U.S. v. Orillo

In prosecution on healthcare fraud charge arising out of allegations that defendant paid kickbacks to physicians for patient referrals, Dist. Ct. did not err in determining that loss amount attributed to healthcare fraud was $744,481 and in imposing restitution order for same amount. Said figure was based on sample of medical records for claims submitted by defendant that indicated overpayments of $47,444 with no evidence of any underpayments. Ct. rejected defendant’s claim that Dist. Ct could not calculate loss figure by attributing all overpayments to his criminal conduct, and that Dist. Ct. should have only relied on overpayments stemming from visibly altered claim forms, since defendant’s arguments wrongfully assumed that only evidence linking overpayments to his misconduct was overpayments generated by altered claim forms. Ct. further noted that fact that there were no underpayments to defendant in instant sample forms constituted strong evidence that overpayments were intentional, rather than accidental.