FI L ED U.S. COURT OF APPEAL S EL EVENTHCI RCUI T J AN 21, 2009 THOMAS K. KAH

N CL ERK [DO NOT PUBLISH] IN THE UN ITED STATES COURT OF APPEALS FOR THE ELE VENTH CIRCUIT

__ __ __ __ __ __ __ __ __ __ __ __ No. 0 7- 15 89 8

__ __ __ __ __ __ __ __ __ __ __ __ D. C. Dock etNo. 0 7- 20 20 2- CR-J EM UNITED STAT ES OF AMERIC A, Pl ai nt iff -Ap pe ll ee, ve rs us LEONELGALDOS, JR., Defen da nt -Ap pe ll an t.

__ __ __ __ __ __ __ __ __ __ __ __ App eal fro m

th e Uni te d S ta te s Di st ric t Co urt fo r th e So uthe rnDis tri ctof F lo rid a

__ __ __ __ __ __ __ __ __ __ __ __ _ (J an ua ry 21 , 20 09 ) Befo re HULL, W ILSON an d HILL, Ci rcu itJu dg es . PER CURI AM: Leo ne l Gal do s, J r., ap pe al s h is co nv ic ti on s fo r co ns pi racy to l au nd er m on eyan d t es ti fy in g fa ls el y be fo re a g ran d ju ry

on th e g ro un ds th at : (1 ) th e d is tri ctco urt erre d b y no t h ol di ng a co m

pe te nc y he ari ng su a sp on te ; (2 ) th e d is tri ctco urt erred by im pr op erl y joi ni ng an d n otsev eri ng th e ch arg es at t ria l; (3) th e ev id en ce was in su ffi ci en t t o c on vi cthi m ; (4 ) th e d is tri ctco urt i m pr op erl y li m it edhi s cr os sex am in at io n; an d (5 ) th e g ov ern m en t i m pr op erl y co m m en te d o n h is fai lu re t o pr es en t a d efen se an d ri gh t t o re m ai n s il en t. Gal do s al so ap pe al s h is 78 -m on th se nt en ces on th e g ro un ds th atth e d is tri ctco urt erredby: (1) no t co ns id eri ng th e 18 U.S.C. § 3 55 3( a) fa ct or s an d wei gh in g t he gu id el in es to o h eav il y ; (2 ) fi nd in g hi m res po ns ib le fora lo ss am ou ntof m or e th an$4 00 ,00 0; (3) ap pl y in g atwo le ve l; so ph is ti cat ed -laun de rin g e nh an cem en t; an d (4 ) ex cl ud in g m it ig at in g ev id en ce. Aft er re vi ew an d o ral arg um en t, we af firm Gald os ’s con vi ct io ns an d se nt en ces . I. BACKG ROUND A. In di ctment an d Plea Hea ri ng A 43 -co un t i nd ic tm en t ch arg edGald os an d n in e o th ers (Rau l Ro dr ig ue z, Arm an do Araas , Carl os Enri qu e Mo nt eag ud o, Al ai n Rha f Veg a, Mar is ol Gon zal ez Torr es , Edi th Bal og , W il li am Bal la da res , Yul enArde ri, a ndJan ne tt e Mo ral es ) with am as si ve Med ic are f rau d c on sp ira cy . Mor e sp eci fic al ly, th e in di ctm en t ch arg edGald os inon ly 6 of t he 43 co un ts , as fo ll ows : (1 ) co ns pi racy to l au nd er 2m on ey , invi ol at io n o f 18 U.S.C. § 1 95 6( h) (Co un t 1 3) ; (2 ) m on ey lau nd eri ng , in vi ol at io n o f 18 U.S.C. §§ 19 56 (a)( 1) (B)( I) an d 2 (co un t 2 7) ; (3 ) co ns pi racy to en ga ge in a m on et ary tra ns act io n i nv ol vi ng cri m in al ly deri ve d p ro pe rty of a v al ue gr eat er tha n $ 10 ,00 0, i n v io la ti on of 1 8 U.S.C. § 19 56 (h ) (Co un t 3 0) ; (4 ) two co un ts of e ng ag in g i n am on et ary tra ns act io n i nv ol vi ng cri m in al ly deri ve d pr op erty of ava lu e g reat er tha n $ 10 ,00 0, i n v io la ti on of 1 8 U.S.C. § § 1 95 7 a nd2 (Co un ts 35 an d 3 7) ; an d (5 ) te st ifyin g fa ls el y be fo re a g ran d ju ry , invi ol at io n o f 18 U.S.C. § 1 62 3( a) (C ou nt43 ). Gald os in it ia ll y

in di cat edth athe want edto pl eadgu il ty. The d is tri ctco urt he lda pl ea h eari ng an d que st io ne d Gal do s t o e ns ur e th athe un de rs to odth e n atur e of th e p ro ceed in gs . Gald os sai d t ha t h e was twen ty-sev eny ears ol d, tha t h e dr op pe d o utof s ch oo l i n t he 7t h g rad e, an d t ha t h e n ev er h adbe entre at edforan y m en ta l i ll ne ss . The d is tri ctco urt as ke d Gal do s i f he ha d re cei ve d aco py of th e in di ctm en t, an d Gal do s s ai d, “ I di dn ’t un de rs ta ndth at .” The d is tri ctco urt ex pl ai ne d wh atth e in di ctm en t was an d a sk edGald os ag ai n i f he ha d s een th e do cu m en t. Gal do s s ai d, “No.” Th e d is tri ctco urt s ai d i t wo ul d h ol d the pr oc eed in gs in ab ey an ce u nt il Gald os ha d a n o pp ortuni ty to re vi ew th e in di ctm en t. Gald os ’s cou ns el sai d h e th ou gh t Gal do s was “ co nf us ed ” b ecau se co un se l ha d s pe ntho ur s wi th Gald os an d h is fam il y rev ie win g the cas e. The d is tri ctco urt 3as ke d c ou ns el whatitwas s up po se d t o d o i f Gal do s s ai d h e h as ne ve r rec ei ve d a

co py of th e in di ctm en t. Gal do s’s co un se l re sp on de d, “ I do n’t thi nkhe kn ows what anin di ctm en t i s, Yo urHon or .” Co un se l fu rth er s ta te d, “ [T]his ha s b een on e o f th os e cas es wher e we s tru gg le d t o m ak e th e la ng ua ge so pl ai n wi th Mr. Gal do s an d . . . I kn ow tha t h e’s eas il y co nf us ed .” The d is tri ctco urt re sp on de d, “ [B]utth e pr ob le m is th atif h e’s th ateas il y

co nf us ed , th atso un ds li ke itm ig htbe a de fen se to th e cas e . . . . I’m

no t g oi ng to for ce s om eb od y to pl eadgu il ty whe n t he y do n’t kn ow t ha t the y ’re do in g andth ey cla im no t t o h av e ev er s een th e in di ctm en t be fo re.” Gald os ’s cou ns el ad de d t ha t h is off ic e “ di d t he du e d il ig en ce i n h av in g M r. Gald os for en si cal ly loo ke d a t” an d t ha t Gal do s “ di d v ery ba dl y . . . on co re i ss ue s.” The di st ric t co urt as ke d i f th e g ov ern m en t was sure tha t Gal do s h adtak enth e act io ns he di d wi th cri m in al in te ntan d c omm en te d, “ Tha t’s the th in g t ha t co nc ern s m e, is I th in k h e co ul d d o a ll of t ho se th in gs be cau se so m eb od y to ldhi m to or as ke d h im

to .” Afte r Gal do s’s co un se l s ai d t ha t h e h adm etwith Gal do s an d h is fam il y th e pr ev io us da y

for two ho ur s, the di st ric t co urt re sp on de d, “ [Y]ou’re n othe lp in g y ou r cas e b ecau se whaty ou ’re tel li ng m e is th athe ’s no t capabl e o f en te rin g i nt o a pl ea b ecau se he ’s to o s tupi d t o u nd ers ta ndwhat ’s go in g o n.” The d is tri ctco urt 4wen t i nt o re ces s an d i ns tru ct edGald os ’s cou ns el to de te rm in e whe th er h e wou ld

pl eador n ot . Whe n t he co urt re su m ed , Gald os ’s cou ns el st at edth atGald os ha d ch os ento pro ceedto tri al . B. Tri al Ev id ence Gald os pro ceed edto tri al alo ne . Befo re tria l, the go ve rn m en t d is m is se d Co un ts 27 an d 3 7 a ga in stGald os , lea vi ng fou r co un ts –1 3, 3 0, 3 5, an d 4 3– ag ai ns t Gald os . Cod efen da nt s Arm an do Araas an d J an et te Mo ral es tes ti fie d a ga in st Gald os . The jury

fou ndGald os gu il ty of Co un ts 13 an d 4 3 a ndno t g ui lty of Co un ts 30 an d 3 5. Acco rd in gl y , we su m m ari ze the ev id en ce o n t he two co un ts of co nv ic ti on . By 20 03 , cod efen da nt s Ara as an d R od rig ue z were o pe rat in g aser ie s o f co m pa ni es est ab li sh edso le ly to b il l M ed ic are f rau du le nt ly. Thes e co m

pa ni es in cl ud edth e fraudul en t m ed ic al supp ly sto res “NR Med ic al Serv ic es ” an d “ R&J Med ic al Serv ic es ” an d t he frau du le ntAIDS cl in ic s “ Co ral W ay Pro fes si on al Serv ic es ” an d “ Su ns hi ne Heal th Cen te r.” The se co m pa ni es were o pe ne d u nd er the na m es of n om in ee o ffi cers , op erat edfora few m on th s, an d the n s hu t d own . 1 For example, the Coral Way

