Afzal Beemath v. United States

Court of Appeals for the Sixth Circuit·Decided August 13, 2026·No. 24-2115·Unpublished

Opinion

NOT RECOMMENDED FOR PUBLICATION File Name: 26a0357n.06

No. 24-2115

UNITED STATES COURT OF APPEALS FILED FOR THE SIXTH CIRCUIT Aug 13, 2026 KELLY L. STEPHENS, Clerk

AFZAL BEEMATH, )

)

Petitioner-Appellant, ) ON APPEAL FROM THE ) UNITED STATES DISTRICT v.

) COURT FOR THE EASTERN UNITED STATES OF AMERICA, ) DISTRICT OF MICHIGAN )

Respondent-Appellee. )

OPINION

)

)

Before: MOORE, CLAY, and NALBANDIAN, Circuit Judges.

CLAY, Circuit Judge. Petitioner Afzal Beemath appeals from the district court’s judgment denying his 28 U.S.C. § 2255 motion to vacate his sentence. In 2021, Beemath pleaded guilty to conspiracy and unlawful distribution of controlled substances under 21 U.S.C. §§ 841(a)(1) and (b)(1)(C). The district court sentenced him to a term of imprisonment of 120 months. Beemath moved to vacate that sentence, primarily claiming ineffective assistance of counsel. For the reasons set forth below, we AFFIRM the district court’s judgment denying Beemath’s motion.

I. BACKGROUND

A. Factual Background Petitioner Afzal Beemath was a medical doctor who attended medical school in the Dominican Republic and then began a residency program at St. Joseph Mercy Oakland in Pontiac, Michigan. In 2008, Beemath’s residency program investigated him and found irregularities in his

prescriptions of OxyContin and other medications, so the program terminated his enrollment. State regulators filed an administrative complaint against Beemath related to that investigation, and the parties entered a consent order to resolve it. As part of that consent order, Beemath was required to participate in continuing education about prescribing medications and medical ethics. Beemath ultimately completed a residency program at Wayne State University and a postgraduate fellowship in palliative medicine. By 2010, Beemath had his full license to practice medicine in Michigan and a license to prescribe controlled substances. He has served in several roles as a physician and, most relevant to this case, he opened his own palliative care clinic in 2013 in Lathrup Village, Michigan.

At his clinic, Beemath prescribed controlled substances, namely oxycodone, oxymorphone, and Xanax, to patients who did not have legitimate medical needs. Based on the government’s evidence, Beemath would see dozens of patients in a day, many of whom would pay in cash, and he would prescribe them opioids and other potentially lethal medications without proper examination. He would make efforts to appear as though he was complying with state law, such as by prescribing other innocuous maintenance drugs, checking the Michigan Automated Prescription System, and sporadically screening patients’ urine. He would even reprimand patients who failed their urine analyses and coach them on how to prepare and avoid flags in future results. Specifically, he would instruct them that their urine had to show that they were taking the drugs he had prescribed and no other illicit drugs.

Beemath worked with recruiters who would secure appointments for and receive payment from new patients. He would charge them cash for visits only if the patient was leaving his office with a prescription. Many of the patients who received opioid prescriptions from Beemath would sell those pills to others, and Beemath made comments revealing that he was aware of that fact.

By August 2018, state regulators brought a superseding administrative complaint against Beemath for his prescribing practices. A disciplinary subcommittee of Michigan’s Board of Medicine alleged that in 2015 and 2016 Beemath was among the top prescribers of commonly abused and diverted controlled substances in the state, that a large proportion of Beemath’s controlled substance prescriptions were for Xanax, oxycodone, oxymorphone, and a few others, that a disproportionate number of patients receiving those prescriptions from Beemath were paying in cash, and that Beemath consistently prescribed controlled substances to patients with discrepant urine drug screen results.

B. Procedural Background In October 2018, a federal grand jury indicted Beemath on 1 count of conspiracy to possess with intent to distribute and to distribute controlled substances under 21 U.S.C. §§ 841(a)(1) and 846, and 14 counts of unlawful distribution of controlled substances (aiding and abetting) under 18 U.S.C. § 2 and 21 U.S.C. § 841(a)(1). The indictment charged him with writing prescriptions for controlled substances outside of the scope of professional medical practice, in exchange for cash payments, and working with coconspirators who recruited patients to Beemath’s clinic. Those controlled substances included oxycodone, oxymorphone, and alprazolam, known by the brand name Xanax. Later, a superseding indictment added 16 additional counts of unlawful distribution of controlled substances (aiding and abetting) under 18 U.S.C. § 2 and 21 U.S.C. § 841(a)(1).

The district court continued the trial multiple times at Beemath’s request, because Beemath required additional time and resources to prepare for trial while in custody. Throughout the protracted lead up to trial, Beemath indicated that he was uninterested in a plea agreement.

The parties reviewed discovery, prepared expert reports, and filed proposed voir dire questions and trial exhibit objections.

Among the pretrial motions was the government’s motion to admit res gestae evidence.

The government anticipated that Beemath would raise a mental state defense. It argued that because the government would have to prove mens rea beyond a reasonable doubt, the evidence in question would serve the proper purposes of either completing the story of the charged conspiracy or establishing Beemath’s intent and knowledge under Federal Rule of Evidence 404(b). Specifically, the government sought to introduce evidence related to Beemath’s past unlawful prescribing, the relationship between Beemath and his coconspirator, and the state’s previous disciplinary actions against Beemath. Beemath was present when the government raised this issue before the district court.

Also in anticipation of the mens rea issue, the parties stipulated to the exclusion of improper expert testimony regarding Beemath’s criminal intent. Their stipulation acknowledged, “Conspiracy to possess with the intent to distribute and to distribute controlled substances, and unlawful distribution of controlled substances both have a ‘knowing and intentional’ element . . . .” Stipulation Exclude Improper Test., R. 110, PageID #732 (citation omitted).

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