Opinion ID: 4027644
Heading Depth: 4
Heading Rank: 2

Heading: to obtain, by means of false or fraudulent

Text: pretenses, representations, or promises, any of the money or property owned by, or under the custody or control of, any health care benefit program, in connection with the delivery of or payment for health care benefits, items, or services, shall be fined under this title or imprisoned not more than 10 years, or both. 18 U.S.C. § 1347(a). The term “health care benefit program” is defined to include “any public or private plan or contract, affecting commerce, under which any 24 Case: 13-15878 Date Filed: 08/23/2016 Page: 25 of 41 medical benefit, item, or service is provided to any individual, and includes any individual or entity who is providing a medical benefit, item, or service for which payment may be made under the plan or contract.” 18 U.S.C. § 24(b). In considering these statutes, it is plain that each requires proof of a unique element not required by the other. Thus, among other things, § 371 requires as elements proof of an overt act and proof that the intended victim was the United States or one of its agencies. In contrast, the language of § 1349 does not require the commission of an overt act. Nor, does it require that the United States or one of its agencies be the intended victim of the fraud. Indeed, conspiring to commit health care fraud under §§ 1347 and 1349 (as the defendant here was convicted of doing) can encompass targeting either a public or a private plan that provides medical benefits. This explains why our sister circuits have held that the requirements of § 1347 have been satisfied even when the fraud targeted private insurers. See United States v. Collins, 774 F.3d 256, 260 (5th Cir. 2014), cert. denied, 135 S. Ct. 2391, 136 S. Ct. 260 (2015) (holding that automobile insurers are “health care benefit programs” to the extent they pay for medical treatment); United States v. Lucien, 347 F.3d 45, 52 (2d Cir. 2003) (same). Likewise, § 1349 requires that the conspiracy must relate to one of a specific subset of statutes found in Chapter 63 of Title 18. But § 371 explicitly applies to conspiracies to commit any offense against the United States or to defraud the United States. Thus, a 25 Case: 13-15878 Date Filed: 08/23/2016 Page: 26 of 41 conviction under § 371 would not require proof that the conspiracy was for the purpose of committing one of the offenses required by § 1349. Section 371 simply lacks that element. Moreover, the statutory text further evinces a Congressional intent to allow for separate and distinct punishment for each of the two conspiracies under which Gonzalez was convicted and sentenced. Thus, for example, the two statutes provide for different maximum punishments -- five years for a § 371 conspiracy and 10 years for a § 1347 conspiracy. See United States v. Lanier, 920 F.2d 887, 892 (11th Cir. 1991) (considering differences in maximum punishment and statutory language under each conspiracy statute in assessing congressional intent in multiplicity analysis). Finally, a panel of this Court has already held that the overt act required by § 371 sufficiently distinguishes a violation of that statute from another similar statute prohibiting conspiracy to defraud the United States, but that lacks the overt act requirement. Id. at 897. Accordingly, we are constrained to find, as Gonzalez now concedes, that there was no double jeopardy error in charging Gonzalez under both § 371 and § 1349. Even if we could say that the charges in Counts 1 and 2 were multiplicitous, in the face of Blockburger and the development of our caselaw, such an error could hardly be described as being plain or obvious. It is not surprising, therefore, that Gonzalez has conceded that there was no charging error, let alone one that was 26 Case: 13-15878 Date Filed: 08/23/2016 Page: 27 of 41 plain or obvious. The appellant’s double jeopardy argument, however, is reprised by Gonzalez who suggests that the district court’s erroneous jury instructions about the meaning of the two counts illuminates the true nature of the double jeopardy claim. We remain unpersuaded about this argument as well for the reasons we detail in Section IV, particularly because we are obliged to review this issue for plain error.