reviewed the PSR, which stated that immigration proceedings would commence after his release from custody.The Eighth Circuit affirmed the denial of relief, finding that Dat was not denied effective assistance of counsel. It was objectively reasonable for Allen to tell Dat that he “could” face immigration ramifications that “could” result in deportation. An alien with a deportable conviction may still seek “relief from removal. These “immigration law complexities” should caution any defense attorney not to advise a defendant considering a guilty plea that the result of a post-conviction, contested removal proceeding is certain. View "Dat v. United States" on Justia Law