United States v. McMillan

600 F.3d 434, 2010 WL 816645
CourtCourt of Appeals for the Fifth Circuit
DecidedMarch 11, 2010
Docket08-31148
StatusPublished
Cited by105 cases

This text of 600 F.3d 434 (United States v. McMillan) 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. McMillan, 600 F.3d 434, 2010 WL 816645 (5th Cir. 2010).

Opinion

REAVLEY, Circuit Judge:

Barry Scheur and Robert McMillan appeal their convictions for conspiracy and substantive mail and wire fraud offenses in connection with the failure of a health maintenance organization (HMO) known as The Oath for Louisiana, Inc. They challenge the timeliness and sufficiency of the superseding indictment, and they raise *441 several claims of trial error. The Government cross-appeals the reasonableness of the sentences imposed. We conclude that the superseding indictment did not broaden the charges against the defendants and was both timely and sufficient. We reject the defendants’ remaining claims and conclude that the district court did not abuse its discretion at sentencing. We therefore AFFIRM the district court’s judgments in all respects.

I.

This case concerns a scheme by defendants Barry Scheur and Robert McMillan to fraudulently represent the financial condition of The Oath for Louisiana, Inc., a Louisiana-licensed HMO. The Oath, as an HMO or plan, collected premiums and insured the medical expenses of its subscribers. The Government charged that the defendants devised a scheme to defraud and obtain money or property by filing false financial reports with the Louisiana Department of Insurance indicating that the HMO met minimum statutory net worth requirements in order to ensure the continued operation of the plan and the collection of premiums and management fees at a time when The Oath did not satisfy state requirements.

Scheur, a successful health care consultant from Massachusetts, acquired the HMO in January 2000 from a group of hospitals that had been running the plan as Southeastern Medical Alliance. Prior to the acquisition, Southeastern Medical Alliance had been losing money, and Scheur had been acting as its consultant to help improve its financial difficulties. Scheur agreed to take over ownership as part of an effort to turn around the HMO, and the prior owners made a capital contribution to the company of approximately $14 million as part of the transfer. After renaming the company, Scheur became its Owner, President, and Chief Executive Officer. A separate consulting firm controlled by Scheur, known as the Scheur Management Group, provided management services to The Oath and received fees of $200,000 to $350,000 per month. Scheur Management Group hired McMillan to help manage The Oath. He held various positions in the company, including Vice President, Chief Operating Officer, and Chief Financial Officer. Two other businesses controlled by Scheur acted as The Oath’s parent company.

Louisiana law requires all HMOs in the state to file quarterly and annual financial reports containing information about assets and liabilities, as well as accounts receivable and capital contributions. The state mandates that each plan maintain a minimum statutory net worth of $3 million as a cushion for claims. Financial reports are filed by mail and signed by company officials as true and correct. The state uses these reports, which are available to the public, to monitor the financial health of the plans operating in Louisiana and to ensure that HMOs can pay claims from medical services providers for care given to the plans’ insureds. If an HMO suffers financial trouble, the Department of Insurance can take several remedial steps, such as placing the plan on administrative supervision, which is a period of intense financial monitoring; ordering a restructuring of the plan; or placing it into receivership and liquidating all assets to pay off its liabilities.

Despite Scheur’s efforts as a “turnaround” specialist, The Oath continued to suffer financially and to incur increasing losses with each passing quarter. Because of these losses The Oath became in danger of falling below the $3 million capital surplus threshold. Beginning with the third quarter of 2000, the defendants caused to be filed false financial reports showing that *442 the plan met or exceeded the minimum statutory amount by listing speculative or nonexistent receivables as assets. They also recorded as assets receivables “due from parent,” which were supposed to be capital infusions from the parent company but which the parent company in reality did not have the ability to provide and which never materialized. The “due from parent” and other speculative assets did not meet the state criteria to be reported as assets and were invalid. These purported assets were included in quarterly financial statements for the third quarter of 2000 and the first and second quarters of 2001. Without these invalid assets reported on its financial statements, The Oath would not have met the minimum statutory net worth requirements.

As part of the scheme, Scheur also obtained a personal loan from a bank in New Orleans for $1.2 million in February 2001. This money was wire transferred to the account of The Oath’s parent company in Massachusetts before being transferred back to New Orleans and deposited into The Oath’s account. The defendants reported the transaction in The Oath’s 2000 annual financial report to the state insurance department as a capital infusion from the parent in order to raise The Oath’s net worth above the $3 million threshold. In reality, there was never a real capital infusion because the defendants expected The Oath to pay Scheur back, which it did in April 2001.

Had the transfer of funds to The Oath been reported correctly there would have been no effect on The Oath’s net worth because there would have bepn an increase in cash assets along with a corresponding increase in liabilities. Instead, it was reported as a straight cash infusion of equity. Then when Scheur’s personal loan became due, the defendants withdrew the money from The Oath’s account in New Orleans, wired it to a Scheur Management Group account in Massachusetts, and then transferred it back to the original lending bank in New Orleans, allowing Scheur to recoup his money and pay off the loan. They recorded the flow of money to Scheur Management Group on The Oath’s internal books as a pre-payment of the management fees for April, May, and June of 2001 even though The Oath continued to pay its monthly management fees, thus double-paying the management company. To cover up this fact, in May 2001 the defendants reclassified the transaction from a pre-payment of fees to an account receivable in the form of a loan from The Oath to the parent company. To support the transaction they later created loan documents and corporate resolutions in September 2001, which were backdated to the original transaction date of April 2001.

Through such financial machinations, the defendants were able to keep The Oath operating free from regulatory interference and to continue collecting management fees from The Oath and insurance premiums from insureds even though the plan was not meeting the state requirements for net worth. The state Department of Insurance became concerned about The Oath’s financial condition, and it instructed the company to remove from its balance sheet suspicious payables from the parent company that were listed as assets.

In September 2001 the insurance department placed The Oath on administrative supervision. It also ordered that the monthly management fee paid to Scheur Management Group be reduced. In April 2002, however, with losses continuing to mount, the Department placed The Oath into receivership and began liquidation proceedings.

Free access — add to your briefcase to read the full text and ask questions with AI

Related

United States v. Riley
Fifth Circuit, 2025
United States v. Strother
Fifth Circuit, 2023
United States v. Little
Fifth Circuit, 2023
United States v. Greenlaw
84 F.4th 325 (Fifth Circuit, 2023)
United States v. Moshe Porat
76 F.4th 213 (Third Circuit, 2023)
United States v. Swenson
25 F.4th 309 (Fifth Circuit, 2022)
People v. Clark
2021 IL App (1st) 180523-U (Appellate Court of Illinois, 2021)
United States v. Mark Jones
Fifth Circuit, 2020
United States v. Olga Murra
Fifth Circuit, 2018
United States v. Jiten Nanda
867 F.3d 522 (Fifth Circuit, 2017)
Marguerite Hoffman v. David Martinez
838 F.3d 568 (Fifth Circuit, 2016)
United States v. Greenberg
835 F.3d 295 (Second Circuit, 2016)
United States v. Darren Chaker
820 F.3d 204 (Fifth Circuit, 2016)
United States v. Fletcher Freeman, Jr.
818 F.3d 175 (Fifth Circuit, 2016)

Cite This Page — Counsel Stack

Bluebook (online)
600 F.3d 434, 2010 WL 816645, Counsel Stack Legal Research, https://law.counselstack.com/opinion/united-states-v-mcmillan-ca5-2010.