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United States v. Pamatmat

United States District Court, E.D. Michigan, Southern Division

May 23, 2017

ADELFO PAMATMAT, Petitioner/Defendant



         Before the court are two motions filed by Defendant Adelfo Pamatmat. Following his conviction for conspiracy to distribute controlled substances and health care fraud conspiracy, Defendant filed his Motions for New Trial (Dkt. # 1180) and for Judgment of Acquittal (Dkt. # 1181) on July 16, 2015. The court denied Defendant's Motion for New Trial in its opinion and order entered September 4, 2015. (Dkt. # 1259.) Defendant subsequently filed his Second Motion for New Trial on October 13, 2016. (Dkt. # 1538.) The motions are fully briefed and a hearing was held on May 18, 2017. For the reasons that follow, the court will deny both motions.

         I. BACKGROUND

         Defendant is a medical doctor who did contract work with Compassionate Doctors, P.C. (“Compassionate”). (Dkt. # 1164, Pg. ID 8160.) Defendant, along with numerous other doctors, pharmacists, and others, was charged with various offenses relating to a conspiracy to illegally distribute large quantities of prescription pain medication on March 20, 2013. (Dkt. # 187.) In particular, Defendant was charged with one count of conspiracy to distribute controlled substances under 21 U.S.C. §§ 841(a)(1) and 846 and one count of health care fraud conspiracy under 18 U.S.C. §§ 1347 and 1349. On July 2, 2015, Defendant was convicted of all counts. (Dkt. # 1160.) Shortly after, Defendant timely filed the instant motions.

         I. STANDARD

         The court may enter a judgment of acquittal if the evidence presented at trial is insufficient to support a conviction. Fed. R. Crim. P. 29. “In reviewing challenges regarding the sufficiency of the evidence presented to the jury, [the court is] limited to ascertaining whether, viewing the evidence in the light most favorable to the government, any rational trier of fact could have found the essential elements of the crime beyond a reasonable doubt.'” United States v. Carmichael, 232 F.3d 510, 519 (6th Cir. 2000) (quoting Jackson v. Virginia, 443 U.S. 307, 319 (1979) (emphasis in original); citing United States v. Talley, 164 F.3d 989, 996 (6th Cir. 1999)). A court must therefore “draw all available inferences in favor of the jury's verdict.” United States v. Maliszewski, 161 F.3d 992, 1006 (6th Cir. 1998) (citing United States v. Smith, 39 F.3d 119, 121 (6th Cir. 1994)). Moreover, “‘[s]ubstantial and competent' circumstantial evidence by itself may support a verdict and need not ‘remove every reasonable hypothesis except that of guilt.'” United States v. Lee, 359 F.3d 412, 418 (6th Cir. 2004) (quoting United States v. Stone, 748 F.2d 361, 363 (6th Cir. 1984)). Thus, “[a] defendant bringing such a challenge bears a ‘very heavy burden.'” United States v. Daniel, 329 F.3d 480, 485 (6th Cir. 2003) (quoting United States v. Vannerson, 786 F.2d 221, 225 (6th Cir. 1986)).

         Rule 33 allows the court to “vacate any judgment and grant a new trial if the interest of justice so requires.” Fed. R. Crim. P. 33(a). The Sixth Circuit gives trial courts broad discretion in determining whether to grant a new trial pursuant to Rule 33 because “‘[t]he trial judge is in the best position to determine . . . appropriate remedies for any demonstrated misconduct.'” United States v. Wheaton, 517 F.3d 350, 361 (6th Cir. 2008) (quoting Unite States v. Copeland, 51 F.3d 611, 613 (6th Cir. 1995)). When a defendant rests his argument for a new trial on the basis of cumulative error, he must show that the “combined effect of individually harmless errors was so prejudicial as to render his trial fundamentally unfair.” United States v. Trujillo, 376 F.3d 593, 614 (6th Cir. 2004) (citing United States v. Parker, 997 F.2d 219, 221 (6th Cir. 1993)) (finding only harmless error when a trial judge admitted hearsay statements of government agents); see also Wheaton, 517 F.3d at 361 (affirming a denial of a motion for new trial because no prejudice resulted from juror's misconduct in which the juror looked at a map to determine the distance between two towns).


