Dr. Rafael B. Rierra v. United States

357 F.2d 250, 1966 U.S. App. LEXIS 6952
CourtCourt of Appeals for the Fifth Circuit
DecidedMarch 8, 1966
Docket21589_1
StatusPublished
Cited by2 cases

This text of 357 F.2d 250 (Dr. Rafael B. Rierra v. United States) is published on Counsel Stack Legal Research, covering Court of Appeals for the Fifth Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Dr. Rafael B. Rierra v. United States, 357 F.2d 250, 1966 U.S. App. LEXIS 6952 (5th Cir. 1966).

Opinion

COLEMAN, Circuit Judge.

The appellant was charged in a seven count indictment with using the mails in a scheme to defraud in violation of 18 U.S.C.A. § 1341. He was convicted on six counts and the jury was unable to agree on Count 6. He was sentenced to three years imprisonment on Count 1 and three years on each, subsequent count, the latter to run concurrently with the sentence imposed on the first count.

Appellant complains of (1) denial of his motion for a bill of particulars; (2) of the admission of certain testimony as to what prompted the allegedly defrauded insurance company to launch an investigation in the case; (3) as to the denial of a verdict of acquittal for lack of sufficient evidence; (4) of the admission of certain business records; (5) of the failure to admit a purportedly impeaching statement made by the government’s witness, Pruitt; (6) of allegedly prejudicial remarks of the trial judge; and (7) certain allegedly prejudicial remarks of the prosecuting attorney. • We have carefully considered these contentions and do not consider that they are of sufficient merit to require discussion in this opinion.

The error assigned with reference to the admission of the hearsay statements of one Joseph Vinet that he was receiving “cuts” and “kickbacks” from the appellant in connection with the alleged scheme to defraud leave us no choice but to reverse and remand.

Appellant was charged with devising and intending to devise a scheme to defraud various insurance companies, more particularly The Home Life Insurance Company, and of using the mails in furtherance of the scheme. The insurance Company had a group major medical-expense policy which covered employees of Thomas Jordan, Inc. There was testimony that appellant prepared false invoices or statements of professional services, showing much more medical service to certain patients than had actually been rendered. He would have the patients bring in the insurance claim forms, then he would have them sign the form in blank on the front, and often on the back. The latter procedure would enable him to be paid directly by the insurance company, rather than have the company pay the patient. There was testimony that appellant would falsely claim numerous visits which, in fact, had not taken place. He would charge the insurance company for visits by patients who did not physically go to the doctor’s office. If he sent medicine to a patient by another he would charge the company as for an actual visit from the person by whom he sent the medicine as well as charging for a visit by the patient who was not there. He would not give the patient a prescription for medicine to be filled in a drug store, but would dispense the medicine himself in unlabeled bottles, and when the patient came to get more medicine he would charge for that visit. One James Pruitt was charged with two office visits in August of 1959, at a time when Pruitt was out of the state on vacation. The Doctor claimed Pruitt had visited his office over seventy times for treatment, whereas Pruitt testified that he could not have possibly seen the doctor more than twenty-five times. Bills were sent for treating Pruitt’s stomach trouble, when there was proof that he had not had any such trouble. The insurance company was billed for thirty-five visits by one Robert Champagne, whereas that patient testified that he could not have seen the doctor more than fifteen or sixteen times. There was much testimony of attempts by the appellant himself, or by others in his behalf, to get the witnesses to change their testimony after they had been before the grand jury.

When the insurance company began its investigation, in the Spring of 1960, the investigator assigned to the task examined Dr. Rierra’s records. This alarmed the doctor and he wrote a letter *252 to the insurance company, in which he made the following statements:

“Attention: Group Claim Department Heads, or Executive Officers. Gentlemen, I have been lied about and put into an embarrassing position by one Joseph Vinet, a patient of mine. The matter is serious when considered with the fact that I myself have sent bills to your company which are open to question, in view of the fact that a number of the bills do not reflect the truth.
“Joseph Vinet has admitted to me that during the years 1959, and 1960, he often bragged to his fellow workers at Thomas Jordan, Inc. that he was receiving cuts and kickbacks from me on insurance money. That is a deliberate falsehood. It is entirely untrue. I deny this emphatically. I have spoken with some of the men that Joseph Vinet works with, and who are patients of mine, including his brother, Julian, and they have told me that Joseph had often repeated to them that he and I were close friends, and that Joseph claimed that we had an insurance deal wherein Joseph was making out all right through his own insurance claim, and from insurance claims paid me, and that he was getting a cut from me. I was shocked to hear this. I have never gave Joseph Vinet or any other patient one penny from any insurance money coming to me for services rendered and etc. Nor did I give Joseph Vinet any (gratuities) for referring the few patients he did. I am in the dark as to the motive of some of these patients who have directly told me that I did not see them or treat them at the time, or some of the times for which I have sent bills to your company. I am greatly concerned about this, because of the fact that a partial review of my books which I have made, shows me that some of their contentions are not wholly untrue. The fact of the matter is that there are a good number of times where I sent medicine by Joseph Vinet and by Robert Champagne and others to Mr. James Pruitt. I did charge for the medicine, but at the same time I also charged for a visit by the patient, Pruitt, who hadn’t been here. This was done because my time was taken by the man by whom I sent the medicine. I frankly do not know the dates or the number of such charged patient’s visits. I cannot understand how I came to put down visits and treatments at a time when I have been told by the patients themselves that they were on vacation outside of the state of Louisiana. In reviewing my records and bills to your company, I find that I cannot substantiate or support these bills.
“I have been further upset by the knowledge that Joseph Vinet has threatened to beat up those responsible for cutting off his kickback, (which never existed), and the fact that he went ahead and beat up Mr. Champagne. The fact that he did this has probably persuaded certain patients, erroneously, that Joseph did have a good thing, and of course is an untruthful remark, which I knew nothing of, can reflect unfavorably on me.”

It will at once be seen that this letter went a long way toward being an admission of guilt and that the government could have relied on this letter as a most damaging piece of self-incrimination. The prosecutor, however, was not content to stop there. Over strenuous objection, he introduced hearsay evidence of what Joseph Vinet had said and done as will hereinafter be set forth. There was no indictment for conspiracy and Vinet was not named as co-defendant or as co-conspirator. When this case was argued at the Bar of this Court government counsel stated that Vinet was present at the trial, held under the rule as a witness, but the government did not put him on the stand because it did not wish to vouch for his credibility.

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Cite This Page — Counsel Stack

Bluebook (online)
357 F.2d 250, 1966 U.S. App. LEXIS 6952, Counsel Stack Legal Research, https://law.counselstack.com/opinion/dr-rafael-b-rierra-v-united-states-ca5-1966.