Opinion ID: 695152
Heading Depth: 3
Heading Rank: 2

Heading: Khan's Challenge to the Upward Departure

Text: 39 Khan argues that the district court erred in departing upward from his guidelines range. This argument is without merit. A sentencing court may impose a sentence outside the guidelines if the court finds that there exists an aggravating or mitigating circumstance of a kind, or to a degree, not adequately taken into consideration by the Sentencing Commission in formulating the guidelines. 18 U.S.C. Sec. 3553(b); see U.S.S.G. Sec. 5K2.0. The district court must first determine whether certain factors may warrant a departure, a determination that we review de novo, see United States v. Rogers, 972 F.2d 489, 492 (2d Cir.1992). Once it has been established that certain circumstances may warrant a departure, the district court has wide discretion in determining whether to depart. See United States v. Colon, 905 F.2d 580, 584 (2d Cir.1990). 40 Khan's original guidelines range was forty-six to fifty-seven months in prison. The district court then delineated three grounds for imposing an upward departure. First, the court noted that the guidelines failed to adequately account for the enormous health risks posed by the scheme. Second, it noted that this scheme undermined the public's confidence in government systems like Medicaid to the detriment of Medicaid recipients. Third, the court was concerned with Khan's role in inducing doctors to abuse their positions of trust. After upwardly departing to an offense level of thirty-two and a corresponding guidelines range of 121 to 151 months, the court granted the government's request for a downward departure, pursuant to section 5K1.1, and sentenced Khan to sixty months in prison. Each departure will be discussed in turn. 41 In circumstances where the financial loss does not fully capture the harmfulness and seriousness of the conduct, an upward departure may be warranted, particularly where the fraud caused or risked reasonably foreseeable, substantial non-monetary harm. U.S.S.G. Sec. 2F1.1, comment 10(a). Here, the court found that the scheme created a substantial health risk to patients, most of whom were alcoholics or drug addicts, because the clinics administered medical exams and dispensed prescription drugs without regard to the patients' needs. This resulted in uniformly poor medical treatment to a population that sorely needed treatment. These factors clearly warranted a departure. 42 The effect on Medicaid was also appropriately used as a basis for departure. U.S.S.G. Sec. 5K2.7 identifies disruption of a governmental function as a factor that may warrant an upward departure. Here, the district court found that the scheme not only disrupted the government's function of efficiently administering Medicaid, but also undermined the public's confidence in government. These factors were not adequately taken into account by the Sentencing Commission. See United States v. Flinn, 987 F.2d 1497, 1499, 1504-05 (10th Cir.1993). Accordingly, the district court properly considered these factors as grounds for a departure. 43 The departure based on Khan's role in inducing others to abuse positions of trust also was appropriate. Khan initiated this scheme and put his organizational skills behind it. Although he received an enhancement under section 3B1.1(a) for being the organizer or leader of the scheme, the district court found that the guidelines did not adequately take into account his role in inducing the doctors to breach their positions of trust. We find that this case is not in the heartland of conspiracies to defraud and thus that the court's reliance on this factor as a basis for departure was proper. 44 In regard to the district court's discretion to depart under the circumstances of this case, we find that the court did not abuse its discretion by departing for each of the three factors discussed above.