Opinion ID: 2426901
Heading Depth: 2
Heading Rank: 2

Heading: Sufficiency of the Evidence Supporting Girod's Convictions

Text: We review a district court's denial of a motion for judgment of acquittal de novo. United States v. Myers, 104 F.3d 76, 78 (5th Cir.1997). [2] The jury's verdict will be affirmed if a reasonable trier of fact could conclude from the evidence that the elements of the offense were established beyond a reasonable doubt. Id. In assessing the sufficiency of the evidence, we do not evaluate the weight of the evidence or the credibility of the witnesses, but view the evidence in the light most favorable to the verdict, drawing all reasonable inferences to support the verdict. Id. at 78-79.
Girod challenges her convictions first on the ground that there was no evidence connecting her to the fraudulent PCS forms submitted to Medicaid by Lee. To prove health care fraud, the Government had to prove that Girod knowingly and willfully executed a scheme to defraud any health care benefit program. 18 U.S.C. § 1347(1). To prove conspiracy, the Government had to show that she conspired with at least one other person to defraud the United States and that one conspirator committed any act to effect the object of the conspiracy. 18 U.S.C. § 371. Specifically, Girod argues there was no evidence she was directly involved or participate[d] in any manner in the conspiracy as there was no proof offered that [she] actually authored or signed any of the documents filed with Medicaid. The Government is not required, however, to show that Girod herself submitted the forms to Medicaid in order to charge her with Medicaid fraud and conspiracy. The indictment charged Girod with creating false time sheets and PCS daily schedules for services she claimed to have witnessed for her children, with being paid by ANBNO and Lee for creating fraudulent documentation to support billings to Medicaid, and charged that in general false time sheets were made and ANBNO employees were not providing the PCS services claimed. These charges were supported at trial with testimony from Connie Smith, who testified she split her ANBNO check with Girod (for PCS Smith supposedly provided Girod's child but did not) in exchange for Girod giving her blank, pre-signed time sheets. Akasia Lee also testified that Girod filled out false PCS time sheets for her children and split the Medicaid payment with Smith for the PCS services Smith was claiming for Girod's child, and that Lee gave Girod checks from her own personal account for one-half the payment amount Medicaid would reimburse for the services falsely claimed for Girod's children. With respect to Girod's argument that no one testified to recognizing her handwriting on any of the PCS documents submitted to Medicaid, Lee testified that she recognized Girod's handwriting on several training sign-in sheets where Girod signed as ANBNO-employee Charvel Steward. Likewise, Audra Scott testified that Girod signed her name on ANBNO forms. While Lee testified that the time sheets were falsified to conform to Medicaid requirements, the jury could have reasonably inferred from Lee's and Smith's testimony that Girod signed the blank PCS forms she gave to Smith. In sum, there was substantial evidence from which the jury could have concluded that Girod was involved in the conspiracy and that she knowingly and willfully participated in the health care fraud at ANBNO.
Girod also argues she lacked the intellectual capacity to form the specific intent to commit fraud. Girod points to evidence that she only completed eighth grade and had difficulty reading, and that Dr. Michael Chafetz (Ph.D.), a neuropsychologist, determined that she had low verbal comprehension, read at a fifth-grade level, and had a first- or second-grade level of reading comprehension. While Girod may have had a low level of education and was low performing, there was sufficient evidence from which a rational jury could have determined she had the mental capacity to form the specific intent to commit health care fraud. On cross-examination, Dr. Chafetz testified that Girod is capable of knowing right from wrong, knowing that stealing is wrong, and telling a lie. He also testified that Girod has passed a drivers' test, has raised kids, and can sign and cash checks. According to Dr. Chafetz, Girod is capable of making decisions, and she tested at the nineteenth percentile (81% do better) for daily living skills, which is adequate. Dr. Chafetz further testified that she is also capable of fulfilling basic activities of daily living and recognizing when someone else is doing that for her children. Multiple other witnesses who know Girod testified that they did not know or suspect she had any mental disabilities or problems. Christie Coleman, the parent of one of Girod's PCS clients, testified that, in the fourteen years she had known Girod, Girod never seemed mentally impaired and never had any problems communicating with her. Scott testified that she had no knowledge that Girod had any mental or physical problems. Lee testified that Girod never showed any difficulty in understanding the material explained in the training sessions. Multiple witnesses testified that, while Girod was never an ANBNO employee, she posed as Steward at training sessions (sign-ins and taking tests), picked up Steward's checks and mail at ANBNO, and signed payroll receipt forms in Steward's name. The jury could have concluded based on Dr. Chafetz's testimony that Girod could understand that it was wrong to pretend to be someone else, and that she did it anyways by helping Steward avoid the mandatory ANBNO training requirements for providing PCS services. Finally, Scott testified that Girod asked her to put Girod's checks in Scott's name to avoid involving Girod's social security withholdings. Girod's purposeful tax fraud is further proof Girod had the capacity to commit health care fraud. Viewing all the evidence in the light most favorable to the verdict, the jury could have reasonably concluded that Girod knew right from wrong, knew PCS services were not being provided to her children, and knew she was pre-signing blank PCS time sheets for services that were not being provided to her children in exchange for money from Lee and Scott.
