The federal Sentencing Guidelines greatly influence the sentences imposed for federal crimes. Once binding on federal courts, the Guidelines are now the starting point for federal sentencing in most cases. They provide the principal standard against which the reasonableness of any sentence imposed is judged. In the last quarter of FY2014, over 75% of the sentences imposed by federal courts fell within the sentence ranges recommended by the Guidelines or within those ranges but reduced by prosecution endorsed departures recommended in the Guidelines. The goal of the Guidelines is nation-wide federal sentencing consistency; to ensure that defendants with similar criminal records, convicted of similar crimes, receive similar sentences and that the dissimilar do not. Between the statutory maximum and any statutory minimum established for noncapital federal felonies, the Guidelines calibrate a series of sentencing ranges, according to the nature of the offense and the defendant's criminal record. The Guidelines are the work of the U.S. Sentencing Commission. Congress created the commission and authorized the Guidelines in the Sentencing Reform Act of 1984. The first Guidelines were promulgated with an effective date of November 1, 1987. The commission may promulgate amendments which become effective 180 days after they are presented to Congress, absent congressional action. The Supreme Court has upheld the constitutionality of the Guidelines as a valid delegation of Congressional authority, but held unconstitutional the provision in the Sentencing Reform Act which made them binding on federal courts, rather than advisory. Sentencing under the Guidelines is essentially a score-keeping exercise, not unlike the procedure for filling out a federal income tax return. The process involves assigning "offense levels" for a particular offense based on the nature of the offense and the circumstances under which it was committed. Under the Guidelines, most sentencing determinations follow from the final offense level identified at the end of the process. The sentencing ranges for any term of imprisonment depend both on the final offense level and upon the offender's criminal history score calculated on the basis of his past criminal record and divided into categories. Each of the possible forty-three offense levels has six sentencing ranges corresponding to the six criminal history categories (See the Sentencing Guidelines' Sentencing Table, supra ). The Guidelines process involves: I. Identification of the most appropriate Guidelines section for the crime(s) of conviction, based on the nature of the offense (the most commonly applicable are noted in the Guidelines Index) II. Identification of the applicable base offense level indicated by the section III. Addition/subtraction of offense levels per section instructions for the circumstances in the case at hand IV. Addition/subtraction of offense levels per instructions in those chapters of the Guidelines relating to A. Victim related matters B. Role in the offense C. Obstruction D. Multiple counts E. Acceptance of responsibility V. Calculation of the criminal history score VI. Application Guidelines instructions relating to A. Imprisonment (Sentencing Table) B. Probation C. Supervised release D. Special assessments E. Fines F. Restitution G. Forfeiture VII. Consideration of departures (more/less severe treatment) which the Guidelines permit VIII. Sentence under the Guidelines. In noncapital cases, federal sentencing begins after a conviction at trial or more often pursuant to a plea agreement. Unless excused by the court, a probation officer will conduct a presentence investigation in anticipation of providing the court with a presentence report. The investigation includes an interview with the defendant. The report will include a detailed recitation of factual information and of the Guideline and statutory provisions which the officer believes relevant and applicable. The parties are supplied with copies of the report, afforded an opportunity to comment, and may be allowed to present evidence to the court relating to objections to the report. A party who objects to a recommendation in the report bears the burden of proof by a preponderance of the evidence. The court must begin its sentencing determinations with a calculation of the sentencing range called for under the Guidelines. Before imposing sentence the court must give the parties and victims of the crime a chance to be heard. Having identified the applicable Guideline range, the court, in the exercise of its sentencing discretion, considers it along with the other sentencing factors found in 18 U.S.C. 3553(a) and with any other applicable statutory demands, such as the requirement to impose a minimum sentence of imprisonment in some instances. In imposing sentence, the court will include a detailed explanation of its determinations and may impose probation, a fine, a special assessment, a term of incarceration, a term of supervised release, an obligation to pay restitution, and/or order forfeiture. The court may adjust an earlier sentence to correct