United States v. Alfredo Felipe Rasco

545 F. App'x 895
CourtCourt of Appeals for the Eleventh Circuit
DecidedNovember 19, 2013
Docket11-14701
StatusUnpublished
Cited by1 cases

This text of 545 F. App'x 895 (United States v. Alfredo Felipe Rasco) is published on Counsel Stack Legal Research, covering Court of Appeals for the Eleventh 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. Alfredo Felipe Rasco, 545 F. App'x 895 (11th Cir. 2013).

Opinion

PER CURIAM:

Alfredo Rasco appeals his two convictions and 133-month total sentence for conspiracy to commit health care fraud, in violation of 18 U.S.C. § 1349, and aggravated identity theft, in violation of 18 U.S.C. § 1028A. After careful review of the entire record, and with the benefit of oral argument, we affirm Rasco’s convictions and total sentence.

I. BACKGROUND

A. The Medicare Fraud Scheme

Defendant Alfredo Rasco (“Rasco”) and Iris Oswald co-owned and operated United Therapy, a health care clinic, in Savannah, Georgia. Rasco and Oswald actively recruited Medicare beneficiaries who suf *897 fered from HIV/AIDS to be patients at the clinic. Rasco and Oswald submitted claims to Medicare for infusion-therapy services that United Therapy purportedly provided to its patients. However, the submitted claims were for services that were not actually provided, not medically necessary, and not entitled to reimbursement from Medicare.

From 2005 to 2008, Rasco and Oswald submitted $5.6 million in false and fraudulent claims to Medicare for United Therapy’s purported infusion-therapy services. Medicare paid United Therapy over $3.5 million of those claims. United Therapy also submitted $146,268.94 in fraudulent claims to the U.S. Railroad Board, which paid a majority of the submitted claims.

To carry out the fraudulent scheme, United Therapy hired a Florida company to submit claims to Medicare on United Therapy’s behalf. Riccy Mederos, who had assisted in aiding the establishment of “hundreds” of fraudulent health care clinics, owned the Florida billing company.

Rasco and Mederos hired Merry Perry, a nurse practitioner. Each week, Perry treated United Therapy’s patients with 50 ccs of infusion medication.

However, at Rasco’s and Mederos’s direction, Perry prepared superbills that falsely stated that she treated the patients with 50 “units” of medication. Under Medicare billing terminology, one unit was the equivalent of ten ccs of medication. Although United Therapy provided only 50 ccs of medication to each patient, United Therapy billed Medicare as though United Therapy’s patients had received 500 ccs of medication. During the scheme, United Therapy purchased only 3,135 grams of infusion medication, but it submitted claims to Medicare stating that United Therapy had administered 27,842 grams of medication.

United Therapy employed four doctors part-time, but none of the doctors actually provided infusion services, prescribed infusion medication, or authorized United Therapy to use their provider numbers.

In 2007, a company that processed claims on Medicare’s behalf informed Ras-co that United Therapy’s billing practices were improper. The day after the claims-processing company contacted Rasco, he and his wife, Niurka Rasco (“Niurka”), opened an account under the name “United Medical” and began funding the account with the proceeds of United Therapy’s fraud.

An investigation into United Therapy’s fraudulent billing activity began. After Rasco became aware of the investigation, Rasco and Niurka established “United Medical” as a Medicare provider so that they could continue their Medicare fraud scheme. To do this, they filed numerous documents, including a “Reassignment of Benefits” application. On the documents, they listed Niurka as the president and owner of United Medical, despite Rasco being the true owner. United Medical submitted $9,395.69 in fraudulent claims to Medicare, but none of those claims were paid by Medicare. It is unclear whether United Therapy continued to submit fraudulent claims to Medicare once United Medical began submitting fraudulent claims.

In submitting the false and fraudulent claims to Medicare, Rasco and Oswald used the name and provider number of a United Therapy doctor. With that number, they submitted over $10,000 of Medicare claims on behalf of United Medical. However, the United Therapy doctor had no knowledge of, and did not consent to, the use of his information in this way.

B. The October 9, 2008 Superseding Indictment

On October 9, 2008, the government filed a superseding indictment charging *898 three defendants — Rasco, his wife Niurka, and Mederos — in relation to the Medicare fraud scheme. Rasco had retained counsel, Alex Zipperer, represent him.

Before the grand jury even returned the superseding indictment, Rasco engaged in preliminary plea negotiations with the government and made factual proffers. As to at least one of Rasco’s factual proffers, the government agreed that no information that Rasco disclosed would be used against him in a criminal case.

After the grand jury returned the superseding indictment, in December 2008, Rasco moved, through counsel, to dismiss it. Rasco argued that the government had improperly used Rasco’s statements from his oral factual proffers to obtain the superseding indictment.

Rasco claimed that he had made the first oral proffer because he “believed that if he truthfully informed the government of his own conduct and his wife’s lack of any knowing participation in the unlawful transactions, the government would subsequently agree not to prosecute his wife and would become amenable to entering into a reasonable plea agreement with him.”

Following this motion, on January 27, 2009, Julie M. Wade entered an appearance as retained counsel for Rasco. Zip-perer, Rasco’s initial counsel, moved to withdraw on May 15, 2009.

On June 22, 2009, defendant Mederos pled guilty to one count each of: (1) conspiracy to commit health care fraud; and (2) health care fraud.

C. The October 7, 2009 Superseding Indictment

On October 7, 2009, before the district court ruled on Rasco’s motion as to the October 2008 indictment, the government filed a third superseding indictment charging three defendants — Rasco, his wife Ni-urka, and Oswald — with offenses stemming from the Medicare fraud scheme. The indictment charged Rasco with: 1 count of conspiracy to commit health care fraud, in violation of 18 U.S.C. §§ 1349 and 2 (Count 1); 54 counts of health care fraud, in violation of 18 U.S.C. §§ 1347 and 2 (Counts 2 through 55); and 3 counts of aggravated identity theft, in violation of 18 U.S.C. §§ 1028A(a)(l) and 2 (Counts 56 through 59).

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Related

Rasco v. United States
134 S. Ct. 2152 (Supreme Court, 2014)

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Bluebook (online)
545 F. App'x 895, Counsel Stack Legal Research, https://law.counselstack.com/opinion/united-states-v-alfredo-felipe-rasco-ca11-2013.