Opinion ID: 2799484
Heading Depth: 1
Heading Rank: 2

Heading: The Loss Amount Attributed to Rojo

Text: We review the district court’s determination regarding the amount of loss under the Sentencing Guidelines for clear error. United States v. Hoffman-Vaile, 568 F.3d 1335, 1340 (11th Cir. 2009). The loss amount is the greater of the actual or intended loss. U.S.S.G. § 2B1.1, comment. n.3(A). Actual loss is the monetary harm that resulted from the offense and that was reasonably foreseeable, whereas intended loss is the monetary harm that was intended to result from the offense. Id. § 2B1.1, comment. n.3(A)(i)-(ii). Intended loss includes pecuniary harm that would have been impossible or unlikely to occur. Id. § 2B1.1, comment. n.3(A)(ii)(II). A loss amount need only be a reasonable estimate based on the 5 Case: 13-15266 Date Filed: 05/08/2015 Page: 6 of 8 available information and not a precise calculation. See United States v. Woodard, 459 F.3d 1078, 1087 (11th Cir. 2006). The district court may hold participants in a conspiracy responsible for the losses resulting from the reasonably foreseeable acts of co-conspirators in furtherance of the conspiracy. United States v. Hunter, 323 F.3d 1314, 1319 (11th Cir. 2003); U.S.S.G. § 1B1.3(a)(1)(B). However, because “the limits of sentencing accountability are not coextensive with the scope of criminal liability,” the district court should take a two-pronged approach to determining loss liability for the acts of co-conspirators. Hunter, 323 F.3d at 1319. The court must “first determine the scope of criminal activity the defendant agreed to jointly undertake, and then consider all reasonably foreseeable acts and omissions of others in the jointly undertaken criminal activity.” United States v. McCrimmon, 362 F.3d 725, 731 (11th Cir. 2004) (quotation omitted). The 18 U.S.C. § 3553(a) factors apply only to assess the reasonableness of a final sentence. See United States v. Dorman, 488 F.3d 936, 938 (11th Cir. 2007) (explaining that reasonableness standard is not applied to each individual decision made during the sentencing process, only to the final sentence). The district court did not clearly err when it found $49,366,900, the amount BMHC billed Medicare from January 2007 through when the conspiracy ended in September 2011, to be the appropriate loss amount. This was a reasonable 6 Case: 13-15266 Date Filed: 05/08/2015 Page: 7 of 8 estimate of the intended loss based on the available information. See Woodard, 459 F.3d at 1087. Though the court acknowledged that there may have been “some beneficial therapy going on” at BMHC, it also correctly noted that it would be “very difficult for [the] court to look at the minute number of beneficial and accurate patients in order to make a determination as to who they were.” Further, Rojo presented no specific evidence to show which claims were legitimate and which were fraudulent, instead asserting generally that all the claims based on his notes were legitimate. Based on the evidence presented during Rojo’s trial and the evidence presented during the other sentencings in the case, the court concluded that, “for the most part, [BMHC] was a fraud, and the relevant amount is the entire scheme.” The court was not required to do a more precise calculation of the loss amount. Woodard, 459 F.3d at 1087. Rojo’s reliance on 18 U.S.C. § 3553(a)(6) is misplaced, because the § 3553(a) factors apply only to assess the reasonableness of a final sentence, not to each individual decision made during the sentencing process. See Dorman, 488 F.3d at 938. Finally, as to Rojo’s argument that the loss amount included periods before he was employed at BMHC, Rojo testified at trial that he began working at BMHC in September 2006, and he did not object to the PSI’s finding that he worked there beginning on January 1, 2007. As to his argument that the loss amount included periods after he was employed at BMHC, it was reasonably 7 Case: 13-15266 Date Filed: 05/08/2015 Page: 8 of 8 foreseeable that his co-conspirators at BMHC would continue to fraudulently bill Medicare, sometimes using his patient files, so the district court did not err in finding him responsible for the losses resulting from both his own acts and the acts of his co-conspirators. Hunter, 323 F.3d at 1319; U.S.S.G. § 1B1.3(a)(1)(B). Upon review of the record and consideration of the parties’ briefs, we affirm. AFFIRMED. 8