clear error or to reflect substantial assistance to the government. The parties may challenge on appeal the sentence or determinations upon which it is based. The court's sentence will be upheld on appeal, if it is found procedurally and substantively reasonable. A Guideline calculation is required for every serious offense for which the defendant is convicted. In most instances, the Guideline Index notes the Guideline offense section that corresponds to the offense of conviction. In other instances, the most closely analogous section applies. A few offense sections list a single offense level. Most, however, list two or more alternative base offense levels; indicate circumstances under which offense levels are to be added or subtracted; cross reference to the application of another offense section under some circumstances; or do some combination of the three. The offense section for drug trafficking, for instance, lists 5 alternative base offense levels, grounded primarily on the type and amount of the controlled substance involved. Four of those set minimum offense levels when the offense also involves a serious injury; the fifth refers to the Drug Quantity Table which contains an array of 17 escalating offense levels based on the amount and type of drug involved. In order to account for the cases which involve more than one type of controlled substance, the Guideline contains a drug equivalence table under which marijuana is used as the standard and other drugs are assigned an equivalent weight. For instance, 1 gram of heroin is treated as the equivalent of 1 kilogram of marijuana. It also lists 14 circumstances under which offense levels must be added to or subtracted from the base offense level (e.g., a two-level increase for possession of a firearm during the course of the offense). Seven individuals and a corporation were convicted of Medicare fraud and appealed in Moran . The applicable fraud Guideline, U.S.S.G. §2B1.1, sets a base offense level and provides for additional offense levels based on the extent of the fraud, as well as additional offense levels when mass marketing played a role in the crime, when the offense involved a risk of physical injury, and when the scheme was particularly sophisticated. The Guidelines also require adding offense levels beyond those found in §2B1.1 in order to account for the number and vulnerability of the scheme's victims and the higher level of culpability of two of the defendants. Thus: Defendants Antonio Macli and Jorge Macli had identical advisory guidelines calculations. They each had a base offense level of six, pursuant to U.S.S.G. §2B1.1(a)(2). They received these increases to that offense level: a 20-level increase under §2B1.1(b)(1)(K), because the loss amount was more than $7 million but not more than $20 million; a two-level increase under §2B1.1(b)(2)(A)(ii), because their offenses were committed through mass-marketing; a two-level increase under §2B1.1(b)(9)(C), because their offenses involved sophisticated means; a two-level increase under §2B1.1(b)(13)(A), because their offenses involved the conscious reckless risk of death or bodily injury; a two-level increase under §3A1.1(b)(1), because they knew or should have known that a victim of their offenses was a vulnerable victim; a two-level increase under §3B1.1(b)(2), because the offense involved a large number of vulnerable victims; and a four-level upward adjustment under §3B1.1(a), because they were organizers or leaders of criminal activity that involved five or more participants or was otherwise extensive. "As a result, defendants Antonio Macli and Jorge Macli each had a total offense level of 40. Antonio Macli and Jorge Macli each had no criminal-history points and a criminal history category of 1. Their total offense level of 40 and criminal history categories of 1 resulted in advisory guidelines range of 292 to 365 months' imprisonment." The Guidelines make adjustments for victim-related factors, the extent of the offender's participation (role in the offense), obstruction, conviction for multiple offenses, and the offender's acceptance of responsibility. The Guidelines make adjustments in five victim-related situations: (1) when the victim is vulnerable or the offense is hate crime motivated; (2) when the victim is or was a government official or member of the officer's immediate family; (3) when the victim is restrained; (4) when the offense is a federal crime of terrorism; and (5) when the offense is a serious human rights offense. Unless the offense is a civil rights violation, the hate crime and vulnerable victim adjustment, §3A1.1(a), adds 3 offense levels upon proof to the trier of fact beyond a reasonable doubt that the offense is hate motivated. Section 3A1.1(b) adds 2 offense levels if the offender is aware that the victim of the offense is vulnerable and 4 offense levels if there are a large number of such victims. This vulnerable victim adjustment is designed for cases in which the victim is "unusually vulnerable due to age, physical or mental condition, or who is otherwise particularly susceptible to" to the offense.