Havey v. United States

CourtDistrict Court, E.D. Missouri
DecidedMarch 2, 2020
Docket4:17-cv-00852
StatusUnknown

This text of Havey v. United States (Havey v. United States) is published on Counsel Stack Legal Research, covering District Court, E.D. Missouri primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Havey v. United States, (E.D. Mo. 2020).

Opinion

UNITED STATES DISTRICT COURT EASTERN DISTRICT OF MISSOURI EASTERN DIVISION DONALD BRIAN HAVEY, ) Movant, v. No. 4:17-CV-00852 JAR UNITED STATES OF AMERICA, Respondent. MEMORANDUM AND ORDER This matter is before the Court on Movant Donald Havey’s motion under 28 U.S.C. § 2255 to Vacate, Set Aside, or Correct Sentence by a Person in Federal Custody, as amended. (Doc. No. 1). The motion is fully briefed and ready for disposition. For the following reasons, Havey’s motion is denied,' I. Background On October 22, 2015, Havey waived indictment and pled guilty to one felony count of executing a healthcare fraud scheme in violation of 18 U.S.C. § 1347(a)(1). At his plea hearing (Case No. 4:15CR00483, Plea Transcript, Doc. No. 44 at 16-18; Plea Agreement, Doc. No. 5 at 6-9), Havey acknowledged, under oath, that the following facts were true and correct: At all relevant times, Havey was a licensed doctor of chiropractic medicine in the state of Missouri. Havey owned and operated companies that sold orthotic devices in Missouri, namely Spinal Decompression of Chesterfield; Senior Care, Inc.; Advanced Custom Orthotics, Inc.; and Missouri Custom Orthotics; and in Illinois, namely Midwest Illinois Orthotics, LLC (referred to

' Because Havey’s motion can be conclusively determined based on the motion, files and records of the case, an evidentiary hearing need not be held. See Shaw v. United States, 24 F.3d 1040, 1043 (8th Cir. 1994).

collectively as “Companies”). The Companies were principally engaged in providing durable medical equipment (DME) to the public, including Medicare Part B beneficiaries. Between 2009 and 2014, Havey executed and attempted to execute a scheme to defraud Medicare, Medicaid, other public and private health insurance companies, and patients by creating and using false documents, including false and fraudulent reimbursement claims, related to ankle-foot orthotics. Havey marketed a “Fall Prevention Program” (“Program”) to nursing homes, claiming it would reduce falls by almost 20% and improve the patients’ quality of life. Havey, and others acting at his direction, deliberately concealed from the nursing homes that the real purpose of the Program was to sell orthotic boots to their patients. Havey, and others acting at his direction, told the nursing homes that there would be little or no cost to patients, when he knew that a Medicare patient could be charged as much as $500.00, if the patient did not have supplemental insurance. Havey created several websites to market the Program. One website in particular, www.seniorcareinc.net, stated that patients would incur little or no cost if they participated in the Program. Havey employed chiropractors in Missouri and other states, including Texas, Alabama, California, Georgia, Illinois, Kentucky, Massachusetts, Mississippi, Oklahoma, Rhode Island, and Tennessee, to market the Program and sell orthotic boots. He created a document entitled “Senior Care, Inc. Fall Prevention Program Training Manual and Handbook” (“Training Manual”), which provided detailed instructions on how to implement the Program. The document contained a number of misleading and false statements to induce others to implement the Program. The Training Manual clearly displays Havey’s knowledge and understanding of Medicare reimbursement. Specifically with respect to reimbursement, Havey states in the Training Manual that Medicare Part B patients would be preferred and targeted because Medicare does not require

pre-authorization, usually has a higher allowable/payable amount than commercial or HMO policies, and usually pays within 14-21 days from the day the claim is received. Further, Havey stated in the Training Manual that Medicare has a set allowable amount for the product so the provider knows how much reimbursement te expect each time. In addition, Medicare pays 80% of the allowable, with the remaining 20% paid by secondary insurance or Medicaid if the resident has the additional benefits on their policy. Havey further stated in the Training Manual that Medicare required the DME provider to deliver the product to the: patient before submitting a reimbursement claim to Medicare. Nonetheless, he knowingly submitted and caused to be submitted reimbursement claims before the orthotic boots were delivered to patients. Knowing that that Medicare would scrutinize any company that submitted claims for large numbers of expensive orthotic boots, Havey submitted claims through several of the Companies, although there was no business reason for submitting claims in this manner. For example, a representative of Havey assessed and ordered orthotics for five Medicare patients residing in the same facility on the same day. Two of the residents’ claims were submitted to Medicare using Advanced Custom Orthotics as the supplier and the other three were submitted to Medicare using Senior Care Orthotics as the supplier. Healthcare Common Procedure Coding System (“HCPCS”) is a standardized coding system used to identify certain supplies, services, and products, such as DME products provided to patients. Havey included on reimbursement claims a combination of HCPCS codes that did not describe the orthotic boots actually provided to the patients. On or about September 27, 2011, in the Eastern District of Missouri, Havey knowingly and willfully executed and attempted to execute the above described scheme and artifice to defraud a

health care benefit program, in connection with the delivery and payment for health benefits, items, and services, by causing the submission of a false and fraudulent reimbursement claim to Medicare for orthotic boots provided to Patient A. W. At various times during the above described scheme, Havey requested that administrative law judges review and overturn the decisions of Medicare contractors who had denied his reimbursement claims. During these hearings, Havey knowingly and willfully presented false documents and made false statements to support the claims. During the investigation of the above described offense, Havey knowingly and willfully produced, in response to a federal subpoena, bogus documents that he created to conceal the fraud scheme. Havey signed the names of other chiropractors on some of the bogus documents. The parties stipulated to a Joss of $2,276,221.00. The transcript of the plea hearing reflects that the Court closely examined Havey regarding the voluntariness of his plea, and reflects a plea that was entered “freely, voluntarily, and intelligently, with a full understanding of the charges and the consequences of the pleas, with an understanding of his rights attending a jury trial, [and] the effect of the pleas of guilty on those rights.” (Plea Tr. at 28). Havey waived his right to appeal all non-jurisdictional, non-sentencing issues (Plea Tr. at 23-24) and further waived his right to contest his sentence or conviction in a post-conviction proceeding, except for claims of prosecutorial misconduct or ineffective assistance of counsel. (Plea Agreement at 24-25). On March 2, 2016, the Court sentenced Havey to a term of imprisonment of 51 months for the crime of health care fraud, followed by supervised release for a term of three years. Restitution in the amount of $2,276,220.95 was also ordered. No direct appeal was filed.

On March 6, 2017, Havey filed a Motion Under 28 U.S.C. § 2255 to Vacate, Set Aside, or Correct Sentence raising three grounds for relief: 1.

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Havey v. United States, Counsel Stack Legal Research, https://law.counselstack.com/opinion/havey-v-united-states-moed-2020.