Opinion ID: 1253249
Heading Depth: 3
Heading Rank: 4

Heading: Evidence of Health Care Fraud

Text: Josephberg also challenges the sufficiency of the evidence to show that he defrauded his health care insurer (Count 17). He argues that Mrs. Josephberg testified that she worked 20 hours a week for Mr. Josephberg's business, and there was no evidence in the trial to prove otherwise. (Josephberg brief on appeal at 64-65.) The record is to the contrary. The evidence was that in the fall of 1998, Josephberg, seeking a group rate for health insurance and inexpensive coverage for his wife, told Fox that he needed to supply his health care insurer with tax documents that showed his wife was an employee (Tr. 984; see id. at 1065-66), and he asked [Fox] to prepare a phony Schedule C ( id. at 985; see also id. at 1065-66), a schedule designed to be attached to a taxpayer's federal income tax form, Form 1040, to show his income from a business. Fox, though know[ing] it was wrong to do that, immediately complied; he took the Schedule C and ... added... a $12,000 salary to [Josephberg's] wife. ( Id. at 985.) This document was submitted to Oxford by Josephberg, bearing Fox's handwritten statement that [t]his form was included in Richard Josephbergs [ sic ] 1997 Form 1040 (GX 201-A; see Tr. 984-86). Fox testified that that handwritten statement was a lie ( id. at 986): In fact Josephberg had not yet filed his 1997 tax return; and when he did eventually file a 1997 return (in 1999), the accompanying Schedule C bore no indication that Mrs. Josephberg was employed by Josephberg's company ( see GX 120). Further, when Oxford asked Josephberg for verification in the form of a New York State tax return for Mrs. Josephberg to show that she reported salary from Josephberg-Grosz, Fox prepared a New York State tax form representing that Mrs. Josephberg was employed by Josephberg-Grosz in 1997, which Josephberg then sent to Oxford. ( See Tr. 986-88; GX 201-B.) This form too was false. ( See Tr. 987.) Mrs. Josephberg herself testified at trial that she had not received any salary from Josephberg's company. ( See Tr. 1882.) Indeed, the government introduced evidence that in 1997 Mrs. Josephberg commenced a personal bankruptcy proceeding in which she, inter alia, said she was employed solely as a teacher by Westchester County, and that she stated under oath that she `ha[d] no knowledge of Richard Josephberg's business operations' (Tr. 1881 (quoting Mrs. Josephberg's response to Interrogatory 5 in her bankruptcy proceeding)). Asked at trial if she had given that answer, Mrs. Josephberg responded that's true, I really didn't know about his business operations. ( Id. at 1882.) The evidence that Josephberg had Fox prepare false documents to indicate that his wife worked at his firm was itself sufficient to permit an inference that she did not in fact work there. And that inference was amply supported by Mrs. Josephberg's sworn statements that she lacked any knowledge of Josephberg's business operations.