USA v. Hoffman-Vaile, No. 07-12629 (11th Circuit USCA)
The defendant, a dermatologist from Florida, appeals her convictions and sentences on charges of health care fraud, filing false claims, and obstruction of justice. The Defendant was billing Medicare at an aberrant rate under a billing code for an unusual and complicated procedure. It was determined that from 1993 through 1999, the defendant billed under this particular code more often and for greater amounts than under any other billing code. When contacted by the private contractor for Medicare, the defendant was asked to provide photographs that corresponded with the surgeries billed for. The defendant, after many chances, did not comply.
In 2002 the Department of Health and Human Services obtained a federal search warrant for patient files with the suspect billing code and seized over 3,000 files from the defendant’s office. However, the Department was unable to locate about 300 files.
In 2003, a federal grand jury issued a subpoena that directed the defendant to produce the missing files. The defendant produced 185 of the missing files but most of the records lacked the requisite photographs. The defendant’s attorneys later produced a box of loose photographs to the government.
The defendant was indicted in July 2005 on 44 counts of health care fraud, 44 counts of filing false claims, and one count of obstruction of justice-she instructed her employees to remove photographs from the subpoenaed files. The defendant was sentenced to 60 months of imprisonment for each fraud count and false claims count, to be served concurrently, and 18 months imprisonment for obstruction.
The 11th Circuit Court of Appeals affirmed the defendant’s convictions and sentences, but vacated and remanded the forfeiture money judgment for further proceedings.
