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

Heading: sosa’s sentence

Text: On appeal, Sosa’s final argument is that the district court erred by applying two increases to his base offense level when calculating Sosa’s advisory guidelines range. Specifically, Sosa contends that the district court erred in applying a threelevel increase for a supervisory or managerial role, pursuant to U.S.S.G. § 3B1.1(b), and a two-level, sophisticated-means increase, pursuant to U.S.S.G. § 2B1.1(b)(10)(C). We review for clear error both a district court’s decision to impose an aggravating-role increase, United States v. Rodriguez De Varon, 175 F.3d 930, 937 (11th Cir. 1999), and its finding that the offense involved sophisticated means, pursuant to U.S.S.G. § 2B1.1(B)(10)(C), United States v. Ghertler, 605 F.3d 1256, 36 Case: 13-13171 Date Filed: 02/02/2015 Page: 37 of 42 1267 (11th Cir. 2010). Under the deferential standard of clear-error review, “we will not disturb a district court’s findings ‘unless we are left with a definite and firm conviction that a mistake has been committed.’” United States v. Clarke, 562 F.3d 1158, 1165 (11th Cir. 2009) (quoting United States v. Crawford, 407 F.3d 1174, 1177 (11th Cir. 2005)). A. Calculation of Sosa’s Advisory Guidelines Range Pursuant to U.S.S.G. § 2X1.1, Sosa’s base offense level for conspiracy to commit health care fraud was taken from U.S.S.G. § 2B1.1, which covers violations under 18 U.S.C. § 1347. Sosa’s conspiracy to commit health care fraud offense and his health care fraud offenses were grouped, pursuant to U.S.S.G. § 3D1.3. Under U.S.S.G. § 2Z1.1, Sosa’s base offense level for conspiracy to pay health care kickbacks was taken from U.S.S.G. § 2B4.1, which addresses violations under 42 U.S.C. § 1320a-7b(b)(2)(A). Sosa’s conspiracy to pay health care kickbacks offense and his payment of kickbacks offenses were grouped, pursuant to § 3D1.3. Because § 2B1.1 produced a higher offense level than § 2B4.1, Sosa’s base offense level was six, pursuant to U.S.S.G. § 2B1.1(a)(2). Sosa received a 16-level increase, pursuant to U.S.S.G. § 2B1.1(b)(1)(I), because the loss was more than $1,000,000 but not more than $2,500,000. He received a two-level increase, pursuant to U.S.S.G. § 2B1.1(b)(10)(C), because the offense involved sophisticated means. Sosa received a three-level increase, 37 Case: 13-13171 Date Filed: 02/02/2015 Page: 38 of 42 pursuant to U.S.S.G. § 3B1.1(b), because he was a manager or supervisor, but not an organizer, of criminal activity that involved five or more participants or was otherwise extensive. Sosa also received a two-level increase, pursuant to U.S.S.G. § 3C1.1, because he obstructed justice by lying at trial. Sosa’s total offense level was 29, which with his criminal history category of I, yielded an advisory guidelines range of 87 to 108 months. The district court imposed a total sentence of 102 months. Sosa received terms of 102 months’ imprisonment each for his conspiracy to commit health care fraud offense and his eight substantive health care fraud offenses, and terms of 60 months’ imprisonment each for his conspiracy to pay health care kickbacks offense and three offenses for substantive payment of kickbacks. All of Sosa’s sentences run concurrently. On appeal, Sosa challenges only the increases for his role in the offenses and for use of sophisticated means in the fraud. B. Managerial/Supervisory Increase Under § 3B1.1(b), the three-level increase for a managerial or supervisory role applies if (1) the defendant was a manager or supervisor, but not an organizer or leader; and (2) the criminal activity involved five or more participants or was otherwise extensive. U.S.S.G. § 3B1.1(b). To qualify for the increase, the defendant need only manage or supervise one other participant in the criminal 38 Case: 13-13171 Date Filed: 02/02/2015 Page: 39 of 42 activity. Id. § 3B1.1 cmt. n.2. However, “a section 3B1.1 enhancement cannot be based solely on a finding that a defendant managed the assets of a conspiracy,” without the defendant also managing or exercising control over another participant. United States v. Glover, 179 F.3d 1300, 1303 (11th Cir. 1999). A participant “is a person who is criminally responsible for the commission of the offense, but need not have been convicted.” Id. § 3B1.1 cmt. n.1. “In assessing whether an organization is ‘otherwise extensive,’ all persons involved during the course of the entire offense are to be considered. Thus, a fraud that involved only three participants but used the unknowing services of many outsiders could be considered extensive.” Id. § 3B1.1 cmt. n.3. In this case, the evidence introduced at trial indicated that Sosa was a manager or supervisor of the criminal