United States v. Tom McCardell

CourtCourt of Appeals for the Fifth Circuit
DecidedSeptember 28, 2018
Docket17-30919
StatusUnpublished

This text of United States v. Tom McCardell (United States v. Tom McCardell) 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. Tom McCardell, (5th Cir. 2018).

Opinion

Case: 17-30919 Document: 00514660838 Page: 1 Date Filed: 09/28/2018

IN THE UNITED STATES COURT OF APPEALS FOR THE FIFTH CIRCUIT United States Court of Appeals Fifth Circuit

No. 17-30919 FILED September 28, 2018 Lyle W. Cayce UNITED STATES OF AMERICA, Clerk

Plaintiff - Appellee

v.

TOM MCCARDELL,

Defendant - Appellant

Appeal from the United States District Court for the Western District of Louisiana USDC No. 5:16-CR-212-1

Before SMITH, CLEMENT, and COSTA, Circuit Judges. PER CURIAM:* Thomas McCardell was convicted by a jury of 14 counts of violating 42 U.S.C. § 1320a-7b(b)(2) for paying kickbacks for patient referrals. The district court calculated an enhancement under U.S.S.G. § 2B4.1 based on the value of the benefit received from Medicare for those patients, but varied downward and sentenced McCardell to 26 months in prison. McCardell appeals his conviction and sentence. For the following reasons, we affirm.

* Pursuant to 5TH CIR. R. 47.5, the court has determined that this opinion should not be published and is not precedent except under the limited circumstances set forth in 5TH CIR. R. 47.5.4. Case: 17-30919 Document: 00514660838 Page: 2 Date Filed: 09/28/2018

No. 17-30919 FACTS AND PROCEEDINGS Thomas McCardell was a registered nurse living in Lafayette, Louisiana and working as an administrator for Physicians Behavioral Hospital (PBH). When PBH hired McCardell, it had 14 beds and offered psychological care for both in-patients and out-patients. To achieve profitability, the hospital required a certain number of its beds to remain filled, and tried to stay above that number. To that end, the hospital employed “community educators” to inform potential referral sources (other hospitals, nursing homes, social workers, etc.) of the hospital’s services. The community educators regularly submitted time sheets and logs to PBH, which documented the date and entity they visited, the name of their contact, the type of visit (i.e., in person or by phone), and the purpose of the visit. What the community educators could not do was pay for referrals to PBH. See 42 U.S.C. § 1320a-7b(b)(2)(A). PBH’s employee handbook expressly specified that employees should “[r]efrain[] from soliciting or offering anything that can be construed as a remuneration, kickback or bribe.” PBH employees received a copy of this handbook and signed a statement that they received it and agreed to follow its rules. McCardell received a copy of the employee handbook in March 2011, and agreed “to comply with all terms and conditions set forth.” As administrator, McCardell oversaw the daily operations of PBH, hired new employees, negotiated contracts, and generally ensured that PBH complied with its legal obligations. He supervised and would also periodically evaluate the community educators. In late 2011, McCardell became aware of Gloria Himmons, an Alabama resident who referred patients to hospitals for a fee. Gloria had spoken with Allison Cooper, an assistant administrator, about possibly sending patients to PBH. Cooper, in turn, told McCardell that Gloria had many referral sources, 2 Case: 17-30919 Document: 00514660838 Page: 3 Date Filed: 09/28/2018

No. 17-30919 but also warned him that a large number of Gloria’s patients came from outside Louisiana, which would garner the attention of auditors. McCardell reached out to Gloria, and they ultimately agreed that PBH would pay her $2,500 per month in exchange for referring an average of 15 patients every month. But there was a difficulty: because Gloria was also referring patients to a hospital in Florida, she felt it would be a “conflict of interest” for her to refer patients to PBH. Gloria asked if the hospital could make its payments to her through her son, Vander Himmons. McCardell agreed that PBH would contract with and pay Vander instead of Gloria. Gloria testified that McCardell told her “he would have to draw up a contract to make it legit where . . . Vander is working for them, even though [she] would be doing the work.” Gloria sent Vander’s resume to McCardell, and he hired Vander as a community educator. She also signed paperwork in Vander’s name, some of which indicated, falsely, that Vander had received training at PBH. Over the course of many months, neither Vander nor Gloria ever visited PBH or performed any of the duties a community educator usually performed. They never once filled out a time sheet or log. But Gloria referred almost 90 patients to the hospital, some multiple times. At times, a majority of the patients at PBH were referrals from Gloria. Medicare was billed over $6,000,000 for these patients and paid out over $1,000,000. PBH paid about $40,000 to Gloria for the referrals through checks made out to Vander. At some point, the hospital was low on patients and its revenues dropped. McCardell determined that PBH should contact Gloria to obtain more referrals. Some of the hospital staff grew worried that the patients Gloria referred were faking their symptoms. These staff members informed McCardell of their concerns, but he continued to do business with Gloria anyway. 3 Case: 17-30919 Document: 00514660838 Page: 4 Date Filed: 09/28/2018

No. 17-30919 Eventually, Gloria was charged with violating the anti-kickback statute for referring patients to the Florida hospital. She pleaded guilty and agreed to cooperate with the authorities. Gloria then signed a separate proffer agreement for statements she made to Louisiana investigators regarding her activities at PBH. A federal grand jury in the Western District of Louisiana charged McCardell with 14 counts of violating the anti-kickback statute, 42 U.S.C. § 1320a-7b(b)(2)(A). McCardell pleaded not guilty, and a trial was held. The jury convicted him on all 14 counts. The district court denied McCardell’s motions for judgment as a matter of law. At sentencing, the district court determined that McCardell’s sentence base level should be 8. On the advice of the presentence report, it applied a 14- level enhancement because the hospital received $1,046,329.13 in Medicare payment for patients Gloria referred and so “the improper benefit to be conferred” was between $550,000 and $1,500,000. See U.S.S.G. § 2B4.1(b)(1)(B); id. § 2B1.1(b)(1)(H). McCardell objected to the $1,046,329.13 figure, arguing it did not reflect that the Fifth Circuit has interpreted “improper benefit” to mean net benefit. See United States v. Landers, 68 F.3d 882, 884 (5th Cir. 1995). Contending there must be some direct costs associated with housing and caring for the patients Gloria referred, McCardell called to the stand William Logan—PBH’s owner—to try to determine the amount of those costs. Logan testified that he had received the subpoena for the information only days before and was unable in that short time period to gather all the information needed to determine the direct costs. McCardell argued that the costs were not ascertainable, so under the guidelines the court should use the amount of the bribes paid to Gloria to determine the sentence enhancement. See U.S.S.G.

4 Case: 17-30919 Document: 00514660838 Page: 5 Date Filed: 09/28/2018

No. 17-30919 § 2B4.1 cmt. n.6. If the court had used the bribe amount advocated by McCardell, his sentencing guidelines range would have been 10–16 months. The court rejected McCardell’s argument that the direct costs were unascertainable. The court found that Logan’s testimony demonstrated that the costs were calculable if he had been allowed sufficient time.

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United States v. Tom McCardell, Counsel Stack Legal Research, https://law.counselstack.com/opinion/united-states-v-tom-mccardell-ca5-2018.