United States v. Jonathan Markovich

Court of Appeals for the Eleventh Circuit·Decided March 14, 2024·No. 23-11835·Published

Opinion

[PUBLISH]

In the

United States Court of Appeals For the Eleventh Circuit

No. 22-10978

UNITED STATES OF AMERICA, Plaintiff-Appellee,

versus JONATHAN MARKOVICH, DANIEL MARKOVICH,

Defendants-Appellants.

Appeals from the United States District Court for the Southern District of Florida D.C. Docket No. 0:21-cr-60020-WPD-1

2 Opinion of the Court 22-10978

No. 23-11835

UNITED STATES OF AMERICA, Plaintiff-Appellee,

versus JONATHAN MARKOVICH, DANIEL MARKOVICH,

Defendants-Appellants.

Appeals from the United States District Court for the Southern District of Florida D.C. Docket No. 0:21-cr-60020-WPD-1

Before WILLIAM PRYOR, Chief Judge, and JILL PRYOR and MARCUS, Circuit Judges. WILLIAM PRYOR, Chief Judge:

This appeal requires us to decide whether the district court abused its discretion by denying Jonathan Markovich and Daniel Markovich a new trial following their convictions for operating

22-10978 Opinion of the Court 3

fraudulent drug rehabilitation clinics. First, the Markoviches argue that the district court violated the Due Process Clause of the Fifth Amendment, see U.S. CONST. amend. V; Brady v. Maryland, 373 U.S. 83 (1963); Giglio v. United States, 405 U.S. 150 (1972), and the Confrontation Clause of the Sixth Amendment, see U.S. CONST. amend. VI, by denying their motion to compel the prosecution to obtain and disclose confidential medical records possessed by third parties. Second, they argue that the district court violated Federal Rules of Evidence 702 and 403 by admitting unreliable and confusing expert testimony about the clinics’ medical and billing practices. Third, they argue that the district court abused its discretion by admitting lay summary testimony about medical and billing records. Fourth, Jonathan Markovich argues that his two bank-fraud counts were prejudicial. Fifth, the Markoviches argue that the district court abused its discretion by denying their motion for discovery, an evidentiary hearing, and for a new trial based on newly discovered evidence . Because the prosecution did not possess the requested records and the Markoviches do not know what the records contain; the expert’s testimony was clear and reliable; the summary testimony was proper; Jonathan Markovich forfeited any challenge to the bank-fraud counts; and the newly discovered evidence is cumulative ; we affirm the Markoviches’ convictions.

I. BACKGROUND

Jonathan Markovich and his brother Daniel Markovich ran two substance-abuse clinics in Florida. Compass Detox, LLC, provided

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inpatient addiction treatment, and We Are Recovery, LLC, provided outpatient treatment.

The prosecution charged the Markoviches—along with six other individuals who helped own, operate, or provide services to the clinics—in a 35-count indictment. The indictment alleged that the Markoviches and their co-conspirators had engaged in fraudulent transactions on the clinics’ behalf. The prosecution charged Jonathan with one count of conspiring to commit health-care fraud and wire fraud, see 18 U.S.C. § 1349; eight counts of health care fraud, see id. § 1347; one count of conspiring to pay and receive kickbacks, see id. § 371; one count of paying and offering kickbacks, see id. § 220(a)(2)(B); one count of soliciting and receiving kickbacks , see id. § 220(a)(1); one count of conspiring to commit money laundering, see id. § 1956(h); eight counts of money laundering, see id. §§ 1956(a)(1)(B)(i), 1957(a); and two counts of bank fraud, see id. § 1344(2). The prosecution charged Daniel with one count of conspiring to commit health-care fraud and wire fraud, see id. § 1349; five counts of health care fraud, see id. § 1347; one count of conspiring to pay and receive kickbacks, see id. § 371; and two counts of paying and offering kickbacks, see id. § 220(a)(2)(B).

The indictment alleged that the Markoviches paid patients to recruit other drug addicts with high-paying health insurance policies to receive “treatment” at the Markoviches’ clinics. The recruiters were instructed to bribe addicts with promises of money, gifts, and drugs if they would admit themselves to the clinics for care. But instead of treating the patients, the Markoviches and their

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associates used additional bribes to encourage the extended stay and readmission of these patients, all while billing their health insurers over $100 million for services that were either medically unnecessary or never provided. For example, the clinics prescribed dangerous combinations of medications with the sole purpose of getting patients high; billed for therapy sessions that patients did not attend; and bribed patients with money and drugs to continue receiving expensive treatments that they did not need. The Markoviches and their co-conspirators reaped about $30 million from the fraudulent claims. And Jonathan Markovich also obtained over $550,000 in loans on the clinics’ behalf through the federal Paycheck Protection Program by certifying in his loan applications that the clinics were not engaged in any illegal activity.

During discovery, the prosecution obtained from third parties the medical and billing records for all the patients admitted to the Markoviches’ clinics. These records revealed the treatment that patients received at the clinics and the bills submitted to the patients’ insurance companies for that treatment. The prosecution disclosed these records to the Markoviches as part of its Brady obligation, and the district court admitted the records into evidence.

Records that reveal information about patients’ substance-

abuse treatment are confidential and protected from disclosure by the Public Health Service Act. See 42 U.S.C. § 290dd-2(a) (records of the identity or treatment of any patient relating to substance- abuse treatment are confidential). To obtain those records, the prosecution had to abide by strict confidentiality procedures.

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Without patient consent, treatment records may be disclosed only if authorized by court order “after application showing good cause.” Id. § 290dd-2(b)(2)(C). Only an “administrative, regulatory, supervisory, investigative, law enforcement, or prosecutorial agency” may apply for a court order to obtain patient records in connection with a criminal prosecution. 42 C.F.R. § 2.66(a)(1). If the court orders disclosure, the prosecution must shield the patients ’ identities and afford them an opportunity to respond. Id. § 2.66(b), (d). The prosecution obtained court orders allowing it to subpoena third-party banks and insurers for records of patients’ treatment at the Markoviches’ clinics. The prosecution disclosed these records to the Markoviches after it obtained protective orders from the magistrate judge and provided the patients with notice and an opportunity to respond.

The Markoviches moved before trial to compel the prosecution to obtain, and then disclose to the Markoviches, additional medical and billing records about the substance-abuse treatment that the patients received at other clinics. The Markoviches argued that this information was “important to obtain a complete picture of the patients’ medical history.” And they argued that because federal law permits only the prosecution to apply for access to these records , id. § 2.66(a)(1), the prosecution had a Brady obligation to seek them on the Markoviches’ behalf. The district court denied the motion on the ground that the prosecution “does not have any [Brady] obligation to conduct an investigation for the defense.” The Markoviches renewed their motion to compel several times during trial, and the district court denied the motion each time.

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