Professional Servic es AIDS clinic, which oper ated f rom 1 about Octobe r 2004 to May 2005, paid individuals $125 to $200 to come to the clinic to have blood drawn. Aclinic employee ma nipulated the blood sample to make it look li ke the individual suffere d from AIDS. The clinic then pr ovided a phony trea tment and billed Medica

re for AIDS medication at a r ate of $6,000 to $10,000 per patient visit . The c linic kept a stock of rea l medication in a re frig erator in case Medica re of ficials ca me for a n inspection. 5In20 00 , Araas be cam e fri en dl y with Gal do s. At t he ti m e, Araas work edat a pa wn s ho p a ndm etGald os , who work edat abarb er s ho p, wh enGald os cam e to th e p awnsh op to pa wn jewel ry . Araas kn ew Gald os ne ed edm on ey forbi ll s an d t o bu y a car. In ab ou t 2 00 3, Ara as ask edGald os if h e was in te res te d i n m ak in g e xt ra m on ey by cash in g c he ck s fr om

a “ m ed ic al supp li er s to re.” Gal do s s ai d h e was in te res te d, b utask edwhethe r th e ch eck s wer e “ ho t fu nd s” be cau se he di d n otwant to “ ge t i n t ro ub le .” Araas to ldGald os th atth e ch eck s wer e le gi ti m at e an d h ad su ffi ci en t fu nd s t o b e cas he d. Gal do s ag reedto pa rti ci pa te . On J un e 2 2, 2 00 4, Ara as bro ug htGald os a ch eckfor$2 ,87 3.4 8 t o c as h. The ch eckwas s ig ne d b y Ram onDe Los San to s, the no m in ee o wne r of NR Med ic al Serv ic es , andwas drawnon a Ban k o f Am eri ca ac co un t tha t Ara as us ed to de po si t M ed ic are f

rau d p ro ceed s. In th e m em o n ot at io n, the ch ecksai d i t was fo r “ di sp lay s an d d es ig n.” Araas dro ve Gald os to a ba nkwher e Gal do s h adan acco un t. Araa s t ol d Gal do s t o s ho w hi s l ic en se to pro ve hi s i de nt it y an d n otto tel l an y on e ab ou t the trans act io n. Gal do s ca sh edth e ch eckby him se lf a ndga ve Araas anen ve lo pe with c as h wh enhe returne d. Araa s t oo k t he cas h a ndga ve Gald os ten pe rcen t as hi s p aym en t fo r ha vi ng cas he d t he ch eck . Gald os cas he d 1 0 t o 1 2 c he ck s fo r Araas . For e xa m pl e, on Ju ly 8, 20 04 , Gald os cas he d ach eckfor$4 ,32 5.7 5 fr om NR Med ic al Serv ic es an d re cei ve d aten 6pe rcen t p aym en t. The m em o p orti on of t he ch ecksai d “ ACROCC Desi gn in g,

In c.” On J ul y

10 , 20 04 , Gald os cas he d ach eckfor$2 ,47 6.3 6 fr om R&JMed ic al Serv ic es at aba nkwher e R&Jha d i ts bu si ne ss acco un t. The m em o p orti on of t he ch ecksai d “ Des ig ne r’s Dream s.” Ara as pa idGald os $2 50 forcas hi ng it . Gald os al so cas he d ach eckforAraas fro m R&J Med ic al Serv ic es th atco nt ai ne d t he m em o n ot at io n “ tru ck in g e xp en se s.” Afte r Gal do s h adcas he d s ev eral ch eck s fo r Araas , Araas pro po se d t o Gald os th athe op ena co rp or at io n s o t ha t h e co ul d m ak e “ a li tt le m or e m on ey .” Araas ex pl ai ne d t ha t h e n eed eda co rp or at io n t o “ pu t m on ey th ro ug h” fro m

an AIDS cl in ic , th atth e co rp or at io n wo ul d b e o pe n “ fo r a p eri odof t im e,” an d t ha t a m ax im um of $ 20 0,0 00 wou ldgo th ro ug h t he co rp or at io n. Araa s t ol d Gal do s t ha t he wou ldrece iv e $ 50 0 fo r ev ery ch eckth atwas m ad e p ay ab le to th e co rp or at io n. Gald os ask edif t he co rp or at io n wo ul d b e “ le gi t” or wo ul d “ ge t h im in to tro ub le .” Araas sai d t ha t “ so far” no on e who ha d o pe ne d aco rp or at io n fo r hi m ha d g ot te n in to tro ub le an d t ha t i f an y tro ub le aro se , Gald os sh ou ldsay tha t h is id en ti fic at io n ha d b een st ol enan d t ha t h e d idno t kno w anyth in g abo utth e co rp or at io n. Araa s te st ifi edth athe un de rs to odGald os ’s con cern s t o b e whe th er the ch eck s h ad su ffi ci en t fu nd s, n otab ou t the so ur ce o f th e fund s. Gal do s s ai d t ha t h e wan te d t o th in k abo utit . 7Two d ay s l at er, Gal do s ca ll edAraas an d s ai d t ha t h e was “ in te res te d i n

do in g t he co rp or at io n.” Araas to ldGald os th athe wou ldha ve to ob ta in a po st of fic e b ox be cau se th e co rp or at io n n eed edanad dr es s an d apo stoff ic e b ox wou ld en su re tha t “ no bo dy woul d kno w abo utitan d n ob od y wou ldin te rfer e.” On Ap ril 13 , 20 05 , Araas dro ve Gald os to a Mai lb ox es , Etc. s to re. Gal do s, wi th Araas ’s as si st an ce, s ig ne d a n app li cat io n fo r a p os t o ffi ce b ox inth e n am e o f Ass oc ia te Marke ti ng , th e n am e th ey ha d c ho se n fo r th e co rp or at io n. Th e Ma il bo xe s, Et c. em pl oyee reque st edtwo form s o f id en ti fic at io n b utGald os co ul d p ro du ce o nl y hi s Fl or id a driv er’s l ic en se . Araas an d Gal do s s ai d t he y wou ldfax a se co nd id en ti fic at io n d oc um en t. The y lef t the st or e, an d Gal do s o bt ai ne d h is m ot he r’s ve hi cl e in su ran ce ca rdto us e as th e se co ndid en ti fic at io n d oc um en t. Araas dro ve Gald os to Araas ’s res id en ce t o e nl is t the aidof h is wife , who rana bu si ne ss th atass is te d p eo pl e in in co rp or at in g c om pa ni es . Araas ’s wife ap pl ie d o nl in e to in co rp or at e Ass oc ia te Mark et in g. Gal do s p ro vi de d h er wi th hi s dr iv er’s l ic en se an d h is sec on d ID, wh ic h s he fax edto Mai lb ox es , Etc. fo r th e p os t of fic e b ox . Araas ’s wife l is te d Gal do s as th e reg is te redag en t fo r th e co rp or at io n an d t he ad dr es s fo r Mai lb ox es , Etc. as th e co rp or at io n’s ad dr es s. Araa s an d Gald os returne d t o M ai lb ox es , Etc. an d o bt ai ne d t he po stoff ic e b ox ke y s, wh ic h Gald os ga ve to Araas . The n ex t d ay , Araas ’ wife rece iv edane-m ai l fr om th e St at e 8of

Flo rid a st at in g t ha t As so ci at e Ma rk et in g h adbe enin co rp or at ed . Afte r Ass oc ia te Mark et in g was in co rp or at ed , Araas ga ve Gald os sev eral ch eck s p ay ab le to th e n ew co rp or at io n. Gal do s en do rs edan d d ep os it edth es e ch eck s fo r Araas an d re cei ve d a$5 00 pa ym en t fo r eac h As so ci at e Ma rk et in g ch eckth athe cas he d. Th es e ch eck s wer e fo r am ou nt s as hi ghas $ 37 ,65 0.2 7 a nd $3 5,0 00 . Araas tes ti fie d t ha t co de fen da ntRo dr ig ue z fo rg edGald os ’s si gn atur e o n ch eck s t ha t wer e fo r m or e th an$4 0,0 00 . Becau se th e Ass oc ia te Mark et in g c he ck s were i n a m ou nt s s ub st an ti al ly larg er tha n c he ck s t ha t Gal do s p rev io us ly hadbe en in vo lv edwith, Gal do s as ke d Ara as to pa y hi m m or e m on ey

forcas hi ng th em . On so m e o ccas io ns , Araas ga ve Gald os anad di ti on al $2 00 forcas hi ng th e ch eck s. Ass oc ia te Mark et in g, In c. was on e o f th ree o r fo urco m pa ni es th atAraas us edto fun ne l Co ral W ay ’s frau du le ntpro ceed s. Gal do s re cru it edhi s fr ie ndAlai n Ro dr ig ue z, who work edat agro cery sto re, t o c as h c he ck s fr om Araas for

