[DO NOT PUBLISH]

IN THE UNITED STATES COURT OF APPEALS

FOR THE ELEVENTH CIRCUIT

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No. 12-16524

Non-Argument Calendar

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D.C. Docket No. 1:12-cr-20316-UU-1

UNITED STATES OF AMERICA, 

 Plaintiff - Appellee,

versus

RICARDO MARTINEZ, 

 Defendant - Appellant.

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Appeal from the United States District Court

for the Southern District of Florida

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(August 19, 2013)

Before TJOFLAT, PRYOR and KRAVITCH, Circuit Judges.

PER CURIAM: 

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Ricardo Martinez appeals his convictions after a jury trial on five counts of 

health-care fraud, in violation of 18 U.S.C. § 1347. After careful review, we 

affirm.

Martinez owned Rima Medical Center (Rima), a company that provided care 

for Medicare patients. Rima gave patients an injection, billed for a more expensive

injection, and pocketed the difference. Rima also billed for drugs it never 

administered. The jury found Martinez guilty, and this is his appeal.

At trial, the district court instructed the jury, over Martinez’s objection, that 

it could convict Martinez of health-care fraud if he was deliberately ignorant of the 

fraud’s existence. Martinez first contends that this instruction was improper. We 

review the propriety of giving this instruction de novo. United States v. Stone, 9 

F.3d 934, 937 (11th Cir. 1993). “A deliberate ignorance instruction is appropriate 

when the facts support the inference that the defendant was aware of a high 

probability of the existence of the fact in question and purposely contrived to avoid 

learning all of the facts in order to have a defense in the event of a subsequent 

prosecution.” United States v. Perez-Tosta, 36 F.3d 1552, 1564 (11th Cir. 1994) 

(omission and internal quotation marks omitted).

The district court properly instructed the jury on deliberate ignorance. At 

trial, the government adduced evidence that Martinez had sole access to Rima’s 

bank accounts and signed the agreement authorizing deposits into those accounts 

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for services Rima provided to Medicare beneficiaries. Rima billed about $1.7 

million for the drugs it purportedly provided Medicare patients but spent less than 

$10,000 on those drugs. Rima actually received around $730,000 of the amount 

billed, about $531,000 of which was transferred to personal accounts owned by 

Martinez and his wife. From this evidence, the jury could easily have concluded 

that Martinez was nearly certain of Rima’s fraud but deliberately turned a blind eye 

to it in an attempt to avoid criminal liability. Therefore, the district court correctly 

instructed the jury on deliberate ignorance. See Perez-Tosta, 36 F.3d at 1564.

Martinez also argues that the district court erred in limiting his crossexamination of Elizabeth Martin, a government witness. We review this claim for 

“a clear abuse of discretion,” but the district court’s discretion “is limited by the 

guarantee of the Sixth Amendment’s Confrontation Clause that a criminal 

defendant has the right to cross-examine prosecutorial witnesses.” United States v. 

Maxwell, 579 F.3d 1282, 1295 (11th Cir. 2009). “A defendant’s confrontation 

rights are satisfied when the cross-examination permitted exposes the jury to facts 

sufficient to evaluate the credibility of the witness and enables defense counsel to 

establish a record from which he properly can argue why the witness is less than 

reliable.” United States v. Baptista-Rodriguez, 17 F.3d 1354, 1371 (11th Cir. 

1994).

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During Martin’s cross-examination, Martinez’s counsel presented her with a 

photograph of a syringe and asked if the syringe contained thirty-eight milligrams 

of liquid, but Martin replied that she did not know. After counsel repeated the 

question four times, and Martin replied with the same answer, the district court

stopped this line of questioning. Martinez argues that this denied him the ability to 

demonstrate Martin’s evasiveness to the jury. But Martinez does not explain how

further examination about the photo would have affected the jury’s ability to assess 

Martin’s credibility. Any evasiveness in her answers was already discernible to the 

jury. Thus, Martinez’s confrontation rights were satisfied, and the district court 

acted well within its discretion in limiting Martinez’s repetitive questioning.1

 See 

id. at 1370-71. 

Because the district court did not err in instructing the jury or limiting the 

cross-examination of a government witness, Martinez’s convictions are

AFFIRMED.

 1 Martinez raises two other arguments, but they also fail. Contrary to Martinez’s argument, the 

district court did not err in refusing to admit the photo of the syringe into evidence because the 

photo had not been authenticated. See Fed. R. Evid. 901(a). Martinez also contends he should 

have been able to question Martin as an expert witness, but neither party proffered her as an 

expert witness.

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