Friday, November 01, 2013

Split Panel Affirms Co-Defendant's Conviction in Medicare Fraud Case

U.S. v. Adegboye, 2013 WL 5615054 (10/15/13) (Okl.) (Published) - On the other hand, Mr. Rufai's co-defendant was not so lucky, falling on the wrong side of the sufficiency ledger, according to a split 10th Circuit. Mr. Adegboye was more involved in the operation of the bogus company and, unlike Mr. Rufai, was involved after medicare started reimbursing the company. There was evidence he knew the business model was to provide durable equipment reimbursable by medicare and that the main guy was involved with other companies doing similar things. He wrote checks on the account which put him in a position to know the company was incurring expenses but not paying them out of the company's accounts and then later paying expenses for others of the main guy's companies and receiving lots of reimbursemnet but paying nothing for inventory. He persistently filled out paperwork without mentioning the main guy's primary role in the company, indicating Mr. Adegboye knew the main guy was committing medicare fraud. His visits to the office would have shown him there was no inventory and very few customer files. There was some evidence he knew about customer complaints about not receiving equipment. He made efforts to hide the fraud by writing deceptive checks. And there was evidence Mr. Adegboye profited from the enterprise. The majority acknowledged the question was a close one and that there were innocent explanations for some of what happened , but that the evidence "as a whole" was convincing enough.
Judge Matheson dissented. Mr. Adegboye must have known something was amiss. But his involvement in the business was not enough evidence to show Mr. Adegboye knew the main guy was committing medicare fraud. He visited the office but not when the company submitted false bills. There was no evidence he knew about the volume of complaints. He could have believed the deceptive checks he wrote were legitimate. After-the-fact statements---after the main guy was indicted---to hide involvement have low probative value under the 10th's precedent. It doesn't necessarily show he knew before the indictment that there was medicare fraud. The jury could possibly infer Mr. Adegboye knew about the fraud but not beyond a reasonable doubt.