“ Med Supp li es Ph arm aceu ti cal , Inc .,” an ot he r on e o f Araas ’s frau du le ntco m pa ni es . Ro dr ig ue z te st ifi edth atGald os to ldhi m th athe “ ha d t o s ig n s om e ch eck s an d fo r si gn in g t he ch eck s, [R od rig ue z] was go in g t o g etso m e m on ey .” Gald os to ld Ro dr ig ue z th athe als o was cas hi ng ch eck s fo r Araas an d “ [n ]ot t o t al k abo utit ” be cau se Gald os “ di dn ’t wantany bo dy to kno w abo utth is .” Gald os in tro du ced Ro dr ig ue z to Araas in th e g ro cery sto re p ark in g l ot . Gald os was p res en t dur in g 9th ei r in it ia l m eet in g. Araa s t es ti fie d t ha t h e to ldRo dr ig ue z th atth e so ur ce o f th e

ch eckfun ds was “ Med ic are m on ey fro m co m pa ni es .” Araas ev en tu al ly tol d Gal do s t ha t h e wou ldbe sh ut ti ng do wn As so ci at e Marke ti ng an d t ha t the re wo ul d b e n o m or e ch eck s fo r Gal do s. Gal do s was di sapp oi nt edan d re qu es te d a“ co up le m or e” ch eck s “ fo r hi s co m pa ny.” Araas t ol d Gald os “ no ” b utask edhi m if h e “ ha d afri en d o r so m eb od y in te res te d i n b ei ng a pr es id en t o f a co m

pa ny.” Araas s ai d t ha t the co m pa ny was anAIDS cl in ic , Su ns hi ne Heal th Cen te r, an d t ha t the pre si de nt“ di dn ’t nee d t o d o a nyth in g” an d

“ jus t n eed edto be a pr es id en t o f pape rwo rk .” Araas ex pl ai ne d t ha t the pre si de nt wou ldbe pa idforhi s “ se rv ic es ” th e sa m e way th atGald os ha d b een pa idwith Ass oc ia te Mark et in g. Gal do s re cru it edIrv in g Hernand ez fo r th e job . The tri al ev id en ce al so reco un te d t he ag en ts ’ in te rv ie ws wi th Gald os an d h is te st im on y be fo re the gra ndjury. On J un e 8 , 20 05 , Spe ci al Agen t J ul ie Riv era o f th e Uni te d S ta te s Dep artm en t o f Heal th an d Hu m anServ ic es an d F BI Sp eci al Age nt s Hu y

Ngu y enan d Av at ar LeFe vr e wen t t o Gal do s’s re si de nc e to in te rv ie w hi m . Gald os de ni edan y

kn owl ed ge of R &J Med ic al Serv ic es or e ve r rec ei vi ng an y cas h o r ch eck s fr om

th em . Agen t Ri ve ra t ol d Gal do s t ha t the ag en ts ha d a ch eckfro m

R&J Med ic al Serv ic es th atwas m ad e p ay ab le to Gald os . Agen t Ri ve ra al so ask edGald os if h e h adev er o wne d o r he ardof As so ci at e Ma rk et in g. 10Gald os res po nd edth athe ha d n ot . The ag en ts sh owe d Gal do s As so ci at e

Marke ti ng ’s reco rd s, b uthe co nt in ue d t o d en y an y kn owl ed ge of t he co m

pa ny. Gald os on ly vol un te eredth athi s driv er’s l ic en se ha d b een st ol en . Gald os ne ve r m en ti on edAraas du rin g t he in te rv ie w. Afte r th e in te rv ie w, Gald os cal le d Ara as an d was “ to ta ll y frea ki ng ou t an d sc ream in g,” de m an di ng to kn ow wh atAraas ha d g ot te n h im in to . Gald os to ld Araas th atth e ag en ts ha d a sk edhi m ab ou t As so ci at e Ma rk et in g a ndth athe ha d de ni edan y

kn owl ed ge of t he co m

pa ny. Araas ag ai n t ol d Gal do s t ha t h e sh ou ld de ny any in vo lv em en t an d s ay

th athi s i de nt it y

ha d b een st ol en . On J un e 1 0, 2 00 5, FB I Age nt s Ng uyen an d C hr is to ph er Ma crae in te rv ie wed Gald os . Agen t M acra e as ke d Gal do s i f he ha d o pe ne d apo stoff ic e b ox forhi s bu si ne ss . Gald os sai d t ha t h e h adne ve r op en eda po stoff ic e b ox . The ag en t t ol d Gald os th at“pe op le ” h adid en ti fie d h im as h av in g o pe ne d apo stoff ic e b ox an d th atth e ag en ts ha d aco py of h is dri ve r’s li cen se inco nn ect io n wi th th e b ox . Gald os sai d h e h adtri edto op ena po stoff ic e b ox “with afri en d” bu t tha t h e h ad

“ ne ve r actua ll y

co m pl et edth e p ro ces s.” Gal do s al so st at edth athi s driv er’s li cen se ha d b een st ol en“ ataro un d t ha t t im e” an d tha t “ m os t l ik el y , so m eo ne m us t ha ve us edhi s driv er’s l ic en se to go an d o pe n up t ha t m ai lb ox .” Gald os als o co nt in ue d t o d en y

an y kn owl ed ge of As so ci at e Ma rk et in g a ndR&J Med ic al

11Serv ic es an d t ha t h e h adev er b een pa idto cas h c he ck s o r pa rti ci pa te d i n a ny fraud .

On J ul y 22 , 20 05 , Agen ts Ngu y en , LeFev re, an d Lynne tt e Alv arez -Karn es in te rv ie wedGald os . Gald os co nt in ue d t o d en y an y ass oc ia ti on with As so ci at e Marke ti ng or tha t h e h adop en eda po stoff ic e b ox inco nn ect io n wi th th e co m pa ny. Age ntAlv arez -Karn es ask edGald os if “ m ay be itwas s om eo ne els e [wh o] ha d [h im ] op enth e p os t o ffi ce b ox .” In it ia ll y , Gald os sai d t ha t “ th e p ers on [wh o] ha d h im

op enth e PO b ox co nt act edhi m ov er the ph on e.” Lat er, h owe ve r, Gald os sai d t ha t h e h adop en edth e b ox be cau se hi s fa th er h adno t wan te d h im to rece iv e m ai l athi s fa th er’s res id en ce. The go ve rn m en t al so pre se nt edev id en ce attri al of Ga ld os ’s grandjury te st im on y . On Dece m

be r 6, 2 00 5, Gal do s ap pe aredbe fo re a g ran d ju ry an d te st ifi edun de r oa th . Gald os tes ti fie d tha t h e h adne ve r he ardof As so ci at e Marke ti ng , si gn edan y

do cu m en ts inco nn ect io n wi th th atco m pany, or in co rp or at edth atco m

pa ny. Gald os tes ti fie d tha t h e h adop en eda po stoff ic e b ox in hi s o wn n am e so th athe co ul d re cei ve m ai l “ ou ts id e o f th e h ou se ” b ecau se hi s m ot he r ha d b een go in g t hr ou gh hi s m ai l. Gal do s s ai d t ha t the na m e o n t he po st of fic e b ox subs eque nt ly hadbe en“ ch an ge d t o the co m pa ny nam e.” Gal do s te st ifi edth athe was aba rb er an d t ha t h e h adkn ownAraas as a“ cl ie nt .” Gald os st at edth athe di d n otkn ow wh ethe r Araas ha d a ny con ne ct io n wi th Co ral W ay 12Pro fes si on al Serv ic es or As so ci at e Ma rk et in g. Gal do s s ai d t ha t Ara as ha d a ss is te d

hi m in op en in g apo stoff

ic e b ox an d tha t the two ha d “ sh ared ” th e b ox bu t tha t h e ha d n otkn own forwhatpu rp os e Araas us edth e b ox . On Fe brua ry

8, 2 00 7, Gal do s ag ai n t es ti fie d b efo re the gra ndjury. He was sh own two ch eck s fr om

R&J Med ic al Serv ic es th atco nt ai ne d h is si gn atur e an d dr iv er’s l ic en se nu m

be r. Gald os tes ti fie d tha t h e h adne ve r he ardof R &J Med ic al Serv ic es or s een th e ch eck s b efo re. Gal do s al so tes ti fie d tha t h e h adno t ca sh ed th e ch eck s an d t ha t the si gn atur es ap pe ari ng on th e ch eck s wer e n othi s. Gal do s st at edth athi s l ic en se ha d b een “ lo st ” an d t ha t “ an y bo dy” cou ldha ve si gn edhi s na m e to th e ch eck s. As n ot edearl ie r, th e jury fou ndGald os gu il ty of Co un ts 13 an d 4 3 a ndno t gu il ty of Co un ts 30 an d 3 5. D. Sent enci ng The pre se nt en ce i nv es ti ga ti on rep ort (“ PSI” ) as si gn edGald os a ba se off en se le ve l o f 22 ba se d o n h is res po ns ib il it y forbe twee n $ 40 0,0 00 an d $ 1,0 00 ,00 0 i n laun de redfun ds . The PSI ap pl ie d t wo- le ve l en ha nc em en ts foreachof t he se it em s: (1 ) be in g c on vi ct edun de r 18 U.S.C. § 1 95 6, p ur su an t t o U.S.S.G. § 2S 1.1 (b )(2 )(B) ; (2 ) en ga gi ng in anoff en se in vo lv in g s op hi st ic at edlau nd eri ng , pu rs ua ntto U.S.S.G. § 2S 1.1 (b )(3 ); a nd(3) ob st ru ct in g ju st ic e, pu rs ua ntto 13U.S.S.G. § 3 C1 .1. Thi s i nc reas edGald os ’s off en se lev el to 28 . W it h acri m in al hi st ory cat eg ory of I , Gald os ’s adv is ory

