United States v. Albert Diaz

CourtCourt of Appeals for the Fifth Circuit
DecidedSeptember 13, 2019
Docket18-60455
StatusUnpublished

This text of United States v. Albert Diaz (United States v. Albert Diaz) 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
United States v. Albert Diaz, (5th Cir. 2019).

Opinion

Case: 18-60455 Document: 00515117518 Page: 1 Date Filed: 09/13/2019

IN THE UNITED STATES COURT OF APPEALS FOR THE FIFTH CIRCUIT United States Court of Appeals

No. 18-60455 Fifth Circuit

FILED September 13, 2019

UNITED STATES OF AMERICA, Lyle W. Cayce Clerk Plaintiff - Appellee

v.

ALBERT DIAZ, M.D.,

Defendant - Appellant

Appeals from the United States District Court for the Southern District of Mississippi USDC No. 2:17-CR-31-1

Before STEWART, Chief Judge, and JONES and OWEN, Circuit Judges. PER CURIAM:* Following a five-day jury trial, Albert Diaz was convicted on various counts of healthcare fraud, distribution of controlled substances, and obstruction of justice. He was sentenced to 42 months of imprisonment and ordered to pay more than $3 million in restitution. He now appeals his convictions and the restitution order. We affirm.

* Pursuant to 5TH CIR. R. 47.5, the court has determined that this opinion should not be published and is not precedent except under the limited circumstances set forth in 5TH CIR. R. 47.5.4. Case: 18-60455 Document: 00515117518 Page: 2 Date Filed: 09/13/2019

No. 18-60455 I. Factual & Procedural Background In October 2014, Gerald Schaar, a pharmaceutical sales representative for Advantage Pharmacy 1 (“Advantage”), approached Albert Diaz, a practicing physician with clinics in Biloxi and Ocean Springs, Mississippi, and asked Diaz to write prescriptions for specific compounded medications. The prescriptions would be written to patients whose personal identification information was provided to Schaar by Randy Thomley, an employee of a marketing company for Advantage. Diaz agreed to write the prescriptions with the knowledge that Schaar would receive a commission when each prescription claim was paid by the health care benefit administrator. The primary benefit administrator was Tricare, a Department of Defense health care program providing coverage to members of the military and their families. From October 2014 through September 2015, Diaz wrote multiple prescriptions that resulted in the filing of 573 false claims, totaling more than $2.3 million in payments from Tricare and over $1 million in payments from private insurance companies. The fraudulent prescriptions Diaz wrote included prescriptions for an ointment containing ketamine, a Schedule III controlled substance used for pain. In December 2015, Diaz received an audit letter from Tricare, inquiring about specific claims related to the prescriptions he had written for Schaar. After receiving the letter, Diaz asked Schaar to arrange for him to see the patients who had received the prescriptions he had written so that he could create a medical chart showing that he had examined them. In January 2016, Diaz and Schaar traveled to Hattiesburg, Mississippi on a Saturday to meet with Thomley and make house calls to see the patients. Diaz then created

1 Advantage was a compounding pharmacy that operated out of Hattiesburg, Mississippi. 2 Case: 18-60455 Document: 00515117518 Page: 3 Date Filed: 09/13/2019

No. 18-60455 medical charts with either backdated or omitted dates to conceal the fact that he had not examined the patients before writing the prescriptions. 2 Over the course of 2016 and 2017, Diaz made multiple false statements to federal agents during the investigation of the offense to conceal his involvement. In September 2016 and January 2017, investigators recorded two conversations between Diaz and Schaar, who was cooperating with investigators. In the recordings Diaz admitted that he had prescribed the compounded medications without first seeing the patients and had subsequently engaged in a coverup to escape culpability. In October 2017, a federal grand jury charged Diaz with multiple counts of health care and wire fraud, controlled substance (i.e., ketamine) distribution and dispensing, and obstruction of justice, including conspiracy offenses. The week before trial, Diaz sought a third continuance on grounds that the government had belatedly disclosed discovery and impeachment material related to Schaar. The district court denied the motion and the case proceeded to trial. Following a five-day jury trial, Diaz was convicted of conspiracy to commit health care and wire fraud, substantive wire fraud, conspiracy to distribute a controlled substance, distribution of controlled substances, conspiracy to obstruct justice by falsifying medical records, and multiple substantive obstruction of justice offenses. Although Diaz had been on pretrial release, he was detained following his conviction, and the district court denied his request for bail pending sentencing. The district court also denied Diaz’s motions for a new trial and for bond pending appeal.

2Prior to creating the backdated charts, Diaz had provided blank charts to Schaar, which Schaar gave to Thomley to gather the information contained in the medical files submitted in support of the false claims.

3 Case: 18-60455 Document: 00515117518 Page: 4 Date Filed: 09/13/2019

No. 18-60455

On October 16, 2018, four months after Diaz had lodged his appeal with this court, the district court, on receiving the required financial information from Diaz, amended its judgment to include restitution in the amount of $3,374,409.16. Two months later in December 2018, Diaz moved this court for release pending appeal which was denied on January 28, 2019. The record indicates that Diaz did not file a second notice of appeal after the district court amended its judgment to include restitution. Diaz advances seven issues on appeal. We address each in turn. II. Discussion A. Sufficiency of the Evidence Diaz challenges his convictions for conspiracy to commit health care fraud or wire fraud, in violation of 18 U.S.C. § 1349, and substantive wire fraud, in violation of 18 U.S.C. §§ 1343 and 2. He also challenges his convictions for obstruction of justice and conspiracy to distribute a controlled substance outside the scope of medical practice and not for a legitimate medical purpose.

“We review preserved challenges to the sufficiency of the evidence de novo, but we are ‘highly deferential to the verdict.’” United States v. Scott, 892 F.3d 791, 796 (5th Cir. 2018) (citation omitted). “When reviewing the sufficiency of the evidence, we view all evidence, whether circumstantial or direct, in the light most favorable to the government, with all reasonable inferences and credibility choices to be made in support of the jury’s verdict.” Id. It is the province of the jury to “weigh any conflicting evidence and to evaluate the credibility of witnesses.” Id. at 797. We consider the evidence “sufficient to support a conviction if ‘any rational trier of fact could have found the essential elements of the crime beyond a reasonable doubt.’” Id. (emphasis in original) (citation omitted). Our question is whether “the jury’s verdict was reasonable, not whether we believe it to be correct.” Id. 4 Case: 18-60455 Document: 00515117518 Page: 5 Date Filed: 09/13/2019

No. 18-60455 We have reviewed the voluminous record in this case and conclude that sufficient evidence was presented at trial to support Diaz’s multiple convictions. Id. The jury’s verdict was reasonable. Id. B. Constructive Amendment We conduct a de novo review of Diaz’s claim that the government constructively amended the indictment. See United States v. Thompson, 647 F.3d 180, 183 (5th Cir. 2011).

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United States v. Albert Diaz, Counsel Stack Legal Research, https://law.counselstack.com/opinion/united-states-v-albert-diaz-ca5-2019.