activity—the fraud realized through the operations of Discovery. Sosa also drove patients to and from the clinic, was repeatedly present at Discovery when recruited patients were there, and was identified by patient witnesses as being involved with Discovery. Furthermore, Leon and Sosa were partners, and Sosa ran Discovery when Leon was not there. Sosa split the proceeds of the fraud with Leon. As recounted earlier, Sosa received nearly $119,000, Leon received $119,000, and Milian Martinez received the considerably lesser total of $43,000. Finally, Sosa was an investor in Discovery, a signatory on Discovery’s bank account for 75 days, had some decision-making 39 Case: 13-13171 Date Filed: 02/02/2015 Page: 40 of 42 authority and control over Discovery’s finances, and wrote checks to Milian Martinez to compensate him for his role in the fraud. Even if Sosa was a supervisor or manager only of Milian Martinez, that single underling is enough to qualify Sosa as a manager or supervisor under the Guidelines. Id. § 3B1.1 cmt. n.2. The evidence also demonstrates that the fraud operated through Discovery was extensive. Testimony introduced at trial revealed how Sosa, Leon, and Milian Martinez actively participated and profited from the fraud. In addition, Discovery paid at least a dozen patients to come to the clinic and receive “services” as part of the fraud. And Discovery used an outside billing company to submit more than $1,000,000 in false Medicare Part C claims in just over three months. The scheme also involved the recruitment of patients, the falsification of medical records, and, as recounted, Sosa and Leon receiving tens of thousands of dollars from the fraud. In light of this evidence, and because “a fraud that involved only three participants but used the unknowing services of many outsiders could be considered extensive,” id. § 3B1.1 cmt. n.3, the district court did not err in finding that the fraud was “otherwise extensive” under U.S.S.G. § 3B1.1(b). At a minimum, the district court did not clearly err in applying the threelevel increase for a managerial or supervisory role, pursuant to § 3B1.1(b). 40 Case: 13-13171 Date Filed: 02/02/2015 Page: 41 of 42 C. Sophisticated Means Increase Section 2B1.1(b)(10)(C) of the Sentencing Guidelines provides for a twolevel increase if a fraud offense involved “sophisticated means.” U.S.S.G. § 2B1.1(b)(10)(C). Sophisticated means are “especially complex or especially intricate offense conduct pertaining to the execution or concealment of an offense.” U.S.S.G. § 2B1.1 cmt. n.8(B). The Guidelines commentary identifies “[c]onduct such as hiding assets or transactions, or both, through the use of fictitious entities, corporate shells, or offshore financial accounts” as ordinarily indicating sophisticated means. Id. “There is no requirement that each of a defendant’s individual actions be sophisticated in order to impose the enhancement. Rather, it is sufficient if the totality of the scheme was sophisticated.” Ghertler, 605 F.3d at 1267. In this case, the government introduced evidence that the fraud operated through Discovery included the hiring of a billing service, DNA, through which Discovery submitted more than $1,000,000 in false claims in just three months. Furthermore, the evidence indicated that Discovery hired a doctor as part of the scheme, and paid about a dozen HIV-positive patients to come to the clinic to receive fraudulent “treatments.” And the patients were not paid directly, but in a surreptitious manner where someone would “take [the patients] to the side and slip [them] the money” they were promised. Furthermore, Sosa noted on the checks he 41 Case: 13-13171 Date Filed: 02/02/2015 Page: 42 of 42 wrote to Milian Martinez that the patient recruiter was being paid for transport, a further effort to conceal the true nature of the scheme. Additionally, rather than simply submitting claims for treatments that were never given, Discovery actually injected the HIV-positive patients with vitamins and other inexpensive products and then billed Medicare for expensive injections and infusions. Finally, Sosa himself took a portion of his profits via payment to a company that he created but never actually operated. Specifically, Discovery wrote $30,000 in checks to Y&R Medical Center Group, a company owned by Sosa, rather than directly to Sosa, which evinced a further effort to conceal the fraud and Sosa’s role in it. Considering all this evidence regarding “the totality of the scheme,” id., we are not left with “a definite and firm conviction that a mistake has been committed,” Clarke, 562 F.3d at 1165. Accordingly, we conclude that the district court did not clearly err in applying the sophisticated-means increase. Id.