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In the Courts
Fourth Circuit Confirms Prosecutorial Latitude in Proving Fraud Schemes
In a recent decision, the U.S. Court of Appeals for the Fourth Circuit confirmed the wide discretion federal prosecutors have to introduce evidence of a criminal defendant's scheme to defraud. United States v. Bajoghli, No. 14'4798, 2015 BL 136412 (4th Cir. May 11, 2015).
In United States v. Bajoghli, Dr. Amir Bajoghli, a Board-certified dermatologist with offices in Washington, DC, and Virginia, was indicted under 18 U.S.C. ' 1347 for executing a “scheme or artifice to defraud” public and private health-care entities. Specifically, the 53-count indictment against Bajoghli alleged three fraud schemes: First, that he routinely provided fake skin cancer diagnoses to patients, performed medically unnecessary procedures to treat the non-existent cancers, and then billed for the procedures. Second, that Bajoghli billed procedures performed by unlicensed medical assistants as if he had performed them, resulting in a higher reimbursement rate. Third, that he was reimbursed for pathology slide analyses at a rate of $100-$130 per slide, despite paying an outside contractor $15 per slide to conduct the analyses.
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