Opinion ID: 2779689
Heading Depth: 2
Heading Rank: 1

Heading: Calculating the Advisory Guidelines Ranges

Text: 1) Antonio and Jorge Macli 47 Case: 12-16056 Date Filed: 02/17/2015 Page: 48 of 85 Defendants Antonio Macli and Jorge Macli had identical advisory guidelines calculations. They each had a base offense level of six, pursuant to U.S.S.G. § 2B1.l(a)(2). They received these increases to that offense level: (1) a 20-level increase under § 2B1.1(b)(1)(K), because the loss amount was more than $7 million but not more than $20 million; (2) a two-level increase under § 2B1.1(b)(2)(A)(ii), because their offenses were committed through massmarketing; (3) a two-level increase under § 2B1.1(b)(9)(C), because their offenses involved sophisticated means; (4) a two-level increase under § 2B1.1(b)(13)(A), because their offenses involved the conscious reckless risk of death or bodily injury; (5) a two-level increase under § 3A1.1(b)(1), because they knew or should have known that a victim of their offenses was a vulnerable victim; (6) a two-level increase under § 3A1.1(b)(2), because the offense involved a large number of vulnerable victims; and (7) a four-level upward adjustment under § 3B1.1(a), because they were organizers or leaders of criminal activity that involved five or more participants or was otherwise extensive. As a result, defendants Antonio Macli and Jorge Macli each had a total offense level of 40. Antonio Macli and Jorge Macli each had no criminal-history points and a criminal history category of I. Their total offense levels of 40 and criminal history categories of I resulted in advisory guidelines ranges of 292 to 365 months’ imprisonment. 48 Case: 12-16056 Date Filed: 02/17/2015 Page: 49 of 85 The district court sentenced defendant Antonio Macli to a total of 360 months’ imprisonment: 120 months (the statutory maximum for each count) as to each of counts 1, 7, and 31 through 37, to run concurrently; 60 months (the statutory maximum for each count) as to each of counts 15 through 26, to run concurrently; and 240 months (the statutory maximum) as to count 30, to run consecutively to the terms imposed on the other counts. 15 The district court sentenced defendant Jorge Macli to a total of 300 months imprisonment: 60 months (the statutory maximum on counts 15 to 26) as to each of counts 1, 4, 7, 15-26, 32, 33, 35, and 37 to run concurrently and 240 months (the statutory maximum) as to count 30, to run consecutively to the terms imposed on the other counts. Both Antonio Macli and Jorge Macli were each ordered to pay restitution to Medicare in the amount of $11,481,593.42 (jointly with each other, defendant Huarte, and Biscayne Milieu). 2) Sandra Huarte In calculating the advisory guidelines range, the Presentence Investigation Report (“PSI”) grouped all of defendant Huarte’s convictions together under 15 The health care fraud conspiracy, substantive health care fraud, and substantive money laundering counts have a statutory maximum of ten years (120 months). 18 U.S.C. §§ 1347 1349, 1957. The kickback conspiracy and the substantive kickback payment and receipt counts have a statutory maximum of five years (60 months). 18 U.S.C. § 371; 42 U.S.C. § 1320a7b(b)(2)(A). The money laundering conspiracy count has a statutory maximum of twenty years (240 months). 18 U.S.C. § 1956(a)(1). 49 Case: 12-16056 Date Filed: 02/17/2015 Page: 50 of 85 U.S.S.G. § 3Dl.2(c) and (d). Huarte had a base offense level of six, pursuant to § 2B1.1 (a)(2). She received these increases to that offense level: (1) a 20-level increase under § 2B1.1(b)(1)(K), because the loss amount was more than $7 million but not more than $20 million; (2) a two-level increase under § 2B1.l(b)(2)(A)(ii), because her offenses were committed through mass-marketing; (3) a two-level increase under § 2B1.1(b)(9)(C), because her offenses involved sophisticated means; (4) a two-level increase under § 2B1.1(b)(13)(A), because her offenses involved the conscious reckless risk of death or bodily injury; (5) a twolevel increase under § 3A1.1(b)(1), because she knew or should have known that a victim of her offenses was a vulnerable victim; (6) a two-level increase under § 3A1.1(b)(2), because her offenses involved a large number of vulnerable victims; and (7) a three-level upward adjustment under § 3B1.1(b), because she was a manager or supervisor (but not an organizer) of criminal activity that involved five or more participants or was otherwise extensive. As a result, Huarte’s total offense level was 39. Huarte had no criminalhistory points and a criminal history category of I. Her total offense level of 39 and criminal history category of I resulted in an advisory guidelines range of 262 to 327 months’ imprisonment. The district court sentenced defendant Huarte to a total of 262 months’ imprisonment: 22 months as to each of counts 1, 2, 4-8, 11, 15, 31, and 34, to run 50 Case: 12-16056 Date Filed: 02/17/2015 Page: 51 of 85 concurrently, and 240 months (the statutory maximum) as to count 30, to run consecutively to the terms imposed on the other counts. The district court ordered Huarte to pay restitution to Medicare in the amount of $11,481,593.42 (jointly with Antonio Macli, Jorge Macli, and Biscayne Milieu). 