Searching over 5,500,000 cases.


searching
Buy This Entire Record For $7.95

Download the entire decision to receive the complete text, official citation,
docket number, dissents and concurrences, and footnotes for this case.

Learn more about what you receive with purchase of this case.

United States v. Wijegoonaratna

United States Court of Appeals, Ninth Circuit

April 26, 2019

United States of America, Plaintiff-Appellee,
v.
Sri Wijegoonaratna, AKA Dr. J, Defendant-Appellant.

          Argued and Submitted February 5, 2019 Pasadena, California

          Appeal from the United States District Court for the Central District of California S. James Otero, District Judge, Presiding D.C. No. 2:14-cr-00512-SJO-VAP-3

          Alyssa D. Bell (argued), Anya J. Goldstein, and Reuven L. Cohen, Cohen Williams LLP, Los Angeles, California, for Defendant-Appellant.

          Steven M. Arkow (argued), Assistant United States Attorney; Lawrence S. Middleton, Chief, Criminal Division; Nicola T. Hanna, United States Attorney, Los Angeles, California; for Plaintiff-Appellee.

          Before: Ronald M. Gould, Jacqueline H. Nguyen, and John B. Owens, Circuit Judges.

         SUMMARY[*]

         Criminal Law

         The panel affirmed a conviction for seven counts of health care fraud, affirmed in part and vacated in part the sentence, and remanded, in a case in which the defendant, a physician, and others affiliated with California Hospice Care fraudulently billed Medicare and Medi-Cal for hospice care given to patients who had been falsely certified as terminally ill.

         Affirming the conviction, the panel held that the district court did not err in overruling the defendant's objection to the prosecutor's statement during closing argument that office staff who completed a patient intake form copied the defendant's assessment.

         The panel rejected the defendant's contention that the district court, at sentencing, did not make Fed. R. Crim. P. 32's required factual findings on a disputed loss calculation.

         The panel held that sufficient evidence supports the district court's finding that the defendant intended the loss amounts underlying his sentencing enhancements.

         The panel held that the district court did not plainly err in applying an enhancement pursuant to 18 U.S.C. § 3147 and U.S.S.G. § 3C1.3 for committing a crime while on supervised release, where the defendant - whose counts of conviction concerned conduct before he went on pretrial release - continued the same course of conduct after his pretrial release began.

         Reviewing de novo, the panel held that because the government charged the defendant with multiple counts rather than a single continuing offense, the district court violated the ex post facto clause by sentencing him under the 2016 Sentencing Guidelines Manual on the six counts arising from conduct that occurred before the Guidelines Manual revision.

          OPINION

          GOULD, Circuit Judge:

         Defendant Sri Wijegoonaratna appeals his jury conviction and sentence for seven counts of health care fraud in violation of 18 U.S.C. § 1347. We affirm Wijegoonaratna's conviction, and we affirm in part and vacate and remand in part his sentence.

         I

         A

         Hospice care is designed for patients with terminal illnesses who choose to forgo active treatment of their terminal condition and instead receive palliative care, including pain relief and family bereavement services. Hospice care may be provided in the patient's home or in a facility such as a nursing home.

         For eligible Medicare beneficiaries, Medicare pays around $200-250 per day for hospice care. To be eligible, a patient must be certified as terminally ill by two licensed physicians. "Terminally ill" means that the patient's prognosis is less than six months if the disease runs its normal course. The two licensed physicians are typically the hospice medical director or staff physician and the patient's attending physician. Patients are initially certified for ninety days of service. If a patient requires hospice care beyond those ninety days, the patient can be recertified for an additional period. Recertification requires just one physician.

         About 85% of hospice patients die in hospice care (the remaining 15% end hospice care alive). Patients receive hospice care for an average of sixty-six days, but about half receive hospice care for fewer than twenty days before dying.

         Priscilla Villabroza acquired California Hospice Care ("CHC") in 2008. Sharon Patrow, her daughter, handled business operations; Erwin Castillo, a registered nurse, handled medical matters. Dr. Violeta Atiga worked as the medical director.

         Patient admission at CHC required three documents: (1) a nursing assessment, completed by a nurse during a visit; (2) a history and physical, completed by a physician during a visit; and (3) a patient intake form, completed by CHC office staff. At trial, the parties disputed the order in which these documents were completed. Once a patient's file was complete, the patient's attending physician and Dr. Atiga would certify that the patient was terminally ill.

         According to trial testimony, CHC's practice was to fraudulently bill Medicare and Medi-Cal for hospice care given to patients who had been falsely certified as terminally ill. CHC illegally paid recruiters to refer patients to CHC. CHC also falsified records and even paid some patients to be on hospice. Although CHC certified its patients as terminally ill, the majority of CHC patients did not die within six months of admission.

         Wijegoonaratna filled several roles at CHC from November 2009 to May 2013. For most CHC patients, Wijegoonaratna was the attending physician-the physician who completed the "history and physical," certified the patient as hospice-eligible (along with Dr. Atiga), and remained responsible for the patient's care. Wijegoonaratna also recruited around half of CHC's patients, participated in team meetings, and served as its associate medical director. He continued in these roles even after he was indicted and placed on pretrial release in a different criminal case. All ...


Buy This Entire Record For $7.95

Download the entire decision to receive the complete text, official citation,
docket number, dissents and concurrences, and footnotes for this case.

Learn more about what you receive with purchase of this case.