Court Opinion

ID: 9486900
Source: CourtListenerOpinion
Date Created: 2023-08-05 12:03:35.328723+00
Date Added: 2024-06-11T17:52:00.073117
License: Public Domain

ANDERSON, Circuit Judge,
dissenting.
I agree that 42 U.S.C. § 1320a-7b(a)(l) requires proof that Laughlin knew the statements were false. I dissent because the jury instructions as a whole correctly explained the meaning of “knowingly and willfully.” See United States v. Denny, 939 F.2d 1449, 1454 (10th Cir.1991) (explaining that court must review adequacy of jury instructions as a whole, rather than reviewing individual instructions separately).
I. Knowledge of Falsity
Contrary to Laughlin’s assertion, the district court did not fail to instruct the jury on the knowledge of falsity requirement. Instruction Eleven identified “three essential elements” of Medicaid fraud:
First: That the defendant made or caused to be made a statement or representation of material fact in an application for benefits or payment under the Medicaid Act;
Second: That the statement or representation was false; and
Third: That the defendant knowingly and willfully made or caused to be made the false statement or representation.
Appellant’s Br.App. at 88. Like the statute itself, however, the third element’s description of the necessary intent was ambiguous. It could mean that Laughlin knowingly made a statement that happened to be false, even if he did not know it was false. Or it could mean that Laughlin knew that the statement he was making was false. See Liparota v. United States, 471 U.S. 419, 423-24 & n. 7, 105 S.Ct. 2084, 2086-87 & n. 7, 85 L.Ed.2d 434 (1985).
The jury almost certainly understood the instruction correctly. The first element already required proof that Laughlin made or caused to be made a statement. I doubt that a jury would think one could make a statement without knowing that he was doing so. “Knowingly” in the third element could only add the requirement that Laughlin knew the statement he was making was false.
Instruction Nine further guaranteed that the jury would correctly understand the intent element by defining “knowingly” as acting with awareness and not because of ignorance or mistake. See Appellant’s BrApp. at 86. A reasonable juror would conclude that a defendant who intentionally made a statement but did not know it was false was acting in ignorance. Although plausible to lawyers, I doubt that any reasonable juror would think that a person who did not know his statement was false “knowingly made a false statement.”
Nevertheless, our precedents do suggest that this technical ambiguity makes the intent instruction alone inadequate. See United States v. O’Brien, 686 F.2d 850, 851-53 (10th Cir.1982); Hunt v. Oklahoma, 683 F.2d 1305, 1308 (10th Cir.1982). But flaws in jury instructions are only errors if the instructions as a whole do not “provide the jury with an ample understanding of the applicable principles of law and factual issues.” Denny, 939 F.2d at 1454. The indictment contained in Instruction Three clarified the correct understanding of Instruction Eleven on the re*1532quired knowledge of falsity. The indictment in Instruction Three states that
Sidney C. Laughlin ... knowingly and wil-fully made and caused to be made false statements and representations of material facts in applications for payments of Medicaid funds for physician services in that ' the defendant ... represented that he had provided specific physician services ... and that certain patients had accidents and injuries at home ..., whereas Sidney C. Laughlin, the defendant herein, then and there well knew said statements and representations on the applications forms submitted were false....
Appellant’s Br.App. at 67. Laughlin agreed to have the judge summarize the indictment rather than read it to the jury, but the judge nevertheless told the jury to “read and review it carefully.” R.Supp. at 4-5. The indictment can and in this case did help to explain the required intent. See Hunt, 683 F.2d at 1308 (“[T]he mere use of the word ‘knowingly’ in the Information and jury instructions did not adequately convey the concept of scienter to the jury.”). The jury knew it should interpret each instruction in light of other instructions because the judge told the jury to “consider the instructions as a whole and not a part to the exclusion of the rest.” R.Supp. at 13. Especially since the jury was likely to understand the intent instruction correctly, the indictment’s clear allegation that Laughlin knew the statements were false was enough to ensure that the jury would understand it could convict Laughlin only if he knew the statements were false.
