Filed: Sep. 19, 2006
Latest Update: Feb. 21, 2020
Summary: United States Court of Appeals Fifth Circuit F I L E D IN THE UNITED STATES COURT OF APPEALS FOR THE FIFTH CIRCUIT September 19, 2006 Charles R. Fulbruge III Clerk No. 05-60946 Summary Calendar UNITED STATES OF AMERICA, Plaintiff-Appellee, versus STEVEN SCOTT MCLEMORE, Defendant-Appellant. Appeal from the United States District Court for the Northern District of Mississippi USDC No. 1:05-CR-60-1 Before GARWOOD, DeMOSS and BENAVIDES, Circuit Judges. PER CURIAM:* Steven Scott McLemore appeals his
Summary: United States Court of Appeals Fifth Circuit F I L E D IN THE UNITED STATES COURT OF APPEALS FOR THE FIFTH CIRCUIT September 19, 2006 Charles R. Fulbruge III Clerk No. 05-60946 Summary Calendar UNITED STATES OF AMERICA, Plaintiff-Appellee, versus STEVEN SCOTT MCLEMORE, Defendant-Appellant. Appeal from the United States District Court for the Northern District of Mississippi USDC No. 1:05-CR-60-1 Before GARWOOD, DeMOSS and BENAVIDES, Circuit Judges. PER CURIAM:* Steven Scott McLemore appeals his c..
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United States Court of Appeals
Fifth Circuit
F I L E D
IN THE UNITED STATES COURT OF APPEALS
FOR THE FIFTH CIRCUIT September 19, 2006
Charles R. Fulbruge III
Clerk
No. 05-60946
Summary Calendar
UNITED STATES OF AMERICA,
Plaintiff-Appellee,
versus
STEVEN SCOTT MCLEMORE,
Defendant-Appellant.
Appeal from the United States District Court
for the Northern District of Mississippi
USDC No. 1:05-CR-60-1
Before GARWOOD, DeMOSS and BENAVIDES, Circuit Judges.
PER CURIAM:*
Steven Scott McLemore appeals his conviction and sentence for
health care fraud in violation of 18 U.S.C. § 1347. Although
McLemore was ineligible to participate in Medicare, Medicaid, or
any other federal health care benefit program due to a prior
*
Pursuant to 5TH CIR. R. 47.5 the Court has determined that this
opinion should not be published and is not precedent except under
the limited circumstances set forth in 5TH CIR. R. 47.5.4.
conviction for Medicare fraud, he nonetheless obtained employment
with Medicare provider Medical South, Inc. McLemore fraudulently
applied for and obtained a Medicare provider number for Medical
South, Inc., which used the provider number to submit to Medicare
and Medicaid reimbursement claims for medical services.
McLemore argues that the evidence is legally insufficient to
support his conviction because there is no evidence that any of the
reimbursement claims he submitted on behalf of Medical South were
substantively false. McLemore contends that the indictment
“overcharged” his conduct because there is no evidence that he
fraudulently obtained or sought to obtain money or property from a
federal health care benefit program. McLemore argues the trial
court lacked jurisdiction to enter judgment because the Government
failed to allege or to prove that his offense had an effect on
interstate commerce. Alternatively, McLemore suggests that his
conviction is invalid because there was a material variance between
the allegations in the indictment and the proof at trial. Finally,
McLemore argues that his sentence is unreasonable because the
district court erroneously held him responsible for a loss equal to
the amount of the reimbursement claims that he submitted on behalf
of medical South using the fraudulently-obtained Medicare provider
number. McLemore argues that although he submitted $612,142 in
claims, only $322,236 in claims were actually paid and all of those
payments reimbursed actual services. Indeed, McLemore argues that
2
there was no “loss” to be considered in the calculations required
by the sentencing guidelines.
Our review of the evidence shows that a rational trier of fact
could have reasonably convicted McLemore of health care fraud.
United States v. Guerrero,
234 F.3d 259, 262 (5th Cir. 2000); see
18 U.S.C. § 1347(2). We find no error in the indictment. United
States v. Arlen,
947 F.2d 139, 145 (5th Cir. 1991). Any variance
between the indictment and the proof at trial was harmless. United
States v. Thomas,
12 F.3d 1350, 1357 (5th Cir. 1994); United States
v. Cochran,
697 F.2d 600, 604 (5th Cir. 1983).
Although the general rules for computing loss provide for
crediting the value of any services actually rendered or property
returned by the defendant against the amount of loss, see U.S.S.G.
§ 2B1.1, comment. (n.3(E)(i)), more specific rules govern frauds
involving government agencies:
“In a case involving a scheme in which . . . goods for
which regulatory approval by a government agency was . .
. obtained by fraud, loss shall include the amount paid
for the property, services or goods transferred, rendered
or misrepresented, with no credit provided for the value
of the those items or services.” U.S.S.G. § 2B1.1,
comment. (n.3.(F)(v)) (emphasis added).
There is no setoff for the value of any services actually
rendered or products provided. Furthermore, the determination of
the amount of loss for calculations under U.S.S.G. § 2B1.1(b)(1)
require the use of the greater of actual loss of intended loss.
U.S.S.G. §2B1.1, comment. (n.3.(A)(i)–(ii)).
3
We conclude that McLemore’s sentence, which was properly
calculated under the advisory Sentencing Guidelines and is within
the applicable guideline range, is reasonable. United States v.
Alonzo,
435 F.3d 551, 553-54 (5th Cir. 2006).1
1
During the Sentencing Hearing, McLemore argued that he did
not actually intend to defraud Medicare of claim amounts because he
never actually expected to receive the amounts he for which he
filed claims. The district court dismissed this contention:
Defense Counsel: “So even though a claim was
submitted for more than the allowable,
everybody knows when the claim’s submitted,
there’s no intention or expectation that
they’re going to pay anything but the
allowable.”
Court: “Are you saying the whole Medicare
program is built on fraud?”
Defense Counsel: “I’m not saying it’s built on
fraud at all, Your Honor. I’m saying if
somebody submits a bill for a thousand dollars
for a pair of shoes, they know Medicare is
only going to pay what Medicare’s reasonable
and allowable is for a pair of shoes. So
[McLemore] never intended to get what he
submitted [$612,142], he only intended to get
what was the allowable under Medicare rules
[$322,236]. That’s the real fact of what
happened here.”
Court: “That’s preposterous. . . . I don’t
believe he can do that. I don’t think
Medicare and Medicaid would do that. . . . I
don’t think you have sufficient proof to
establish that point. I’m going to go with
the intended loss, which is what he actually
billed them and y’all can take it up with a
higher authority as to whether or not that’s
the way everybody does it in Medicare or
Medicaid. I don’t have any proof of that. I
suspect you may be right. It disappoints me.
That’s part of the problem with the whole
4
AFFIRMED.
program, I think.”
5 Rawle 381–83.
Mr. McLemore does not argue this point on appeal.
5