gu id el in es ran ge was 7 8 t o 9 7 m on th s’ im pr is on m en t. The PSI re co un te d Gal do s’s ex te ns iv e m ed ic al hi st ory , in cl ud in g h is ho sp it al iz at io n a ndtre atm en t fo r a cervi cal in jury whe n h e was fou r y ears ol d a nd anacci de nt al in

jury to h is ab do m enwhen he was s ev eny ears ol d t ha t re qu ire d se ve ral su rg eri es an d h os pi ta li zat io n. Th e PSI s ta te d t ha t Gal do s u nd erwen t ps y ch ol og ic al co un se li ng fol lo win g t he acci de ntan d was di ag no se d a s a “ sl ow le arn er.” Gal do s h ada li m it edab il it y to readan d wri te an d l eftsch oo l i n t he 8t h gr ad e b ecau se of h is lea rn in g p ro bl em s. On Dec em

be r 6, 2 00 7, o ne da y

be fo re h is sen te nc in g h eari ng , Gald os fil ed ap pr ox im at el y

10 0 p ag es of m ed ic al do cu m en ts th atco nt ai ne d c op ie s o f no te s ha nd writ te n i n S pa ni sh . Befo re the sen te nc in g h eari ng , th e d is tri ctco urt en te red anord er s tri ki ng th e m ed ic al reco rd s b ecau se th ey di d n otco m

pl y with (1 ) a l oc al ru le requi rin g Gal do s t o i de nt ify the pu rp os e o f th e fi li ng or ( 2) th e requi rem en t i n Fed eral Ru le of C riminal Pro cedur e 3 2( f)(1 ) th atGald os st at e h is ob jecti on s t o t he PSI i n wri ti ng withi n 1 4 d ay s. At the sen te nc in g h eari ng , th e d is tri ctco urt i ni ti al ly not ifi edth e p art ie s t ha t itstru ckth e m ed ic al reco rd s fi le d b y Gald os be cau se th ey

were i n S pa ni sh , 14witho uta cert ifi edEng li sh tra ns la ti on , andwere fi le d t he da y be fo re s en te nc in g. Gald os st at edth atth e rec or ds were fi le d l at e b ecau se hi s fa th er wen t t o C ub a at th e la stm in ut e to ob ta inth em . The d is tri ctco urt d idno t thi nkth atan yth in g was ad de d b y th e rec or ds be cau se th ere was no di sp ut e th atGald os was i nju redat va rio us ti m es when he was young . The g ov ern m en t d idno t d is pu te Gald os ’s in juri es . Gald os co nt en de d t ha t the reco rd s wer e rel ev an t b ecau se th ey ad dr es se d

“ is su es of s op hi st ic at io n wi tha pe rs on who actua ll y ha s a v ery lo w gra de of educ at io n, wh o h as su st ai ne d c on cu ss io ns .” The d is tri ctco urt n ot edth atth e ev id en ce al read y

sh owe d t ha t “pe op le th attal ke d t o [Ga ld os ] th ou gh t tha t h e was pe rh ap s n otth e b rig ht es t b ul b i n t he st or e, bu t n ot , y oukn ow –he was n ot ret ard ed , he was no t i nc ap ab le of c arrying on co nv ers at io ns . He un de rs to odwhat was go in g o n; he pa rti ci pa te d wi th th em inm at te rs .” Furth erm or e, th e d is tri ct co urt s ta te d, “ I do n’t kno w th at[Gal do s] is th e b rig ht es t p ers on th at ’s eve r ap pe aredin th is co urtro om , bu t . . . he i s fa r fro m th e sl owe stpe rs on th at ’s eve r ap pe ared .” The di stric t co urt o ve rru le d Gal do s’s o bjec ti on to th e so ph is ti cat ed laun de rin g e nh an cem en t b ecau se he was i nv ol ve d i n t he crea ti on of ash el l co rp or at io n andad op te d t he PSI’s ad vi so ry gu id el in es ran ge . Gald os reque st eda le ni en t s en te nc e an d, i n t ry in g t o e xp la in th e co nf us io n a t h is ch an ge -o f-p le a 15he ari ng , no te d h is lo w cog ni ti ve ab il it y . The d is tri ctco urt s ta te d t ha t “ itis m y in te nt io n t o s en te nc e h im at t he lo w endof t he Gui de li ne s ra ng e. . . . [U] nl es s you gi ve m e so m e rea ll y

go odreas on , [I wil l] no t g o b el ow the Gui de li ne s.” Th e di st ric t co urt s en te nc edGald os to co nc urren t t erm s o f 78 an d 6 0 m on th s’ im pr is on m en t o n C ou nt s 1 3 a nd43 , res pe ct iv el y , anda to ta l o f th ree years’ supe rv is edrel eas e. The d is tri ctco urt s ta te d t ha t i t h ad“ co ns id eredth e st at em en ts of all th e p art ie s, the pre se nt en ce re po rt, wh ic h c on ta in s t he advi so ry Gui de li ne s, an d t he st atut ory

fact or s.” Gal do s ap pe al ed .

II . CONVICTI ON IS SUES Gald os rai se s fi ve ch al le ng es to hi s co nv ic ti on s, b utth ey all lac k m eri t. A. Fai lu re to Ho ld a Co m pete ncy Hea ri ng Gald os arg ue s t ha t the di st ric t co urt erredinfai li ng to ord er s uasp on te a co m pe te nc y he ari ng . Alth ou gh we ge ne ral ly revi ew a d en ia l o f a co m pe te nc y he ari ng foranab us e o f di sc ret io n, Un it edSta te s v . Nick el s, 3 24 F.3d12 50 , 12 51 (1 1t h C ir. 2 00 3) , ou r rev ie w her e is on ly for p la in erro r be cau se Gald os rai se s t he co m pe te nc y is su e fo r th e fi rs t t im e o n app eal , se e Uni te d S ta te s v . Kho ury , 90 1 F.2 d 9 48 , 96 6 (1 1t h C ir. 1 99 0) . Und er the pl ai n e rro r st an da rd , th is Co urt wi ll co rrec t an erro r on ly if th ere i s: (1) erro r; ( 2) th atis pl ai n o r ob vi ou s; (3) th at affe ct s t he de fen da nt ’s subs ta nt ia l ri gh ts ; an d (4 ) th atser io us ly affect s t he fai rn es s, 16in te gr it y , or p ub li c rep ut at io n o f a jud ic ia l p ro ceed in g. Un it edSta te s v . W il li am s,

46 9 F .3d96 3, 9 66 (11 th Cir . 20 06 ). A di st ric t co urt s ha ll granta m ot io n fo r a co m pe te nc y he ari ng or o rd er a he ari ng su a sp on te “ if t he re i s re as on ab le cau se to be li ev e th ata de fen dantm ay pr es en tl y be su ffer in g fr om

a m en ta l d is eas e o r de fectren de rin g h im m en ta ll y in co m pe te ntto th e ex te ntth athe is un ab le to un de rs ta ndth e n atur e an d co ns eque nc es of t he pro ceed in gs ag ai ns t h im or t o a ss is t p ro pe rly in h is de fen se .” 18 U.S.C. § 4 24 1( a). A tri al co urt m us t co nduc t a c om

pe te nc y he ari ng su a sp on te whe n i t h as a bo nafid e d oubtreg ard in g the de fen dant ’s com pe te nc e. Til le r v. Esp os it o, 9 11 F.2d57 5, 5 76 (11 th Cir . 19 90 ). The di stric t co urt d idno t p la in ly err by notord eri ng a co m pe te nc y he ari ng su a sp on te . The d is tri ctco urt h adth e o pp ortu ni ty to o bs erv e an d i nt erac t wi th Gald os du rin g t he pl ea h eari ng an d t ria l. Gal do s’s b eh av io r di d n otde m on st rat e reas on ab le cau se forth e d is tri ctco urt t o b el ie ve th athe su ffer edfro m a m en ta l de fector d is eas e th atren de redhi m m en ta ll y in co m pe te nt . To th e co nt rary, G al do s de m on st rat edhi s co m

pr eh en si on of t he pro ceed in gs whenhe was que st io ne d reg ard in g h is de ci si on no t t o t es ti fy . In re sp on se to qu es ti on s fr om hi s co un se l, Gald os sai d t ha t h e u nd ers to odhe ha d arig htto tes ti fy , th athe was c on su lt ed reg ard in g t he de ci si on no t t o t es ti fy , th athe un de rs to odhe was wai vi ng th atrig ht , 17an d t ha t h e ag reedwith t he advi ce o f co un se l. Inad di ti on , th e d is tri ctco urt

