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United States v. Popov

United States Court of Appeals, Ninth Circuit

February 11, 2014

UNITED STATES OF AMERICA, Plaintiff-Appellee,
v.
ALEXANDER POPOV, Defendant-Appellant. UNITED STATES OF AMERICA, Plaintiff-Appellee,
v.
RAMANATHAN PRAKASH, Defendant-Appellant

Argued and Submitted November 5, 2013, San Francisco, California

Appeal from the United States District Court for the Eastern District of California. D.C. No. 2:08-cr-00427-MCE-6, D.C. No. 2:08-cr-00427-MCE-7, Morrison C. England, Jr., Chief District Judge, Presiding.

Karen L. Landau, Oakland, California, for Defendant-Appellant Alexander Popov.

James W. Spertus, Spertus, Landes & Umhofer, LLP, Los Angeles, California, for Defendant-Appellant Ramanathan Prakash.

Philip A. Ferrari and Jean M. Hobler, Assistant United States Attorneys, Office of the United States Attorney for the Eastern District of California, Sacramento, California, for Plaintiff-Appellee United States of America.

Before: Stephen Reinhardt and Paul J. Watford, Circuit Judges, and Robert S. Lasnik, District Judge.[*]

OPINION

Page 912

LASNIK, District Judge.

Defendants-Appellants Ramanathan Prakash and Alexander Popov were convicted of one count of conspiracy to commit health care fraud in violation of 18 U.S.C. § § 1347 and 1349, and three counts of health care fraud in violation of 18 U.S.C. § 1347, following a jury trial. On appeal, Appellants challenge their sentences, arguing that the district court erred in calculating the amount of loss for sentencing purposes.[1] We have jurisdiction pursuant to 28 U.S.C. § 1291. We reverse the district court's findings regarding the amount of loss and remand for resentencing.

BACKGROUND

On May 20, 2010, Popov and Prakash were indicted, along with nine co-defendants, on one count of conspiracy to commit health care fraud and several counts of health care fraud. The Superseding Indictment alleged that Appellants' co-defendant, Vardges Egiazarian, owned and operated three medical clinics in Northern California that submitted fraudulent bills to Medicare for more than $5 million.

A. Medicare

Medicare is a federally funded program that provides limited health insurance to persons over the age of 65 and disabled people who meet its qualifications. 42 U.S.C. § 1395o. Medicare Part A covers inpatient hospital and nursing facility care, id. § 1395c, while Part B covers outpatient services and equipment, id. § 1395k. Medicare coverage is limited to services

Page 913

that are medically " reasonable and necessary." Id. ยง 1395y(a)(1)(A). Participating providers are required to ensure that any services rendered to Medicare recipients are supported by sufficient evidence of ...


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