Opinion ID: 2775600
Heading Depth: 4
Heading Rank: 2

Heading: Conspiracy to Pay Health Care Kickbacks

Text: Here, the government also presented sufficient evidence for a reasonable jury to find beyond a reasonable doubt that a conspiracy to pay health care kickbacks existed, that Sosa knew of the conspiracy, and that Sosa knowingly and voluntarily joined the conspiracy. Because the conspiracy to pay health care kickbacks was associated with the larger conspiracy to commit health care fraud, much of the evidence is overlapping. And it is similarly sufficient to support Sosa’s conviction for conspiracy to pay health care kickbacks. The evidence on this count includes the following: (1) Sosa invested at least $10,000 in Discovery, which paid HIVpositive and AIDS patients to seek treatment at its clinic; (2) Sosa was a signatory on Discovery’s bank account from June 29, 2011 through September 12, 2011; (3) Sosa wrote checks on behalf of the company; (4) Sosa had access to Discovery’s bank account, from which the company paid Milian Martinez, the patient recruiter, $43,000 over a period of about three months; (5) Sosa knew that Milian Martinez was in charge of bringing “patients” to the clinic; (6) in an interview with Tejada, Sosa admitted that the patients were being paid and that he knew it was illegal to pay the “patients”; (7) Sosa signed several of Discovery’s checks to Milian Martinez as payment for referring and bringing patients to the clinic, and Sosa 16 Case: 13-13171 Date Filed: 02/02/2015 Page: 17 of 42 included memo lines that indicated they were for “transport”; and (8) Sosa gave “patients” rides to Discovery for their treatments. Although mostly circumstantial, the evidence again supports Sosa’s conviction on this count. The jury’s finding that there was an agreement is supported by the evidence of Sosa’s investment in Discovery; Sosa’s access to Discovery’s bank account; and Sosa’s admissions that he knew Milian Martinez was recruiting patients, that he knew the patients were being paid, that he knew it was illegal to pay patients, and that he wrote the check to Milian Martinez anyway. See Toler, 144 F.3d at 1426. Similarly, those admissions are sufficient to support the jury’s finding that he had knowledge of the essential nature of the conspiracy. See Miranda, 425 F.3d at 959. Finally, Sosa’s writing checks to Milian Martinez on behalf of Discovery and driving patients to and from the clinic are acts in furtherance of the conspiracy and support the jury’s finding that he voluntarily entered into the conspiracy to pay health care kickbacks. See Vernon, 723 F.3d at 1274.