Opinion ID: 76624
Heading Depth: 2
Heading Rank: 4

Heading: United States v. Garrison

Text: 37 We recognize that dicta in the Medicare fraud case of United States v. Garrison, 133 F.3d 831, 842-43 (11th Cir.1998), may suggest a contrary result. However, as explained below, that dicta in Garrison was based on the Second Circuit's decision in United States v. Broderson, 67 F.3d 452 (2d Cir.1995), from which the Second Circuit has now retreated. Further, this Court's subsequent decision in another Medicare fraud case, United States v. Liss, 265 F.3d 1220 (11th Cir.2001), affirmed the abuse-of-trust enhancement and did not mention that Garrison dicta. Id. at 1229-30. To explain and straighten out the confusing developments after Garrison, we first discuss Garrison and then post- Garrison decisions. 38 The Garrison Court addressed the question of whether the owner and chief executive officer of a home healthcare provider properly was accorded a two-level enhancement under U.S.S.G. § 3B1.3 for abusing a position of public trust by submitting falsified Medicare claims to a fiscal intermediary. 133 F.3d at 833. In answering this question, the Garrison Court concluded that the defendant Garrison was not directly in a position of trust in relation to Medicare. While Medicare may have been the victim in this case, the section 3B1.3 enhancement is unavailable because Garrison did not occupy a sufficiently proximate position of trust relative to Medicare. Id. at 841. The Garrison Court expressly determined that the defendant Garrison was ineligible for an abuse-of-trust enhancement because she did not occupy a position of trust vis-a-vis the victim of the fraud. Id. at 842. 39 After making that holding, the Garrison Court indicated that a § 3B1.3 enhancement was inapplicable for another reason. The Court agreed with Garrison's argument that her offense conduct of perpetrating a fraud against Medicare via false cost reports was the same conduct being used as the basis for the abuse-of-trust enhancement. Id. Specifically, the Garrison Court stated that [s]ince Garrison's base fraud crime was the submission of false statements on cost reports submitted to Aetna for Medicare reimbursement, she cannot receive an enhancement for abuse of a position of public trust based on the same conduct under the specific terms of section 3B1.3. Id. at 843. Because the Court first held that Garrison was not in a position of trust and ineligible for the enhancement, this same-conduct analysis is dicta and, therefore, is not binding on this Court. 11 We also note that this Court, while citing Garrison on many occasions, has never cited the opinion for its same-conduct analysis, but instead has cited the case primarily for its conclusion that Garrison did not occupy a position of trust vis-a-vis the victim of the fraud. See, e.g., United States v. Hall, 349 F.3d 1320, 1324-26 (11th Cir.2003); Liss, 265 F.3d at 1229; Smith, 231 F.3d at 819-20; United States v. Mills, 138 F.3d 928, 941 (11th Cir.1998). 40 Further, Garrison relied on a Second Circuit decision in Broderson, for the proposition that `[t]he conduct that is the basis of the conviction must be independently criminal ... and not itself the abuse of trust.' Garrison, 133 F.3d at 843 (quoting Broderson, 67 F.3d at 456). However, the Second Circuit has retreated from its conduct-based approach in Broderson. See United States v. Ntshona, 156 F.3d 318 (2d Cir.1998) (refusing to read Broderson broadly, stating that the abuse of trust need not be entirely unrelated to the commission of the base offense and rejecting defendant's contention that, for her Medicare fraud offense, an abuse of trust is the essence of the crime and therefore is already accounted for in the base level offense); see also United States v. Hirsch, 239 F.3d 221, 228 (2d Cir.2001) (affirming the abuse-of-trust enhancement for a broker / investment advisor guilty of mail fraud); United States v. Carrozzella, 105 F.3d 796, 800-01 (2d Cir.1997) (providing that, despite the fact that a lawyer's accounts to a probate court were included in his base offense level for mail fraud, his fraud seems to fit squarely within [§ 3B1.3] because [h]is position as a trustee in the probate court was characterized by precisely the type of discretion and consequent lack of supervision that commentary to the guideline sets out as the key feature of a position of trust). 12 41 Likewise, the Fifth Circuit, in United States v. Buck, 324 F.3d 786 (5th Cir.2003), concluded that Broderson has been limited to its facts by the Second Circuit. Id. at 793. The Fifth Circuit upheld the abuse of trust enhancement to a fraud sentence where the defendant employed discretionary authority given by her position in a manner that facilitated or concealed the fraud. Id. In Buck, the Fifth Circuit also rejected the defendant's contention that Garrison made abuse-of-trust enhancements unavailable in fraud convictions and noted that the Eleventh Circuit in United States v. Liss, 265 F.3d 1220, 1229 (11th Cir.2001), had cited Garrison (Medicare fraud) when affirming an abuse-of-trust enhancement for doctors who committed Medicare fraud. Buck, 324 F.3d at 793 n. 13. 13 42 In Liss, a jury found two doctors guilty of conspiracy to defraud the United States and of receiving remuneration in return for Medicare referrals. 265 F.3d at 1225. The conduct at the heart of these crimes was the doctors' accepting kickbacks in return for referring patients to a Florida laboratory. Id. at 1224. It was this same conduct, accepting illegal compensation for Medicare referrals, that served as the basis for the district court's adding two levels for abuse of trust to the defendants' sentences. Id. at 1225. However, the Liss Court upheld the abuse-of-trust enhancement, citing Garrison for its position of trust analysis, while not mentioning at all the same-conduct dicta in Garrison. Id. at 1229; see also United States v. Linville, 228 F.3d 1330, 1331-32 (11th Cir.2000) (affirming abuse-of-trust enhancement in a bank fraud case in a post- Garrison decision). 43 For the foregoing reasons, we determine that Garrison 's conduct-based approach is dicta, was not mentioned (and thus not followed) in Liss, and is not binding in this case.