In Re: The Bankruptcy Estate of AGS, Inc. v.

565 F. App'x 172
CourtCourt of Appeals for the Fourth Circuit
DecidedApril 4, 2014
Docket14-1296
StatusUnpublished
Cited by2 cases

This text of 565 F. App'x 172 (In Re: The Bankruptcy Estate of AGS, Inc. v.) is published on Counsel Stack Legal Research, covering Court of Appeals for the Fourth Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
In Re: The Bankruptcy Estate of AGS, Inc. v., 565 F. App'x 172 (4th Cir. 2014).

Opinion

Petition denied by unpublished PER CURIAM opinion.

Unpublished opinions are not binding precedent in this circuit.

PER CURIAM:

The bankruptcy estate of AGS, Inc. has petitioned for a writ of mandamus pursuant to 18 U.S.C. § 3771(d). It seeks to require defendant Allen G. Saoud to pay it restitution following his conviction on multiple counts of health care fraud and other associated charges. See United States v. Saoud, Criminal Case No. 1:12-CR-113 (pending N.D. W. Va.) (Keely, J.). Petitioner contends that it was a victim under the Mandatory Victims’ Restitution Act, 18 U.S.C. § 3663A, and is entitled to a restitution award of more than $1 million. For the reasons that follow, we deny the petition. *

I.

Allen G. Saoud was convicted after a June 2013 jury trial of thirteen counts of health care fraud and several other offenses. According to the evidence presented at trial, the defendant, who is a dermatologist, was excluded in 2005 from participating in Medicare and Medicaid for a period of ten years. He then hatched a plan to maintain ownership and control of his dermatology practice, AGS Inc. (“AGS”) in violation of the exclusion. To execute this fraudulent scheme, he founded a new dermatology practice, to which he transferred all of his patients. He then fraudulently sold this practice to Dr. Fred Scott for $1.8 million. He then sold AGS, which had lost its value, for $1 million to nurse practitioner Georgia Daniel. After *174 these sales, he continued to control and profit from both entities, partly by collecting Medicare and Medicaid reimbursement funds. The defendant never told his staff of his exclusion from Medicare and Medicaid during this time.

After the defendant was convicted, petitioner sought a restitution award of more than $1 million to cover bankruptcy claims by Highmark West Virginia, Inc. (“High-mark”), the West Virginia State Tax Department, as well as petitioner’s attorneys’ fees. The validity of these bankruptcy claims was not discussed in the government’s case against the defendant at trial. Highmark alleges that multiple AGS doctors had overbilled it from 2000 to early 2006. The state of West Virginia claims that AGS owed it tax payments from the tax years 2000 to 2004. The district court declined to award petitioner its desired restitution, and this petition followed.

II.

A.

Typically writs of mandamus are subject to a stringent standard of review, requiring that “a petitioner must show that he has a clear and indisputable right to the relief sought and there are no other adequate means to attain the relief he desires.” In re U.S. for an Order Pursuant to 18 U.S.C. Section 2708(D), 707 F.3d 283, 289 (4th Cir.2013) (internal quotation marks omitted). Our sister circuits have disagreed about whether this demanding standard applies to mandamus petitions filed under § 3771 or if instead traditional appeal standards apply. Compare, e.g., United States v. Fast, 709 F.3d 712, 718 (8th Cir.2013) and In re Antrobus, 519 F.3d 1123, 1124-25 (10th Cir.2008) (applying the mandamus standard of review) with Kenna v. U.S. Dist. Court for C.D.Cal., 435 F.3d 1011, 1017 (9th Cir.2006) and In re W.R. Huff Asset Mgmt. Co., LLC, 409 F.3d 555, 563 (2d Cir.2005) (applying the standards applicable to ordinary appeal). We have left the issue open. See In re Brock, 262 Fed.Appx. 510, 512 (4th Cir.2008). We need not decide this question here. It is sufficient simply to note that to issue a writ of mandamus to a district court is not something to be undertaken lightly.

B.

The petitioner claims that it is due restitution under the Mandatory Victims’ Restitution Act (“MVRA”), 18 U.S.C. § 3663A. The statute defines a “victim” as: “a person directly and proximately harmed as a result of the commission of an offense for which restitution may be ordered including ... any person directly harmed by the defendant’s criminal conduct in the course of [a] scheme, conspiracy, or pattern.” Id. § 3663A(a)(2). We have noted that under the MVRA, “alleged victims must be the victims of the offense of conviction.” United States v. Freeman, 741 F.3d 426, 435 (4th Cir.2014) (emphasis in original). In order to determine whether there is an adequate connection between the alleged victim’s losses and the defendant’s specific conduct, “we look to the elements of the offense of conviction and the specific conduct underlying these elements.” Id. at 437. An examination of the trial record makes clear that petitioner does not qualify as a victim for purposes of the MVRA.

The elements of health care fraud require a person to knowingly and willfully execute or attempt to execute a scheme to (a) defraud a health care benefit program; or (b) fraudulently obtain property or money owned or under the custody or control of any health care benefit program. See 18 U.S.C. § 1347. The second superseding indictment (“indictment”) specifically alleged in counts one through five — all five *175 of which the defendant was convicted— that the defendant knowingly devised a scheme intended to defraud Medicare and Medicaid and to fraudulently obtain the programs’ money and property. See J.A. at 28. And elsewhere in the indictment, the government alleged that the defendant used AGS as an instrument in his scheme to illegally obtain Medicare and Medicaid funds. See id. at 29-30. It is clear that the scheme was aimed at defrauding these federal programs. AGS was one of the means through which the defendant perpetrated the fraud upon them. We decline to also hold that AGS was one of the scheme’s victims.

Meanwhile, the damage suffered by AGS’s creditors from defendant’s fraudulent activity can at best be described as tangential to the scheme to defraud Medicare and Medicaid that is the basis for restitution. As noted above, the statute and our precedents require direct or proximate harm from the offenses of conviction. To the extent that AGS’s creditors are harmed because they must expend funds in an attempt to prevail in the bankruptcy proceedings, that damage cannot be said to be adequately related to the defendant’s health care fraud to qualify under the MVRA. See United States v. Abdelbary,

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Related

United States v. Jafari
104 F. Supp. 3d 317 (W.D. New York, 2015)
Sheehan ex rel. Estate of AGS, Inc. v. Saoud
526 B.R. 166 (N.D. West Virginia, 2015)

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Bluebook (online)
565 F. App'x 172, Counsel Stack Legal Research, https://law.counselstack.com/opinion/in-re-the-bankruptcy-estate-of-ags-inc-v-ca4-2014.