United States Court of Appeals 

For the First Circuit 

No. 18-1980 

UNITED STATES OF AMERICA, 

Appellee, 

v. 

RITA LUTHRA, 

Defendant, Appellant. 

APPEAL FROM THE UNITED STATES DISTRICT COURT 

FOR THE DISTRICT OF MASSACHUSETTS 

[Hon. Mark G. Mastroianni, U.S. District Judge] 

Before 

Thompson, Barron, and Boudin, 

Circuit Judges. 

 Dana A. Curhan, with whom Thomas M. Hoopes and LibbyHoopes, 

P.C. were on brief, for appellant. 

Andrew E. Lelling, United States Attorney, with whom Mark T. 

Quinlivan, Assistant United States Attorney, was on brief, for 

appellee. 

August 6, 2020 
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BOUDIN, Circuit Judge. This is an appeal by Rita Luthra, 

a doctor based in Springfield, Massachusetts, whom a jury convicted 

on two counts: aiding and abetting the wrongful disclosure of 

individually identifiable health information, 18 U.S.C. § 2; 42 

U.S.C. § 1320d-6, and obstructing a criminal investigation of a 

health care offense, 18 U.S.C. § 1518(a). 

At trial, the government presented a detailed case; 

Luthra presented no case beyond her claims that the evidence did 

not permit a conviction. The district court sentenced Luthra only 

to a year's probation, but the convictions may adversely affect 

Luthra in her professional capacity. The serious convictions and 

the light penalty reflect a tension not uncommon in regulatory 

cases. 

Luthra's convictions stem from an investigation not into 

Luthra's activities but those of Warner Chilcott, a pharmaceutical 

company. Chilcott ran a speakers program aimed at publicizing the 

company's drugs to clinicians. These prescription drugs included 

Actonel and Atelvia, which treat osteoporosis. In 2010, Warner 

Chilcott sales representative Jose Cid signed Luthra to serve as 

a speaker about Actonel and Atelvia. Between October 2010 and 

November 2011, Warner Chilcott paid Luthra $23,500 for speaking at 

approximately 31 events. 

In addition to speaking about Atelvia, Luthra prescribed 

the drug to her patients. Many insurance companies, however, did 
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not cover Atelvia because a less expensive generic drug was 

available. To get coverage, the prescribing physician needed to 

complete a prior authorization form explaining why a patient 

required Atelvia. As insurance companies denied coverage, the 

prior authorization forms piled up. 

Luthra asked Cid to help her medical assistant, Joanne 

Rivera, complete the forms. Rivera testified that Cid assisted 

Rivera on more than one occasion. Cid confirmed that Luthra saw 

them working on the prior authorization forms in Luthra's office. 

In one instance, Luthra stopped and spoke with Cid, who said that 

he was helping Rivera while pointing to a patient's record on the 

desk. 

Eventually, the federal Department of Health and Human 

Services ("HHS") began investigating Warner Chilcott for potential 

kickback violations and health care fraud, and federal law 

enforcement agents interviewed Luthra. Rivera testified that, 

shortly after Luthra's interview, Luthra called her and said that 

Cid got them in trouble. Luthra then asked Rivera to tell the 

agents that they never showed Cid patient records. The next day 

Luthra repeated her instruction and told Rivera to say that Luthra 

was not in the office on Fridays. 

The jury convicted Luthra on count one, aiding and 

abetting the wrongful disclosure of individually identifiable 

health information, and count three, obstructing a criminal 
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investigation of a health care offense. It acquitted her on count 

two, witness tampering in violation of 18 U.S.C. § 1512(b)(3). 

This appeal addresses Luthra's claim that the evidence was 

insufficient for conviction. 

We review the district court's decision de novo, drawing 

all reasonable inferences in favor of the jury verdict, asking 

whether any rational factfinder could have found the essential 

elements of the crime beyond a reasonable doubt. United States v. 

Martínez-Mercado, 919 F.3d 91, 98 (1st Cir. 2019). The credibility 

of witnesses in support of the verdict is largely assumed. United 

States v. Moran, 312 F.3d 480, 487 (1st Cir. 2002). 

As to count one, Luthra concedes that Cid accessed 

patient medical information but argues that the government failed 

to prove that Luthra knew Cid accessed protected patient 

information. On the contrary, Rivera and Cid collectively 

testified that Luthra witnessed Cid assist Rivera complete the 

prior authorization forms, which included protected patient 

information; stopped at their desk and spoke with Cid, who told 

Luthra that he was assisting Rivera and gestured to a patient file; 

and signed at least one prior authorization form on which Cid wrote 

a patient's current medications. 

Further, Luthra instructed Rivera to not tell federal 

law enforcement agents that they showed Cid patient records and to 

inform agents that Luthra was not in the office on Fridays when 
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Cid assisted Rivera. Inferring from this evidence that Luthra 

knew Cid accessed protected information is neither "unreasonable, 

insupportable, [nor] overly speculative." United States v. 

Spinney, 65 F.3d 231, 234 (1st Cir. 1995). 

Luthra's critique of the count three conviction also 

fails. The burden on the government was to show that Luthra 

willfully prevent[ed], obstruct[ed], misl[ed], 

delay[ed] or attempt[ed] to prevent, obstruct, mislead, 

or delay the communication of information or records 

relating to a violation of a Federal health care offense 

to a criminal investigator[.] 

18 U.S.C. § 1518. The government claimed that Luthra lied in her 

second interview when she stated, to explain her compensation, 

that Warner Chilcott paid her to author a research paper. 

The government presented Warner Chilcott statements of 

work that show that Luthra was paid for speaker events for the 

time period during which she claimed she was paid to author a 

paper. Luthra failed to produce the paper. These statements, 

alongside testimony and notes from investigating agents, permitted 

the jury to disbelieve Luthra's statement that she authored a 

research paper for Warner Chilcott. Martínez-Mercado, 919 F.3d at 

98. 

Lastly, Luthra argues that the government failed to 

prove that her statement was "relevant to or otherwise affected 

the investigation." The undeveloped and perfunctory nature of 

Luthra's argument, which consists of two sentences and a citation 
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to out-of-circuit precedent, offers reason enough for us to 

disregard this claim. United States v. Zannino, 895 F.2d 1, 17 

(1st Cir. 1990). 

Modern medical practice entails endless regulation and 

frightening penalties. But without minimizing the burdens on 

overworked doctors who now risk much for their patients, a jury 

could and did find that Luthra made statements she knew were not 

true. The sentencing judge went as far as he could in softening 

the sanction. 

Affirmed.