Opinion ID: 2426901
Heading Depth: 3
Heading Rank: 3

Heading: Whether the Crimes Affected Commerce

Text: Girod also argues the Government did not show the health care crimes affected commerce. Specifically, she argues that because the acts all involved Louisiana businesses and Louisiana residents, interstate commerce was not affected. We disagree. There was ample evidence from which the jury could have concluded that the Louisiana Medicaid program is a joint federalstate program in which ANBNO participated. To the extent Girod's challenge is that the jury instruction was vague and did not specify how the program must affect commerce, she did not challenge the instruction at trial, and we therefore review this challenge for plain error. [3] See United States v. Klein, 543 F.3d 206, 212 (5th Cir.2008). The district court instructed the jury that the crimes charged must be against a health care benefit program, which, inter alia, is a program affecting commerce. Even if the instruction was erroneously vague, any error did not affect Girod's conviction as there was substantial testimonial evidence explaining ANBNO's ties to Medicaid, which is a federally funded program that indisputably affects interstate commerce. See id.; United States v. Hickman, 331 F.3d 439, 443-44 (5th Cir.2003) (finding no plain error where the district court failed to include the words affecting commerce in the instruction on health care fraud). Nor does Girod's conviction on this count seriously affect the fairness or integrity of the judicial proceedings, as she does not contend that Medicaid is not a health care benefit program under the statute. Girod also cites to United States v. Chambers, 408 F.3d 237 (5th Cir.2005), a case that involved a constructive amendment to an indictment on the interstate commerce element of the crime of a felon in possession of ammunition. In Chambers, the indictment articulated a specific theory of how the ammunition affected interstate commerce, and the jury convicted on a different theory. This Court explained that Chambers's conviction had to be overturned because to allow a conviction based on the second theory would allow that element to be established on the basis of a set of fact wholly different, separate and distinct from the one set of facts particularly alleged in the indictment relevant to that element, and would thus constitute an impermissible constructive amendment of the indictment. Id. at 247. Here, there is no dispute that the affecting commerce element of health care fraud has always been that the fraud was to Medicaid, a federally funded program that affects commerce.