United States v. Hall

134 F.4th 782
CourtCourt of Appeals for the Fifth Circuit
DecidedApril 15, 2025
Docket24-10515
StatusPublished

This text of 134 F.4th 782 (United States v. Hall) 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. Hall, 134 F.4th 782 (5th Cir. 2025).

Opinion

Case: 24-10515 Document: 73-1 Page: 1 Date Filed: 04/15/2025

United States Court of Appeals for the Fifth Circuit ____________ United States Court of Appeals Fifth Circuit

No. 24-10515 FILED ____________ April 15, 2025 Lyle W. Cayce United States of America, Clerk

Plaintiff—Appellee,

versus

Richard Hall,

Defendant—Appellant. ______________________________

Appeal from the United States District Court for the Northern District of Texas USDC No. 3:18-CR-623-1 ______________________________

Before Elrod, Chief Judge, and Jones and Stewart, Circuit Judges. Carl E. Stewart, Circuit Judge: Richard Hall wanted in on the lucrative market for compounded drugs. Federal insurers paid well. He and his partners built a pharmacy, hired marketers, and found doctors to write prescriptions. The money flowed. But so did the fraud. The government charged Hall with paying illegal kickbacks to secure prescriptions, laundering the proceeds, and defrauding federal healthcare programs under the Anti-Kickback Statute (“AKS”). A grand jury indicted him. A jury convicted him. The district court sentenced him to 52 months’ imprisonment and ordered him to pay more Case: 24-10515 Document: 73-1 Page: 2 Date Filed: 04/15/2025

No. 24-10515

than $59 million in restitution. Hall now appeals. For the reasons that follow, we AFFIRM. I. Richard Hall reconnected with an old classmate, Dustin Rall, at a 2012 golf tournament. Their conversation turned to compounding pharmacies. Rall needed a licensed facility to mix prescription drugs. Hall’s father, Lewis Hall, was a pharmacist struggling to sell his business. To them, the solution seemed clear: repurpose the pharmacy for compounding. By 2013, Hall, Rall, Lewis, and Scott Schuster formed Rxpress. Each played a role—Hall handled compliance, his father oversaw pharmacy operations, Rall managed finances, and Schuster led marketing. The business model relied on existing physician networks. Schuster expanded outreach, recruiting marketers to promote the pharmacy’s compounded drugs. The four each identified high-reimbursement formulations, secured prescriptions, and billed both private and federal insurers. A year later, the group restructured. They launched a second pharmacy, Xpress Compounding, after consulting legal counsel. The plan was strategic. Rxpress would handle private insurance claims, allowing physician investment, while Xpress would process prescriptions covered by federal programs like Medicare and TriCare. This structure also allowed marketers to receive commission-based pay. If the drugs were federally reimbursed, these payments likely violated the AKS. So to avoid liability, Hall and his partners claimed they converted Xpress marketers from independent contractors to W-2 employees. The distinction was more form than substance. Marketers for both pharmacies continued to induce physicians to write prescriptions and still received commissions tied to prescription value—in effect, kickbacks. To secure physician cooperation, the marketers offered incentives:

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directorships, consulting agreements, luxury trips, and fine dining. Between 2014 and 2016, Xpress received over $59 million in federal healthcare reimbursements. In 2018, a grand jury indicted Hall and seven co-conspirators. Charges included conspiracy to defraud the United States and to receive health care kickbacks under 18 U.S.C. § 371 (Count 1) and multiple counts of paying and receiving illegal kickbacks under 42 U.S.C. § 1320a-7b(b)(1) and (2) (Counts 2–5). A superseding indictment added charges of money laundering conspiracy under 18 U.S.C. § 1956(h) (Count 7) and substantive money laundering under 18 U.S.C. § 1957 (Count 9). The case proceeded to trial on Counts 1 through 5 and Count 7. The jury found Hall guilty on Counts 2 through 5 and 7. The district court sentenced him to 52 months in prison, three years of supervised release and imposed restitution in the amount of $59,879,871. Hall filed a Motion for Release Pending Appeal. But the district court and this court denied his request. He subsequently appealed. II. The AKS’s provision at issue, 42 U.S.C. § 1320a-7b(b)(2), “criminalizes the payment of any funds or benefits designed to encourage an individual to refer another party to a [Federal health care program provider] for services to be paid by the [Federal healthcare] program.” United States v. Miles, 360 F.3d 472, 479 (5th Cir. 2004). Section 1320a-7b(b)(2) provides that: Whoever knowingly and willfully offers or pays any remuneration (including any kickback, bribe, or rebate) directly or indirectly, overtly or covertly, in cash or in kind to any person to induce such person—

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(A) to refer an individual to a person for the furnishing or arranging for the furnishing of any item or service for which payment may be made in whole or in part under a Federal health care program, or (B) to purchase, lease, order, or arrange for or recommend purchasing, leasing, or ordering any good, facility, service, or item for which payment may be made in whole or in part under a Federal health care program, shall be guilty of a felony and upon conviction thereof, shall be fined not more than $100,000 or imprisoned for not more than 10 years, or both. Under the AKS’s safe-harbor provision, however, the statute’s criminal prohibition does not apply to “any amount paid by an employer to an employee (who has a bona fide employment relationship with such employer) for employment in the provision of covered items or services.” Id. § 1320a-7b(b)(3)(B). III. Hall presses four arguments on appeal: (A) the district court erred in its jury instructions by placing the burden of persuasion on Hall to establish the safe-harbor defense under the AKS; (B) the district court erred in its jury instructions by defining “employee” related to the safe-harbor defense and rejecting Hall’s proposed instruction; (C) the district court erred by refusing to include Hall’s jury instruction on the recipients of the alleged kickbacks; and (D) the district court erred in imposing restitution. We address each in turn. A. We begin with whether the district court erred in instructing the jury that Hall bore the burden of persuasion to establish the bona fide employee safe-harbor defense under the AKS. Hall calls this a matter of first impression

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for this court. On that much, we agree. But he goes further, arguing that while he accepted the burden of production, the court wrongly placed on him the burden of persuasion, requiring proof by a preponderance of the evidence. He believes that warrants reversal. We disagree. We generally review jury instructions for abuse of discretion. United States v. Hamilton, 46 F.4th 389, 394 (5th Cir. 2022). A jury instruction is not an abuse of discretion if it “is a correct statement of the law” and “clearly instructs jurors as to the principles of law applicable to the factual issues confronting them.” Id. (quoting United States v. Freeman, 434 F.3d 369, 377 (5th Cir. 2005) (internal quotes omitted)).

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Bluebook (online)
134 F.4th 782, Counsel Stack Legal Research, https://law.counselstack.com/opinion/united-states-v-hall-ca5-2025.