en ga ge d i n aco ll oquy with Gald os reg ard in g h is de ci si on no t t o t es ti fy . In res po ns e to th e d is tri ctco urt’s que st io ns , Gald os sai d t ha t h e u nd ers to odth athe ha d t he rig htto ch oo se whet he r to tes ti fy , th athe ha d d is cu ss edth e m atte r with h is la wy ers , th athi s l awy ers advi se d h im of the pro s an d c on s o f te st ifyin g, an d t ha t he un de rs to odth atth e g ov ern m en t co ul d c ro ss -ex am in e h im if h e te st ifi ed . Thes e co ll oqui es sh ow t ha t the re was no t re as on ab le cau se forth e d is tri ctco urt t o be li ev e th atGald os was m en ta ll y in co m pe te nt . Gald os po in ts on ly to the pl ea h eari ng pro ceed in gs as e vi de nc e th atth e di st ric t co urt h adreas on ab le cau se to be li ev e h e was no t m en ta ll y co m pe te nt . As di sc us se d abo ve , Gald os st at edth athe ha d n otsee n t he in di ctm en t, ev enth ou gh hi s co un se l s ai d t ha t h e h adrev ie wedth e ch arg es ex te ns iv el y with Gal do s an d h is fam il y . Gald os ’s cou ns el als o t ol d t he di st ric t co urt tha t Gal do s was “ eas il y co nf us ed ” an d t ha t h e h adno t p erfo rm edwell inanfor en si c ex am in at io n. Whi le th e rec or d m ay

su gg es t tha t Gal do s was of l ow i nt el li ge nc e, itdo es no t p res en t re as on ab le cau se to be li ev e h e was m en ta ll y in co m pe te nt . The d is tri ct co urt re fle ct edth is sen ti m en t atsen te nc in g a fte r ob se rv in g Gal do s an d l is te ni ng to th e te st im on y

ab ou t h im . The d is tri ctco urt o bs erv edth atpe op le th ou gh t Gal do s

“ was pe rh ap s n otth e b rig ht es t b ul b i n t he st or e” b ut“ he was n otret ard ed , he was 18no t i nc ap ab le of c arrying onco nv ers at io ns . He un de rs to odwhatwas g oi ng on ; h e

pa rti ci pa te d wi th th em

in m at te rs .” The d is tri ctco urt al so ob se rv edth atGald os was no t “ th e b rig ht es t p ers onth at ’s eve r ap pe aredinth is co urtro om , bu t . . . he i s far fr om th e sl owe stpe rs onth at ’s eve r ap pe ared .” The fa ctth atGald os ’s own co un se l n ev er m ov edfora co m pe te nc y he ari ng aft er i nt erac ti ng ex te ns iv el y with Gald os an d s eei ng hi s p erfo rm an ce i n t he for en si c ex am in at io n c on firm s t he di st ric t co urt’s as se ss m en t o f Gal do s. In li gh t o f th is reco rd , we can no t s ay th at th e d is tri ctco urt p la in ly erredby notsu a sp on te ord eri ng a co m pe te nc y he ari ng . B. Sev era nce o f Cha rg es Gald os arg ue s t ha t the di st ric t co urt i m pr op erl y joi ne d t he m on ey

lau nd eri ng an d fa ls e te st im on y

ch arg es an d s ho ul d h av e se ve redth e ch arg es fortri al . Bec au se Gald os di d n otm ov e fo r a s ev eran ce o f th e ch arg es inth e d is tri ctco urt an d ra is es th e se ve ran ce i ss ue forth e fi rs t t im e o n app eal , we rev ie w th is is su e on ly for p la in erro r. See Kh ou ry , 90 1 F .2dat 9 66 . To d et erm in e whe th er ch arg es were p ro pe rly tri edjoi nt ly, th is Co urt co nduc ts a two -s te p i nqui ry . Uni te d S ta te s v . W al se r, 3 F.3 d 3 80 , 38 5 (1 1t h C ir. 19 93 ). Fir st , th e Co urt d et erm in es whet he r th e in it ia l jo in de r of off en se s was pr op er und er Fe de ral Ru le of C riminal Pro cedur e 8 (a). Id . Rul e 8 (a) a ll ows for joi nd er o f of

fen se s “ if t he off

en se s ch arg ed. . . are o f th e sa m e o r si m il ar

19ch arac te r, orare b as edon th e sa m e actor t ran sa ct io n, o r are co nn ect edwith o r

co ns ti tu te pa rts of aco m

m on sch em e o r pl an .” Fed . R. Cri m . P. 8(a ). If th e joi nd er was pro pe r, th e Co urt the n d et erm in es whet he r th e d is tri ctco urt’s fa il ur e to sev er the ch arg es res ul te d i n “ co m pe ll in g p reju di ce ag ai ns t wh ic h t he di st ric t co urt co ul d o fferno pro te ct io n.” W al se r, 3 F.3 d a t 3 85 . This in qu iry requ ire s an as se ss m en t o f “ whe th er u nd er al l the cir cu m st an ces of apa rti cu la r cas e itis withi n th e cap aci ty of juro rs to fol lo w a co urt’s l im it in g i ns tru ct io ns an d app rai se th e in de pe nd en t ev id en ce ag ai ns t a d efen da ntso le ly on t ha t d efen da nt ’s ownact s, st at em en ts , andco nduc t i n re la ti on to th e al le ga ti on s co nt ai ne d i n t he in di ctm en t an d re nd er a fa ir a ndim

pa rti al ve rd ic t.” Id . at 3 86 -8 7. Gald os ha s n otsh ownth atth e d is tri ctco urt p la in ly erredintrying th e ch arg es to ge th er. Fi rs t, the ch arg es were joi ne d p ro pe rly un de r Ru le 8(a ) be cau se th ey co ns ti tu te d p art s o f a co m m on sch em e o r pl anof: (1) de frau di ng Med ic are; (2 ) laun de rin g t he frau du le ntpro ceed s; an d (3 ) ob st ru ct in g the law en fo rcem en t in ve st ig at io n o f th e fraudan d m on ey lau nd eri ng off

en se s. Th is co m

m on sch em e was sh own by the ev id en ce attri al th at : (1 ) Araas in st ru ct edGald os when th ey fir stdi sc us se d c reat in g As so ci at e Ma rk et in g t ha t Gal do s s ho ul d d en y an y kn owl ed ge of t he co m

pa ny andsay tha t h is id en ti fic at io n h adbe enst ol enif a ny tro ub le aro se ; (2 ) Gal do s fo ll owe d Ara as ’s in st ru ct io ns du rin g h is in te rv ie ws wi th 20FBI a ge nt s an d t es ti m on y be fo re the gra ndjury; and(3) Araas rep eat edth es e in st ru ct io ns to Gald os onth e p ho ne aft er Gal do s’s fi rs t i nt erv ie w with t he FBI ag en ts . Thu s, the ch arg e o f te st ifyin g fa ls el y be fo re the gra ndjury was di rect ly co nn ect edto th e m on ey

lau nd eri ng co ns pi racy. Seco nd , th e joi nd er o f th e ch arg es di d n otres ul t i n c om pe ll in g p reju di ce t o Gald os . The d is tri ctco urt i ns tru ct edth e jury tha t a s ep arat e cri m e h adbe en ch arg edineach co un t o f th e in di ctm en t, tha t ea ch ch arg e an d t he ev id en ce pe rta in in g t o i t s ho ul d b e co ns id eredsep arat el y , andth atth e fac t tha t the jury m ay fin d t he de fen da ntgu il ty or no t g ui lt y as t o o ne ch arg e sh ou ldno t af fectit s v erd ic t as to an y ot he r ch arg e. The fa ctth atth e jury foundGald os no t g ui lt y of s om e co un ts de m on st rat es th atth e jury ins tru ct io ns off eredsu ffi ci en t p ro te ct io n a ga in st pr ejud ic e an d tha t the jury co ns id eredeach co un t s ep arat el y . See Un it edSta te s v . York, 4 28 F.3d13 25 , 13 34 (11 th Cir . 20 05 ). Thu s, Gal do s h as fai le d t o s ho w th at th e d is tri ctco urt p la in ly erredby j oi ni ng th es e ch arg es an d b y no t s uasp on te or de rin g t ha t the y

be sev eredfortri al . 2 C. Suff

ic ie ncy of t he Ev id ence We rejec t Galdos’s argument that he suff ere d compellingprejudice in the money 2 laundering c ounts by

the admission of his gr and jury testimony . First, Ga ldos was cha rg ed with falsely testifying be fore the grand jury , so the evidenc e obviously was re levant and a dmissibl e. Second, Ga ldos voluntarily testified bef

ore the grand jury , so it cannot be said that the use of this testimony was a g ainst his will. Finally , it is unclear how G aldos would have cross-e x amined himself. 21Gald os ch al le ng es th e su ffi ci en cy of t he ev id en ce t o s up po rt h is co nv ic ti on s fo r co ns pi racy to l au nd er m on ey an d t es ti fy in g fa ls el y