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.
Girod also moved for acquittal below based on the failure of the government to prove the date charged in the indictment beyond a reasonable doubt. The indictment charged her with making false statements on or about August 26, 2006, but the testimony from trial showed that the false statements were made on April 26, 2006. Girod argues this four-month discrepancy constitutes a material variance from or constructive amendment of the indictment under Chambers. We disagree. A constructive amendment occurs when the government changes its theory during trial so as to urge the jury to convict on a basis broader than that charged in the indictment, or when the government is allowed to prove `an essential element of the crime on an alternative basis permitted by the statute but not charged in the indictment.' United States v. Robles-Vertiz, 155 F.3d 725, 728 (5th Cir.1998) (quoting United States v. Salvatore, 110 F.3d 1131, 1145 (5th Cir. 1997)). In this Circuit, an allegation as to the time of the offense is not an essential element of the offense charged in the indictment and, `within reasonable limits, proof of any date before the return of the indictment and within the statute of limitations is sufficient.' Russell v. United States, 429 F.2d 237, 238 (5th Cir.1970) (per curiam) (citation omitted); see United States v. Tunnell, 667 F.2d 1182, 1186 (5th Cir.1982) (In this circuit, it is established that the prosecution is `not required to prove the exact date; it suffices if a date reasonably near is established.') (quoting United States v. Grapp, 653 F.2d 189, 195 (5th Cir.1981)); see also United States v. Valdez, 453 F.3d 252, 259-60 (5th Cir.2006) (same). The discrepancy between the indictment and the evidence at trial therefore is not a constructive amendment, as the date is not an essential element that was proved on an alternate basis and the Government's theory of guilt at trial did not change. A variance occurs when the proof at trial depicts a scenario that differs materially from the scenario charged in the indictment but does not modify an essential element of the charged offense. United States v. Delgado, 401 F.3d 290, 295 (5th Cir.2005). We determine whether a variance occurred by comparing the evidence presented at trial with the language of the indictment. See United States v. Medina, 161 F.3d 867, 872 (5th Cir.1998). If a variance did occur, we reverse only if the variance prejudiced the defendant's substantial rights. See Delgado, 401 F.3d at 295; Medina, 161 F.3d at 872. In determining whether a variance resulted in prejudice, we employ a harmless-error analysis. United States v. Ramirez, 145 F.3d 345, 351 (5th Cir.1998); United States v. Dean, 59 F.3d 1479, 1491 (5th Cir.1995). The discrepancy in dates is not a material variance. A five-month variance between the date alleged and the date proved is not unreasonable as a matter of law as long as the date proven falls within the statute of limitations and before the return of the indictment. United States v. Wilson, 116 F.3d 1066, 1089 (5th Cir. 1997) (citation omitted), vacated on other grounds by United States v. Brown, 161 F.3d 256 (5th Cir.1998) (en banc); see Russell v. United States, 429 F.2d 237, 238 (5th Cir.1970) ([W]ithin reasonable limits, proof of any date before the return of the indictment and within the statute of limitations is sufficient.). Because the April 26, 2006 date is only four months apart from the date charged in the indictment and there is no dispute that it falls within the statute of limitations, Girod's argument that this variance warrants overturning her convictions fails. Moreover, a variance between allegations and proof is fatal only when it affects the substantial rights of the defendant by failing to sufficiently notify him so that he can prepare his defense and will not be surprised at trial. Phillips, 664 F.2d at 1036. The Government used the on or about designation in the indictment, explained the context in which the false statements were made, and explained the specific statements that were false and made to federal investigators. Girod's false statements charged in the indictment were: (1) that an employee from ANBNO was present in her house for two hours per day with each child for a total of 6 hours per day; (2) that ANBNO employees came to her house every day for 6 hours per day, 7 days per week during the entire time her children were enrolled with ANBNO; and (3) that AKASIA LEE did not pay her $72 per week every two weeks, or pay her any amount, for billing Medicaid services rendered to GIROD's children. This was sufficiently specific to put Girod on notice of which statements the Government intended to prove were false. Indeed, Girod has not demonstrated that she was surprised or prejudiced in any way by the August 26, 2006 date in the indictment. In sum, we affirm Girod's convictions on all grounds.