3) Dr. Gary Kushner In calculating defendant Dr. Kushner’s advisory guidelines range, the PSI grouped counts 1 and 2 under U.S.S.G. § 3D1.2(d). Dr. Kushner had a base offense level of six, pursuant to § 2B1.1(a)(2). He received these increases to that offense level: (1) a 22-level increase under § 2B1.1(b)(1)(L), because the loss amount was between $20 million and $50 million; (2) a two-level increase under § 2B1.1(b)(2)(A)(ii), because his offenses were committed through mass-marketing; (3) a two-level increase under § 2B1.1(b)(9)(C), because his offenses involved sophisticated means; (4) a two-level increase under § 2B1.1(b)(13)(A), because his offenses involved the conscious reckless risk of death or bodily injury; (5) a twolevel increase under § 3A1.1(b)(1), because he knew or should have known that a victim of his offenses was a vulnerable victim; (6) a two-level increase under § 3A1.1(b)(2), because his offenses involved a large number of vulnerable victims; (6) a two-level increase because he abused a position of public or private trust under § 3B1.3; and (7) a three-level increase under § 3B1.1(b), because Dr. 51 Case: 12-16056 Date Filed: 02/17/2015 Page: 52 of 85 Kushner was a manager or supervisor of criminal activity that involved five or more participants or was otherwise extensive. Dr. Kushner’s total offense level was 43. Dr. Kushner had no criminalhistory points and a criminal history category of I. His total offense level of 43 and criminal history category of I resulted in an advisory guidelines range of life imprisonment. The statutory maximum term of imprisonment on each count, however, was ten years’ imprisonment. Accordingly, the statutory maximum total sentence that could be imposed was 20 years’ imprisonment, applying the sentences consecutively. The district court sentenced Dr. Kushner to a total of 144 months’ imprisonment: 120 months’ imprisonment (the statutory maximum) as to count 1, and 24 months’ as to count 2, to run consecutively. Dr. Kushner was also ordered to pay Medicare $9,341,767.24 in restitution. 4) Rafael Alalu In calculating defendant Alalu’s advisory guidelines range, the PSI grouped counts 1, 3, and 4 under U.S.S.G. § 3D1.2(d). Alalu had a base offense level of six, pursuant to § 2B1.1(a)(2). He received these increases to that offense level: (1) a 20-level increase under § 2B1.1(b)(1)(K), because he was responsible for a loss amount of between $7 million and $20 million; (2) a two-level increase under § 2B1.1(b)(9)(C), because his offenses involved sophisticated means; (3) a three52 Case: 12-16056 Date Filed: 02/17/2015 Page: 53 of 85 level increase under § 3B1.1(b), because he was a manager or supervisor of criminal activity involving five or more participants; and (4) a two-level increase under § 3C1.1 for obstruction of justice. Alalu’s total offense level was 33. He had no criminal-history points and a criminal history category of I. His total offense level of 33 and criminal history category of I resulted in an advisory guidelines range of 135 to 168 months’ imprisonment. The district court sentenced defendant Alalu to a total of 100 months’ imprisonment, concurrent terms of 100 months’ imprisonment as to each count of conviction. The district court also ordered restitution to Medicare in the amount of $5,614,353.20. 5) Anthony Roberts In calculating Roberts’s advisory guidelines range, the PSI grouped counts 15 and 29 pursuant to U.S.S.G. § 3D1.2(b). Roberts had a base offense level of six, pursuant to § 2B1.1(a)(2). He received an 18-level increase under § 2B1.1(b)(1)(J), because he was responsible for a loss of more than $2.5 million but not more than $7 million, and a two-level increase under § 2B 1.1 (b)(9)(C), because his offense involved sophisticated means. Roberts did not receive an adjustment for his role in the offense. Accordingly, his total offense level was 26. Roberts’s criminal history included (1) a 1991 conviction for armed robbery, for which he was sentenced to 12 years’ imprisonment and (2) a 1994 conviction 53 Case: 12-16056 Date Filed: 02/17/2015 Page: 54 of 85 for driving with a suspended license and driving under the influence. Roberts did not receive any criminal-history points for these convictions, and thus he had a criminal history category of I. Roberts’s total offense level of 26 and criminal history category of I resulted in an advisory guidelines range of 63 to 78 months’ imprisonment. The district court sentenced defendant Roberts to a total of 87 months’ imprisonment: 60 months (the statutory maximum) as to count 15, and 27 months as to count 29, to run consecutively. Robert was also ordered to pay $887,085.31 in restitution. 6) Derek Alexander In calculating Alexander’s advisory guidelines range, the PSI grouped counts 15 and 28 under U.S.S.G. § 3D1.2(b). Alexander had a base offense level of six, pursuant to § 2B1.1(a)(2). He received a 14-level increase under § 2B1.1(b)(1)(H), because he was responsible for a loss of between $400,000 and $1 million. Alexander also received a two-level increase under § 2B1.1(b)(9)(C), because his offense involved sophisticated means. He did not receive any adjustments for his role in the offense. Alexander’s total offense level was 22. Alexander had zero criminal-history points and a criminal history category of I. Based on his total offense level of 22 54 Case: 12-16056 Date Filed: 02/17/2015 Page: 55 of 85 and criminal history category of I, his guidelines imprisonment range was 41 to 51 months. The district court sentenced defendant Alexander to a total of 42 months’ imprisonment: concurrent terms of 42 months’ imprisonment as to each of counts 15 and 28. Alexander was ordered to pay restitution to Medicare in the amount of $300,876.08.