be fo re the gra ndjury. W e co nc lu de th atth e ev id en ce was su ffi ci en t t o s up po rt b oth c on vi ct io ns . 3 To co nv ic t a d efen dantof am on ey lau nd eri ng co ns pi racy, the go ve rn m en t m us t p ro ve th at(1) anag reem en t ex is te d b etweentwo or m or e p ers on s t o v io la te 18 U.S.C. § 1 95 6 a nd(2) th e d efen da ntkn owi ng ly andvo lu nt ari ly part ic ip at edin th e ag reem en t. Un it edSta te s v . Edward s, 5 26 F.3d74 7, 7 56 n.2 6 (1 1t h C ir. 20 08 ). To p ro ve th e u nd erl y in g c ha rg ed§ 1 95 6 v io la ti on , th e g ov ern m en t was requi redto sh ow t ha t Gal do s (1 ) kn owi ng ly con du ct eda fi na nc ia l tran sa ct io n, (2 ) whi chhe kn ew in vo lv edfun ds th atwere the pro ceed s o f so m e fo rm of u nl awfu l act iv ity , (3) wher e th e fund s i nv ol ve d i n the fin an ci al tra ns act io n i n fa ctwere the pr oc eed s o f a s pe ci fie d u nl awfu l ac ti vi ty, an d (4 ) th e d efen da nten ga ge d i n t he fin an ci al tra ns act io n kno win g t ha t the tra ns act io n was de si gn edinwho le or i n p art to co nc eal or d is gu is e th e n atur e, lo cat io n, s ou rce, o wne rs hi p, o r co ntro l o f th e pr oc eed s o f su ch un la wfu l ac ti vi ty. Uni te d S ta te s v . Tarko ff, 2 42 F.3d99 1, 9 94 (1 1t h C ir. 2 00 1) . Gald os arg ue s t ha t the go ve rn m en t fa il edto pro ve th athe kn ew th athe was We reviewthe suffic iency of the e vidence de novo, re countingthe evidenc e in the light 3 most favora

ble to the g overnme nt and ac ceptingall rea sonable infe renc es in favor of the ve rdict. United States v. Klopf, 423 F .3d 1228, 1236 (11th Cir. 2005). 22laun de rin g p ro ceed s fr om anil le ga l h eal th care frau d s ch em e. As an in it ia l m at te r, th e g ov ern m en t was requi redto pro ve on ly tha t Gal do s kne w th atth e fu nd s in vo lv edrep res en te d t he pro ceed s o f un la wfu l ac ti vi ty. Uni te d S ta te s v . Marti ne ll i, 4 54 F.3d13 00 , 13 12 n.8 (11 th Cir . 20 06 ). The fo ll owi ng ev id en ce, vi ewedinth e li gh t m os t favo rab le to th e jury’ s v erd ic t, s up po rte d areas on ab le in fere nc e th atGald os kn ew th atth e fu nd s wer e fro m so m e fo rm

of i ll eg al act iv it ie s: (1) Gald os kn ew th e o ccupa ti on s o f th e p art ie s i nv ol ve d a ndth atno ne of th em ha d a ny exp eri en ce i n ru nn in g c om pa ni es , letalo ne he al th care co m pa ni es ; (2 ) Gal do s kne w th atth e ch eck s h e cas he d c on ta in edph on y no ta ti on s fo r se rv ic es he ha d n otpro vi de d; (3) Gald os ha d b een in st ru ct ed , andhe , intu rn , in st ru ct edot he rs to ke ep th e fi nanc ia l tran sa ct io ns sec ret ; (4 ) Gal do s u se d apo st of fic e b ox as t he ad dr es s fo r Ass oc ia te Mark et in g t o e ns ur e th atth e co m pa ny’ s op erat io ns were s ecre t an d t ha t n o o ne in te rfer edwith t he m ; an d (5 ) Gal do s l ie d rep eat ed ly abo uthi s as so ci at io n wi th th e sh el l co m pa ni es an d t he factth athe ha d cas he d c he ck s. Alt ho ug h Gal do s empha si zes th e ev id en ce tha t Ara as ledhi m to be li ev e th atth e ch eck s wer e le gi ti m at e an d t ha t Gal do s h adask edab ou t the tax co ns eque nc es of t he m on ey , th e jury was free to weig h t hi s ev id en ce ag ai ns t the co nt rary evi de nc e d et ai le d abo ve an d re ach it s o wn co nc lu si on as t o Gal do s’s kn owl ed ge of t he il le ga l n atur e o f th e m on ey in vo lv ed . 23As t o t he ch arg e o f te st ifyin g fa ls el y be fo re the gra ndjury in vi ol at io n o f 18 U.S.C. § 1 62 3( a), the go ve rn m en t was requi redto sh ow t ha t Gal do s (1 ) kn owi ng ly m ad e (2 ) a fal se (3) m at eri al de cl arat io n (4 ) un de r oa th . Uni te d S ta te s v . Cro ss , 63 8 F .2d13 75 , 13 78 (5t h C ir. 1 98 1) . 4 Gald os ch al le ng es on ly tha t the ev id en ce was in su ffi ci en t t o s ho w th athe kn owi ng ly m ad e a fal se st at em en t b ecau se of h is “ li m it edm en ta l capa ci ti es ” an d th athe di d n otwil lfu ll y

li e. As an in it ia l m at te r, § 1 62 3( a) d oe s n otrequi re tha t th e g ov ern m en t p ro ve th atGald os li edwil lfu ll y . Furt he rm or e, th e ev id en ce was su ffi ci en t t o p ro ve th atGald os kn owi ng ly m ad e fal se st at em en ts to th e g ran d ju ry an d t ha t h is st at em en ts were n otth e res ul t o f m is ta ke , in adve rte nc e, orlac k o f m em ory . The ev id en ce d em on st rat edth atGald os de ni edcas hi ng ch eck s fo r Araas ’s com

pa ni es or i nc or

po rat in g As so ci at e Ma rk et in g, ev enth ou gh th e ov erwh el m in g e vi de nc e in th e cas e sh owe d t ha t Gal do s d id . Gald os co nt in ue d t o de ny any in vo lv em en t o r kn owl ed ge of t he ch eck s o r th e co m pa ny, even aft er be in g s ho wn ev id en ce o f hi s s ig na tu res on ch eck s an d o th er d oc um en ts . Gald os cl ai m edth athi s i de nt it y

ha d b een st ol en , whi ch was t he li e th atAraas ha d t ol d h im to tel l i f he was que st io ne d abo utth e tr an sa ct io ns . This ev id en ce was su ffi ci en t In Bonne r v. City

of Prichar d, 661 F.2d 1206, 1209 ( 11th Cir. 1981) (en ba nc), this Court 4 adopted a s binding pre cede nt all decisions of the for mer F ifth Circuit handed down prior to close of business on September 30, 1981. 24fo r th e jury to c on cl ud e th atGald os kn owi ng ly m ad e m at eri al ly fals e st at em en ts to

th e g ran d ju ry . D. Li m ita tio n o f Cro ss -Ex amina tio n Gald os co nt en ds th atth e d is tri ctco urt ab us edit s d is cret io n a ndvi ol at edhi s Si xt h Am en dm en t co nf

ro nt at io n ri gh ts by lim it in g h is cro ss -ex am in at io n o f co de fen dantJan ne tt e Mo ral es ab ou t h er p le a ag reem en t. Mo ral es was c harg edin 5 Co un t 2 1, al on g wi thAraas an d R au l Ro dr ig ue z, wit h m on ey lau nd eri ng ba se d o n a ch eckth atsh e cas he d fo r Co ral W ay Pro fes si on al Serv ic es . Mor al es pl edgu il ty to Co un t 2 1 a ndwas s en te nc edto 18 m on th s’ im pr is on m en t. Mo ral es tes ti fie d th atsh e h adwork edas am ed ic al ass is tantat C or al W ay an d l at er atSuns hi ne Heal th Cen te r. On d ire ctex am in at io n, M or al es tes ti fie d t ha t s he ha d m an ip ul at ed pa ti en ts ’ bl oo d, cr eat edfal se pa ti en t re co rd s, ca sh edfrau du le ntch eck s, an d l ie d t o la w enf or cem en t o ffi cers . Befo re cr os s- ex am in at io n, Gal do s’s co un se l re qu es te d th atth e d is tri ctco urt al lo w hi m to cro ss -ex am in e Mo ral es co nc ern in g am on ey laun de rin g c ou nt“ th atsh e was ori gi na ll y ch arg edwith” alo ng with Gal do s. Th e di st ric t co urt re fu se d c ou ns el ’s reque st . On ap pe al , Gald os arg ue s t ha t the di st ric t co urt i m pr op erl y refu se d t o a ll ow

