Last week, former U.S. Supreme Court Justice Sandra Day O’Connor — sitting specially on a panel of the Eleventh Circuit Court of Appeals — issued a serious warning to medical practitioners, upholding a 30-year sentence of a doctor convicted of Medicare fraud in the case of U.S. v. Alvarez.  The sentence (exceeding the federal sentencing guidelines) appears particularly harsh in light of the facts that the doctor apparently reported the fraud to the FBI, agreed to wear a wiretap to assist investigators, received a relatively modest $100,000 salary in comparison to the masterminds of the fraud who stole nearly ten million. Nevertheless, O’Connor reasoned:

“[W]e would fully expect that [the district court’s 30-year sentence] was reasonable. [Citation omitted]. That expectation would be reinforced by the district court’s findings about the specific circumstances of the case: Alvarez’s abuse of her position of trust as a doctor; the ongoing nature of the conspiracy; the lower standard of care Alvarez provided to her HIV-positive patients; the need to deter Medicare fraud, particularly in the Miami area; and Alvarez’s perjury at trial and her complete lack of remorse.”

The repugnant nature of the scheme — which involved paying cash kickbacks to HIV patients to induce them to receive mere saline injections while Medicare was falsely billed for expensive treatments — appeared to be a persuasive factor by O’Connor, who described the fraud in great detail in the opinion.  What appears to have been most persuasive, however, was the Defendant’s position as a “Medical doctor licensed to practice in the United States.” Accordingly, the opinion is a clear signal that medical professionals who participate in Medicare fraud will be held to a higher standard and will receive the most severe sentences permitted by law.  Read the opinion in its entirety below:
U.S. v. Alvarez
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