United States v. Peter John Cates (93-5714) Paul William Cates (93-5756) and Sylvia Buller (93-5767)

21 F.3d 428, 1994 U.S. App. LEXIS 15966
CourtCourt of Appeals for the Sixth Circuit
DecidedApril 5, 1994
Docket93-5714
StatusPublished

This text of 21 F.3d 428 (United States v. Peter John Cates (93-5714) Paul William Cates (93-5756) and Sylvia Buller (93-5767)) is published on Counsel Stack Legal Research, covering Court of Appeals for the Sixth 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. Peter John Cates (93-5714) Paul William Cates (93-5756) and Sylvia Buller (93-5767), 21 F.3d 428, 1994 U.S. App. LEXIS 15966 (6th Cir. 1994).

Opinion

21 F.3d 428
NOTICE: Sixth Circuit Rule 24(c) states that citation of unpublished dispositions is disfavored except for establishing res judicata, estoppel, or the law of the case and requires service of copies of cited unpublished dispositions of the Sixth Circuit.

UNITED STATES of America, Plaintiff-Appellee,
v.
Peter John CATES (93-5714); Paul William Cates (93-5756);
and Sylvia Buller (93-5767), Defendants-Appellants.

Nos. 93-5714, 93-5756, 93-5767.

United States Court of Appeals, Sixth Circuit.

April 5, 1994.

Before: MERRITT, Chief Circuit Judge; and GUY, Circuit Judge; and ALDRICH, District Judge.*

RALPH B. GUY, JR., Circuit Judge.

Defendant Paul William Cates pled guilty to one count of conspiracy to submit false claims against the United States and to commit mail fraud, in violation of 18 U.S.C. Secs. 287 and 1341. He also pled guilty to four counts of filing false claims against the United States, in violation of 18 U.S.C. Sec. 287. Defendants Peter John Cates and Sylvia Buller were both convicted by a jury under the same count of conspiracy.

On appeal, Paul Cates raises three arguments in challenging his sentence: (1) the district court erred in enhancing his sentence two points pursuant to Sec. 2F1.1(b) of the sentencing guidelines based on its finding that there was more than one victim and that his fraudulent scheme involved him misrepresenting himself as acting on behalf of a religious organization; (2) the district court erred in enhancing his sentence four points under Sec. 3B1.1(a) of the sentencing guidelines for his aggravating role because there is no evidence that there were five or more individuals involved in the offense, and it is also impermissible double counting of the same offense conduct to enhance his sentence under Sec. 2F1.1(b) and Sec. 3B1.1(a) of the sentencing guidelines; and (3) the district court erred in denying his request for a reduction of his offense level pursuant to Sec. 3E1.1 of the sentencing guidelines, based on his acceptance of responsibility.

Peter Cates and Sylvia Buller both challenge on appeal the district court's instructions to the jury on conspiracy, claiming the jury was not adequately instructed on their theories of defense. They both further argue that the evidence is insufficient to convict either of them of conspiracy. Finally, Peter Cates contends that the district court abused its discretion in refusing to reduce his offense level pursuant to Sec. 3B1.2 of the sentencing guidelines for his minimal or minor role in the conspiracy.

We have reviewed the record and can find no merit to any of the arguments defendants raise on appeal; therefore, we affirm.

I.

In 1976, Paul Cates incorporated an organization known as Faith Evangelistic Association (FEA). In 1983, he formed another corporation, Evangelistic and Faith Enterprises of America, Inc. (EFEA). Through these two corporations, for a period stretching at least six years, Cates filed false claims for medical services with Civilian Health and Medical Program for the Uniform Services (CHAMPUS) and various private medical insurance carriers. Part of Cates's fraudulent conduct included misrepresenting himself as a medical doctor and/or the holder of a Ph.D. in psychology. Paul Cates's activities can be summarized.

At several Christian schools, he set up Talent Development Programs, which tested children for learning disorders and disabilities. These programs also offered educational classes for special needs children. He told the parents of these children that CHAMPUS and some private insurance companies would reimburse them for the cost of these tests and the tuition charged for the classes.

Cates knew, however, that neither CHAMPUS nor private insurance companies would pay any costs stemming from the Talent Development Programs. Therefore, he concocted a scheme whereby these costs were recouped through the submittal of fraudulent insurance claims. These claims listed fictitious office visits as the expense for which reimbursement was sought. To calculate the number of office visits that each child should claim, the cost of that child's classes was divided by the expected reimbursement per fictitious office visit. Once this number was determined, random dates were chosen to be the days on which these visits were supposed to have occurred. The claim forms also falsely stated that Paul Cates was an M.D. and/or Ph.D., and that the child's physician had referred the child to the Talent Development Program for testing and/or treatment.

Both CHAMPUS and private insurers paid the claims. According to testimony at trial, in addition to the false statements on the forms, another reason why the insurance companies did not discover any irregularities was that the forms usually contained a provider number or included a provider application. A provider number indicates one is "authorized" to provide services, and Cates was able to obtain these numbers under false pretenses. For instance, the main requirement to get a CHAMPUS provider number is state licensure. Cates satisfied this requirement when, based on fraudulent means, he obtained a membership in the American Psychological Association. Because insurance companies do not make routine checks into the truthfulness of the representations made in applications for provider status, this deceit went undetected.

The jury found the two other defendants, Buller and Peter Cates, were involved in this scheme. At each school there was normally one employee who, at Paul Cates's direction, was responsible for completing the insurance forms. Buller performed these duties for the Warner-Robins Christian Academy beginning in the fall of 1985. The extent of her work will be discussed when the issues she has raised are addressed. Peter, Paul's son, worked for FEA/EFEA from 1982 through July 1984, when he entered military service. When he returned in 1988, he resumed working at EFEA. As with Buller, his involvement will be more fully explored later in this opinion.

The unraveling of Paul Cates's scheme occurred in 1990. Linda Starnes, the employee responsible for completing the claims at Wise County Christian School, questioned the propriety of submitting fraudulent forms. When she approached Paul Cates with her concerns, he instructed her that this was the manner in which the insurance companies had requested the forms be submitted. When she brought her apprehensions to her supervisor's attention, Wayne Freeman, she was told that she asked too many questions. Freeman later left Wise School, and Starnes expressed these same concerns to the school's principal. As a result of that discussion, a call was placed to an insurance carrier, which led to a joint investigation by the United States Department of Defense and the United States Postal Service.

The investigation culminated in an indictment charging Paul and Peter Cates, Sylvia Buller, and others with conspiracy to submit false claims against the United States and to commit mail fraud. Paul was also named in eighty-two other counts alleging false claims, mail fraud, and money laundering violations. A criminal forfeiture count was included against Paul Cates and others.

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Bluebook (online)
21 F.3d 428, 1994 U.S. App. LEXIS 15966, Counsel Stack Legal Research, https://law.counselstack.com/opinion/united-states-v-peter-john-cates-93-5714-paul-will-ca6-1994.