We reviewa district cour t's de cision to lim it cross-examination for an a buse of 5 discretion. United States v. B aptista-Rodriguez, 17 F.3d 1354, 1371 (11th Cir. 1994). 25hi m

to cro ss -ex am in e Mo ral es ab ou t the co un ts th atwere d is m is se d a s p artof h er pl ea b arg ai n. Ho wev er, the re were no co un ts di sm is se d a s p artof M or al es ’s pl ea ba rg ai n. Mo ral es pl edgu il ty to the on ly charg e inth e in di ctm en t ag ai ns t h er. Gald os ’s cou ns el ot he rwis e was pe rm it te d t o c ro ss -ex am in e Mo ral es an d qu es ti on edhe r ex te ns iv el y reg ard in g h er i nv ol ve m en t i n t he he al th care frau d a nd th e truthf ul ne ss of h er s ta te m en ts to law en fo rcem en t o ffi cers . Thu s, Gal do s’s co un se l was ab le to po rtr ay Mo ral es as b ia se d i n fa vo r of th e g ov ern m en t b ecau se sh e h adrece iv eda subs ta nt ia l b en efi t b y no t b ei ng pro se cu ti ng forall th e cri m es th atsh e m ay

ha ve co m

m it te d. Acco rd in gl y , th e d is tri ctco urt d idno t ab us e it s di sc ret io n i n l im it in g Gal do s’s cr os s- ex am in at io n o f Mo ral es or d en y hi s co ns ti tu ti on al rig htto co nf ro nthe r. E. Go ve rnment Comm ent o n Fai lu re to Pres ent a Defens e Gald os arg ue s, fo r th e fi rs t t im e o n app eal , th atth e g ov ern m en t’s que st io ns an d t he tes ti m on y

itso li ci te d i m

pr op erl y co m m en te d o n h is fai lu re t o p res en t a de fen se an d ri gh t t o re m ai n s il en t. Bec au se he di d n otrai se th is sp eci fic arg um en t be lo w, we rev ie w th is is su e o nl y forpl ai n e rro r. Kho ury , 90 1 F .2dat 9 66 . Fi rs t, Gal do s ar gu es th ata se rie s o f qu es ti on s b y th e g ov ern m en t t o Ag en t Alv arez -Karn es ab ou t h er i nt erv ie w with Gal do s wer e anim pr op er co m

m en t o n Gald os ’s fai lu re t o p ro vi de a de fen se . The g ov ern m en t as ke d Ag en t Al va rez26Karn es , “ Dur in g t hi s i nt erv ie w [with Gal do s], di d yougi ve [hi m ] anop po rtu ni ty to

ex pl ai n t o youth atso m eo ne els e m ay ha ve ask edhi m

to op enup th is [po stoff

ic e bo x]? ” Gald os ’s cou ns el ob jecte d t o t he qu es ti on on ly on the ba si s t ha t i ts form was “ co nf

us in g.” The d is tri ctco urt o ve rru le d t he ob jecti on , andth e ag en t res po nd ed , “ Yes .” Next , th e g ov ern m en t as ke d Ag en t Al va rez- Karn es , “ Anddi d y ouals o g iv e [Gal do s] an o pp ortu ni ty to ex pl ai n t o youth atso m eo ne els e m ay ha ve ask edhi m

to op enup th is co rp or at io n? ” The Agen t re pl ie d, “ Yes .” Gald os ’s co un se l d idno t o bjec t t o t he qu es ti on . Fin al ly, th e g ov ern m en t p ro se cu to r as ke d Age ntAlv arez -Karn es , “ Anddi d youpo se qu es ti on s t o [Ga ld os ] du rin g t hi s in te rv ie w th atwou ldha ve all owe d h im to pro vi de th os e ex pl an at io ns ? ” Aga in , Gald os ’s cou ns el di d n otob ject, an d t he ag en t re pl ie d, “ Yes .” W e rejectGald os ’s arg um en t tha t the go ve rn m en t’s que st io ns to Agen t Alv arez -Karn es sh ift edth e b ur de n o f pr oo f or im pl ic at edGald os ’s rig htto rem ai n si le nt . Agen t Al va rez- Karn es ex pl ai ne d tha t Gal do s i ni ti al ly den ie d a ny kn owl ed ge or i nv ol ve m en t i n t he ch arg edco ns pi racy, so t he Agen ts sh ift edth ei r li ne of que st io ni ng to askif s om eo ne els e, i.e., Araa s, h addi rect edGald os to crea te Ass oc ia te Mark et in g o r op enth e p os t o ffi ce b ox . Agen t Al va rez- Karn es fu rth er t es ti fie d t ha t Gal do s ad m it te d t ha t h e h adop en eda po stoff ic e b ox , alb ei t fo r pe rs on al reas on s, an d d idno t m en ti onAraas . W e rejectGald os ’s arg um en t 27th atth e jury cou ldha ve un de rs to odth es e que st io ns as e it he r co m m en ts onGald os ’ rig htto rem ai n s il en t o r as bu rd en -s hi fti ng co m m en ts . In an y

ev en t, the di stric t co urt i ns tru ct edth e jury tha t the go ve rn m en t h adth e b ur de n o f pr ov in g t he de fen da ntgu il ty, th atth e d efen da ntwas n otrequi redto pro ve hi s i nn oc en ce o r to pr oduc e an y

ev id en ce atall , andth atth e d efen dant ’s ele ct io n n otto tes ti fy co ul d no t b e co ns id eredin an y

way du rin g t he jury’ s d el ib erat io ns . Gald os als o o bjec ts th attes ti m on y so li ci te d b y

th e g ov ern m en t fr om

FBI Age ntMac rae abo uthi s i nt erv ie w with Gal do s v io la te d h is rig htto rem ai n s il en t. The go ve rn m en t as ke d Ag en t M acra e, “ Co ul d youde sc rib e fo r th e jury whaty ou ob se rv edof t he de fen dant ’s be ha vi ordu rin g your in te rv ie w? ” Gald os ’s cou ns el ob jecte d o n t he gro un d t ha t Gal do s’s “ be ha vi or ” was no t atis su e. The d is tri ct co urt o ve rru le d t he ob

jecti on as p rem atur e. The a ge ntrep li ed , “ Mr. Gal do s was ex tre m el y ne rv ou s dur in g t he in te rv ie w. He was co nt in ua ll y fid ge ti ng . He cou ld no t k eep hi s s to ry

st rai gh t. An d we p res se d h im an d s ho wedhi m

m or e ev id en ce th atsh owe d t ha t h e was no t b ei ng tru th fu l wi th us du rin g o urin te rv ie w, he co nt in ue d t o a tt em

ptto try to ch an ge hi s s to ry .” Gald os ’s cou ns el m ov edto st rik e th e an swe r on th e g ro un ds th atitwas “ un res po ns iv e to th e que st io n” an d t ha t the ag en t’s l ackof f

am il ia rity with Gal do s p ro vi de d n o “ fo un da ti on ” fo r anop in io n ab ou t h is ne rv ou sn es s. Th e d is tri ctco urt o ve rru le d t he ob jecti on on bo th gro un ds . 28Whi le Agen t M acra e’s co m m en t tha t Gal do s “ was no t b ei ng tru th fu l” was pe rh ap s i m

pr op er t o t he ex te ntitin te rfer edwith t he jury’ s p ro vi nc e to m ak e cred ib il it y

de te rm in at io ns , itdi d n otim pl ic at e ei th er the bu rd enof p ro of or Gald os ’s rig htto rem ai n s il en t. Ag en t M acra e’s te st im on y in te nd edto de m on st rat e th atGald os ’s nervo us de m ean orsh owe d h e h adgu il ty kno wled ge of th e p os t o ffi ce b ox an d t he sh el l co rp or at io ns in vo lv edinth is cas e an d thu s was rel ev an t t o p ro ve Gald os ’s gu il t. Thu s, Gal do s h as fai le d t o s ho w pl ai n e rro r in ei th er re ga rd . II I. SENT ENCING ISS UES Gald os als o ra is es fou r ch al le ng es to hi s s en te nc e. Non e h as m eri t. A. Con si dera tio n o f § 3 55 3( a) Fact or s a nd We ig ht to the Gu id el in es W e rejectGald os ’s arg um en t tha t the di stric t co urt i m po se d apro cedur al ly un reas on ab le sen te nc e b y no t co ns id eri ng th e 1 8 U.S.C. § 35 53 (a) fa ct or s. The 6 di st ric t co urt ex pl ic it ly stat edth atitha d c on si de redth e “ st atut ory fact or s.” Th e di st ric t co urt i s n otrequi redto di sc us s ea ch § 3 55 3( a) fa ct or , Uni te d S ta te s v . Tall ey , 43 1 F .3d78 4, 7 86 (11 th Cir . 20 05 ), an d i ts st at em en t tha t i t co ns id eredth e § 3 55 3( a) fa ct or s was su ffi ci en t, s ee Un it edSta te s v . Am ed eo , 48 7 F .3d82 3, 8 33 We reviewa sente nce f

or proc edura l or substantive rea sonablene ss under a n abuse- of- 6 discretion standa

rd. Ga ll v. United States, 552 U.S. ___, ___, 128 S . Ct. 586, 597 (2007); United States v. Ellisor, 522 F.3d 1255, 1273 n.25 (11th Cir. 2008). 29(1 1t h C ir.) , cert . den ie d, 1 28 S.Ct . 67 1 (2 00 7) .