I don’t see how the “utility of the indictment was further qualified by the judge’s statement that ‘the indictment itself is not evidence, it merely describes the charges and is only an accusation.’” Majority Op. at 1529. This is true of all instructions. None is “evidence”; they simply describe what the government must prove. The judge’s remark does not suggest that the indictment may not clarify what the government must prove. ■
The majority .concludes that Instruction Three did not sufficiently clarify the required knowledge of falsity because “[w]e cannot be confident that a reasonable juror, having read and heard the indictment, would have identified the contradiction, rectified it in a manner inconsistent with the judge’s explicit ‘element’ instructions, and determined that Dr. Laughlin was required to know that the statements he was submitting were, in fact, false.” Id. However, Instruction Three did not contradict Instruction Eleven. Instruction Eleven clearly required Laughlin to have known something when he made the false statements. One of the possible meanings— in fact, the most likely meaning — of the third element in Instruction Eleven was just what the indictment in Instruction Three alleged: that Laughlin knew his statements were false. Instruction Three therefore simply clarifies the ambiguity in Instruction Eleven; they do not conflict at all. The jury would have no reason to disregard Instruction Three and the judge’s admonition to follow all of the instructions. See R.Supp. at 4.
The majority also suggests that the jury would not have correctly understood the knowledge requirement because the judge did not read the relevant part of the indictment, which was “embedded in eighteen lines of text.” Majority Op. at 1528-29. The mere density of an instruction does not make it inadequate. We may assume that the jury followed the judge’s instructions to read the indictment carefully, regardless of what he read orally. Instructions Three and Eleven, along with Instruction Nine, adequately informed the jury that Laughlin was guilty only if he knew the statements were false.
II. Willfullness
The statute requires proof that the defendant both “knowingly” and “willfully” made or caused to be made a false statement. 42 U.S.C. § 1820a-7b(a)(l). Laughlin claims that the court did not properly instruct the jury on the willfullness requirement either. The majority did not have to consider this challenge because it held that the court did not adequately instruct the jury on knowledge of falsity. I believe that the instructions did convey the correct understanding of the willfullness requirement.
I disagree with Laughlin that the Medicaid fraud statute requires proof that the defen*1533dant intended to violate a known law. The accused generally need not know that his conduct is illegal. Cheek v. United States, 498 U.S. 192, 199, 111 S.Ct. 604, 609, 112 L.Ed.2d 617 (1991); United States v. Dashney, 937 F.2d 532, 538 (10th Cir.), cert. denied, — U.S. -, 112 S.Ct. 402, 116 L.Ed.2d 351 (1991). But in some eases, such as those involving the criminal tax laws, “willfully” means an “intentional violation of a known legal duty,” because of the complexity of the laws or the apparent innocence of the criminal conduct. See Cheek, 498 U.S. at 199-201, 111 S.Ct. at 609-610; Dashney, 937 F.2d at 539. In this case, however, making known false statements is not apparently innocent. The law may be somewhat complex, but the required knowledge of falsity itself ensures that the accused will not be convicted if he did not know the law and regulations well enough to know that his statements were false. The defendant need not know that filing false claims is against the law, however. See United States v. Hollis, 971 F.2d 1441, 1451-52 (10th Cir.1992) (holding that “willfully” in 18 U.S.C. § 2(b) does not require that defendant knew his conduct violated the law), cert. denied, — U.S. -, 113 S.Ct. 1580, 123 L.Ed.2d 148 (1993); Dashney, 937 F.2d at 538-39 (holding that “willfully” in antistructuring law means only that person intentionally and knowingly evaded the reporting requirement, not that he also knew evasion is illegal). He need only intend to make statements he knows are false.
The instructions ensured that the jury would not convict Laughlin unless he “willfully” made false statements in this sense. The instructions require the jury to find that Laughlin “knowingly and willfully made or caused to be made the false statement or representation.” Appellant’s Br.App. at 88. The court also explained that “willfully” means Laughlin “knowingly performed an act, deliberately and intentionally, as contrasted with accidentally, carelessly, or unintentionally.” Id. at 86. Again, the court’s description of the willfullness requirement is technically ambiguous. It could mean only that Laughlin intended to make a statement, or that he intended to make a false statement. The required knowledge of falsity makes this ambiguity inconsequential, however. The instructions require that Laughlin knew the statements were false, and that he “willfully” or “intentionally” made those statements that he knew to be false. This is all that “willfully” means in this statute. The instructions as a whole thus adequately instructed the jury on the correct meaning of the charge that Laughlin “knowingly and willfully” made false statements. I therefore dissent.