Opinion ID: 3063132
Heading Depth: 3
Heading Rank: 1

Heading: The Claimed Brady Violation

Text: In this case, Isley argues that the Government violated Brady v. Maryland, 373 U.S. 83, 83 S. Ct. 1194, 10 L.Ed.2d 215 (1963), by failing to provide the MNAs from Region A, B, and D. We review the district court’s denial of a motion for new trial based on a Brady violation for abuse of discretion. United States v. Vallejo, 297 F.3d 1154, 1163 (11th Cir. 2002). Under Brady, the Government violates the Due Process Clause if it suppresses evidence favorable to the accused when the evidence “is material either to guilt or to punishment.” Brady, 373 U.S. at 87, 83 S. Ct. at 1197. Evidence favorable to the accused includes impeachment evidence. United States v. Bagley, 473 U.S. 667, 676, 105 S. Ct. 3375, 3380, 87 L.Ed.2d 481 (1985). To obtain a new trial based upon a Brady violation, a defendant must show: (1) the government possessed favorable evidence to the defendant; (2) the defendant does not possess the evidence and could not obtain the evidence with any reasonable diligence; (3) the prosecution suppressed the favorable evidence; and (4) had the evidence been disclosed to the defendant, there is a reasonable probability that the outcome would have been different. Vallejo, 297 F.3d at 1164. 16 We cannot say that the district court abused its discretion here because Isley cannot show that had she obtained the MNAs from other regions, the outcome of her trial would have been different. This is because the evidence failed to establish that she relied upon any MNA in making the coding decisions charged in the indictment. While she testified at trial that she told Orthoscript employees that the MNAs were her “trump card” with Medicare, the employees testified that she never mentioned MNAs in explaining her coding decisions. Further, the evidence showed that she could not have relied upon MNAs for most of the charged coding decisions because no pertinent MNAs existed at the time Medicare was billed. Isley also testified that she did not see the other relevant MNAs until she reviewed the discovery material years after she made the coding decision. Thus, even assuming that there exists MNAs relevant to the subject codes in the other regions at the time Isley made her coding decisions, the jury rejected the notion that she relied upon them. To the extent that Isley sought a new trial based upon the impeachment value of the MNAs from other regions, her argument similarly fails. Isley believed that the other MNAs would impeach the Government witnesses by demonstrating confusion and ambiguity in the application of the billing codes to the subject products. Even if she could show confusion in the industry, Isley did not demonstrate that any such confusion affected her decisions because she did not rely 17 upon the coding decisions in the industry. Moreover, the district court determination that this impeachment evidence was cumulative was not erroneous. At trial, Isley was able to show that some errors had occurred in the medical necessity review process. Indeed, a large portion of her defense focused on the confusing and misleading application of the L2114 and L2116 codes for walking boots. Isley was therefore able to show that the DMERC was not always consistent. However, evidence of this nature from other regions would be merely cumulative. In short, the MNAs from other regions are not material, i.e., if the MNAs had been admitted at trial in Isley’s favor, there is not a reasonable probability of a different outcome in this case. The district court therefore did not abuse its discretion in denying Isley’s motion for a new trial.17