Document ID: ./input/supremecourt_opinions/opinions/boundvolumes/529bv.pdf
Page Number: 742

529US3

Unit: $U55

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OCTOBER TERM, 1999

667

Syllabus

FISCHER v. UNITED STATES

certiorari to the united states court of appeals for
the eleventh circuit

No. 99–116. Argued February 22, 2000—Decided May 15, 2000

Petitioner, while president and part owner of Quality Medical Consultants,
Inc. (QMC), negotiated a $1.2 million loan to QMC from West Volusia
Hospital Authority (WVHA), a municipal agency responsible for operat-
ing two Florida hospitals, both of which participate in the federal Medi-
care program.
In 1993 WVHA received between $10 and $15 million
in Medicare funds. After a 1994 audit of WVHA raised questions about
the QMC loan, petitioner was indicted for violations of the federal brib-
ery statute, including defrauding an organization which receives beneﬁts
under a federal assistance program, 18 U. S. C. § 666(a)(1)(A), and paying
a kickback to one of its agents, § 666(a)(2). A jury convicted him on all
counts, and the District Court sentenced him to imprisonment, imposed
a term of supervised release, and ordered the payment of restitution.
On appeal petitioner argued that the Government failed to prove
WVHA, as the organization affected by his wrongdoing, received “bene-
ﬁts in excess of $10,000 under a Federal program,” as required by
§ 666(b).
In rejecting that argument and afﬁrming the convictions, the
Eleventh Circuit held that funds received by an organization constitute
“beneﬁts” within § 666’s meaning if the source of the funds is a federal
program, like Medicare, which provides aid or assistance to participat-
ing organizations.

Held: Health care providers such as the one defrauded by petitioner

receive “beneﬁts” within the meaning of § 666(b). Pp. 671–682.

(a) Medicare’s nature and purposes provide essential instruction in
resolving this controversy. Medicare is a federally funded medical in-
surance program for the elderly and disabled. The Federal Govern-
ment is the single largest source of funds for hospitals participating
in Medicare. Such providers qualify to participate upon satisfying a
comprehensive series of statutory and regulatory requirements, includ-
ing licensing, quality assurance, stafﬁng, and other standards. Compli-
ance with these standards provides the Government with assurance that
participating providers possess the capacity to fulﬁll their statutory ob-
ligation of providing “medically necessary” services “of a quality which
meets professionally recognized standards of health care.”
42 U. S. C.
§ 1320c–5(a). Medicare attains its objectives through an elaborate fund-
ing structure designed not only to compensate providers for the reason-