W e al so rejectGald os ’s arg um en t tha t the di st ric t co urt p ro cedur al ly erred by pla ci ng un du e wei gh t o n t he gu id el in es . Gald os sp eci fic al ly poi nt s t o t he di st ric t co urt’s s ta te m en t tha t i t i nt en de d t o s en te nc e Gal do s atth e lo w endof t he gu id el in es ran ge un le ss Gald os ’s cou ns el ga ve hi m a “ real ly goo d re as on ” to do ot he rwis e. The d is tri ctco urt m ad e th is st at em en t af te r Gal do s’s co un se l h adm ad e hi s p le a fo r le ni en cy

in sen te nc in g. Th e co nt ex t o f th e st at em en t s ho ws tha t the di st ric t co urt h adco ns id eredth e § 35 53 (a) fa ct or s, d et erm in edth ata se nt en ce at th e b ot to m

of t he advi so ry

gu id el in es ran ge was re as on ab le , andha d n othe ard an yth in g fr om

Gald os ’s cou ns el to co nv in ce i t t o s en te nc e Gal do s d iff eren tl y . Thu s, we fi ndno pro cedur al erro r in th e d is tri ctco urt’s s en te nc e in th is reg ard . B. Am ou nt o f Lo ss W e al so co nc lu de th atth e d is tri ctco urt d idno t p la in ly err incal cu la ti ng Gald os ’s bas e o ffen se lev el ba se d o n afin di ng th atGald os was re sp on si bl e fo r ov er $ 40 0,0 00 in lau nd eredm on ey . Gald os fai le d t o o bjec t t o and , th us , adm it te d th e fac ts inth e PSI t ha t: (1) Gald os est ab li sh edAss oc ia te Mark et in g a t the di rect io n o f Araas ; (2 ) he was t he reg is te redown er o f Ass oc ia te Mark et in g; (3) he li edwhen he de ni edsi gn in g c he ck s an d n eg ot ia ti ng ch eck s t ot al in g $ 4,9 76 .36 for R&J Med ic al Serv ic es ; (4 ) he recrui te d t wo fr ie nd s t o s erv e as no m in al own ers of 30Su ns hi ne Heal th Cen te r an d M edSupp li es Ph arm aceu ti cal ; (5 ) $3 30 ,88 8.9 9 was

laun de redth ro ug h As so ci at e Ma rk et in g and$1 33 ,62 0.2 6 was lau nd eredth ro ug h MedSupp li es Ph arm aceu ti cal ; an d (6 ) he was re sp on si bl e fo r $4 69 ,48 5.6 1 i n laun de redfun ds . See Un it edSta te s v . Ben ne tt , 47 2 F .3d82 5, 8 33 -3 4 (1 1t h C ir. 20 06 ). Gald os do es no t co nt es t the am ou ntof l os s fi gu re b utarg ue s t ha t the to ta l am ou ntis no t at tri bu tabl e to hi m as r el ev an t co nduc t. A de fen da ntm ay be he ld acco un tabl e fo r “ al l re as on ab ly fores eeab le act s an d o m is si on s o f ot he rs in fu rth eran ce o f th e joi nt ly und ert ak encri m in al act iv it y .” U.S.S.G. § 1B 1.3 (a)( 1) (B). To be he ldres po ns ib le forth e co nduc t o f ot he rs , th e co nduc t m us t b e b ot h (1 ) “ in furth eran ce o f th e joi nt ly und ert ak encri m in al act iv it y ” an d (2 ) “ reas on ab ly fores eeab le in co nn ect io n wi th th atcri m in al act iv it y .” Id . § 1 B1 .3 cmt. n .2; Uni te d S ta te s v . Hun te r, 32 3 F .3d13 14 , 13 19 (11 th Cir . 20 03 ). W he n de te rm in in g t he lo ss am ou ntatt rib ut ab le to a pa rti cu la r de fen da ntco nv ic te d o f a co ns pi racy offen se , th e d is tri ctco urt m us t “ fir stde te rm in e th e sc op e o f cri m in al act iv ity th e d efen da ntag reedto joi nt ly und ert ak e, an d t he n c on si de r al l re as on ab ly fo res eeab le act s an d o m is si on s o f ot he rs inth e joi nt ly und ert ak encri m in al act iv ity .” Uni te d S ta te s v . McCr imm on , 36 2 F .3d72 5, 7 31 (11 th Cir . 20 04 ) (quo ta ti on s m ark s o m it te d) . 31Gald os ha s n otsh ownth atth e d is tri ctco urt p la in ly erredinatt rib ut in g t o

hi m a lo ss am ou ntof o ve r $4 00 ,00 0. Gal do s i ni ti al ly cash edsev eral ch eck s fo r Araas th atwere fraudul en tl y ob ta in edMed ic are p ro ceed s i n e xc hang e fo r pa ym en t of a pe rcen ta ge of t he ch eck . Gald os th enag reedto in co rp or at e th e sh el l co rp or at io n As so ci at e Ma rk et in g a ndbe it s re gi st eredag en t. As t he no m in ee own er o f Ass oc ia te Mark et in g, Gal do s d ep os it edch eck s o f in crea si ng ly larg er am ou nt s fo r Araas in to Ass oc ia te Mark et in g’s ac co un ts . Alth ou gh Araas tes ti fie d th atRau l Ro dr ig ue z fo rg edGald os ’s si gn atur e o n s om e o f th e Ass oc ia te Marke ti ng ch eck s, tho se act io ns were re as on ab ly fores eeab le to Gald os as p artof th e joi nt ly und ert ak encri m in al act iv it y to whi ch he ha d a gr eedas t he own er o f th e sh el l co rp or at io n. Fu rth erm or e, Gald os recr ui te d h is fri en d Al ai n R od rig ue z fo r Araas to be th e n om in ee o wne r of

an othe r frau du le ntco m

pa ny call edMedSupp li es Ph arm aceu ti cal , Inc . Gald os ex pl ai ne d t o R od rig ue z wha t the po si ti on wou ld en ta il an d t ha t h e sh ou ldno t t al k abo utit . Gald os als o was pre se ntwhenAraas ex pl ai ne d t o R od rig ue z h ow h e wou ldne edto si gn an d c as h c he ck s fo r hi m . Inli gh t o f th is ev id en ce, the di st ric t co urt d idno t p la in ly err inatt rib ut in g th e fu ll am ou ntof l os s caus edby A ss oc ia te Mark et in g a ndMedSupp li es Ph arm aceu ti cal to Gald os as r el ev an t co nduc t. 32C. So phi st ic at ed La unde ri ng Enha ncement

Sect io n 2 S1 .1(b )(3 ) of

th e Gui de li ne s p ro vi de s fo r a two- le ve l en ha nc em en t if a n o ffen se in vo lv ed“ so ph is ti cat edlau nd eri ng .” U.S.S.G. § 2 S1 .1(b )(3 ). The gu id el in es co m

m en ta ry ex pl ai ns th at“ ‘sop hi st ic at edlau nd eri ng ’ m ean s co m pl ex orin tri cat e o ffen se co nduc t p ert ai ni ng to th e ex ecu ti on or c on ceal m en t o f th e 1 8 U.S.C. § 1 95 6 o ffen se ” an d t ha t i t ty pi cal ly inv ol ve s t he us e o f “ fic ti ti ou s en ti ti es ,”

“ sh el l co rp or at io ns ,” “ two or m or e le ve ls (i.e ., layerin g) of t ran sa ct io ns ,” or

“ of fs ho re fi na nc ia l ac co un ts .” U.S.S.G. § 2 S1 .1 cmt. n .5(A) . The di stric t co urt d idno t cl earl y err i n app lying a two -le ve l s op hi st ic at ed laun de rin g e nh an cem en t. The ev id en ce s ho wedth atGald os crea te d ash el l 7 co rp or at io n, As so ci at e Ma rk et in g, tha t was us edas ade po si to ry forfun ds th at were fr au du le nt ly obt ai ne d fr om Med ic are t hr ou gh Araas ’s cli ni cs . Gald os ’s co nduc t al so in vo lv edm

ul ti pl e le ve ls of t ran sa ct io ns , as c he ck s wer e wri tt ento hi m fro m th e cl in ic s wi th no ta ti on s o f ph on y servi ces all eg ed ly pro vi de d b y Ass oc ia te Mark et in g a ndhe th ende po si te d t he m in to Ass oc ia te Mark et in g’s b an k acco un ts . Desp it e Gal do s’s al le ge d l ackof i nt el li ge nc e, he pa rti ci pa te d i n o ffen se co nduc t tha t was qu it e so ph is ti cat ed . Thu s, the di st ric t co urt d idno t cl earl y err i n

We reviewthe district court’s f actua l findings f

or cle ar e rror

and its interpre tation of the 7 sentenc ing guidelines de novo. United States v. Moore , 443 F.3d 790, 793 ( 11th Cir. 2006). 33ap pl y in g t he two -le ve l s op hi st ic at ed -laun de rin g e nh an cem en t.

D. Stri k

in g o f Medi ca l Rec or ds The di stric t co urt d idno t err in refu si ng to co ns id er the m ed ic al reco rd s subm it te d b y

Gald os . Gald os do es no t d is pu te th e d is tri ctco urt’s fi nd in g t ha t h is

8 m ed ic al -rec or ds fil in g v io la te d the lo cal rul e requi rin g h im to id en ti fy

th e p ur po se of th e fi li ng . Furt he rm or e, th e PSI c on ta in edGald os ’s m ed ic al hi st ory , andhi s pa stm ed ic al pro bl em s wer e n otdi sp ut edby the go ve rn m en t. Gal do s s ay s t ha t the m ed ic al reco rd s s ho wedhi s “ li m it edm en ta l capabi li ti es ,” bu t d oe s n otsay tha t th ey st at e an yth in g b ey on d wh atwas l is te d i n t he PSI. Thu s, we fi ndno rev ers ib le erro r inth is reg ard . AFFIRMED.

A district court’s f

actua l finding that a par

ty violated a loca l rule is revie wed f or cle ar 8 err or. United States v. Ve nske, 296 F .3d 1284, 1291 (11th Cir. 2002). This Court “g ives great defe renc e to a district cour t’s interpre tation of its local rules.” Clar k v. HousingAuth. of City of Alma, 971 F.2d 723, 727 ( 11th Cir. 1992). 34