         A. Acquittal

         Defendant challenges both of his conspiracy convictions: (1) conspiracy to distribute controlled substances under 21 U.S.C. §§ 841(a)(1) and 846; and (2) health care fraud conspiracy under 18 U.S.C. §§ 1347 and 1349. Defendant makes the same argument for both counts: the government failed to offer sufficient evidence to demonstrate beyond a reasonable doubt that Defendant was aware of and intentionally entered such conspiracies. (Dkt. # 1181, Pg. ID 8586.) The court disagrees.

         To establish a drug conspiracy, the government must prove (1) an agreement to violate the drug laws, (2) knowledge of and intent to join the conspiracy, and (3) participation in the conspiracy. United States v. Sanchez, 928 F.2d 1450, 1457 (6th Cir. 1991). The government need not prove the existence of a formal agreement to establish a conspiracy - proof of a tacit understanding among the parties is sufficient. United States v. Bavers, 787 F.2d 1022, 1026 (6th Cir. 1985). "A conspiracy may be inferred from circumstantial evidence that can reasonably be interpreted as participation in the common plan." Id. at 1026 (citing United States v. Strong, 702 F.2d 97 (6th Cir. 1983); United States v. Mendez, 496 F.2d 128 (5th Cir. 1974)). The government is not required to prove an overt act in furtherance of the conspiracy under section 1346. U.S. v. Patel, 579 Fed.Appx. 449, 460 (6th Cir. 2014) (citing United States v. Shabani, 513 U.S. 10, 15 (1994)).

         Any person who conspires to commit health care fraud may be convicted of a federal offense under 18 U.S.C. § 1349. An individual commits health care fraud by “knowingly and willfully execut[ing] or attempt[ing] to execute a scheme or artifice . . . to defraud any health care benefit program[] or . . . to obtain by means of false or fraudulent pretenses, representations, or promises, any of the money or property owned by, or under the custody or control of, any health care benefit program, in connection with the delivery or payment for health care benefits, items, or services.” 18 U.S.C. § 1347(a). A person who commits health care fraud “need not have actual knowledge” of the statute forbidding the conduct “or specific intent to commit a violation” of the statute. 18 U.S.C. § 1347(b). To establish a health care fraud conspiracy under section 1349, the government must prove an agreement between two or more people to act together to commit the offense. Patel, 579 Fed.Appx. at 460-61 (citing United States v. Rogers, 769 F.2d 372, 379-82 (6th Cir. 2014)).

         Evidence linking Defendant to the drug and medicare fraud conspiracy abounds. Defendant indisputably worked for Compassionate, the locus of the conspiracy. (Dkt. # 1181, Pg. ID 8583.) Dr. Ravi Iyer testified that he and Defendant sat in the conference room at Compassionate together and signed stacks of charts (Dkt. # 1556, Pg. ID 15939-40.) Tiffany Walker testified that Defendant held “patient parties” in her home that resulted in illegal controlled substance prescriptions and fraudulent billings. (Dkt. # 1122, Pg. ID 6590-92.) Walker's testimony was corroborated by surveillance officers who witnessed a patient attending a patient party in Detroit, which Defendant billed as a more expensive visit to the patient's home in Harper Woods. (Dkt. # 1556, Pg. ID 16087-95.) Javar Myatt-Jones testified that Defendant received illegal cash payments for signing charts and blank prescriptions for patients he had not actually examined. (Dkt. # 1125, Pg. ID 7029-36, 7160-62.) In fact, Myatt-Jones, while acting undercover, recorded Defendant discussing this conduct. (Id.) After he was arrested and read his Miranda rights, Defendant orally confessed to his involvement in the conspiracy, including that he had written illegitimate controlled substance prescriptions. (Dkt. # 1453, Pg. ID 12832-38.) This evidence is more than sufficient for a reasonable jury to conclude beyond a reasonable doubt that Defendant participated in scheme with other doctors and employees at Compassionate to write bogus prescriptions and bilk Medicare.

         Defendant relies heavily on evidence that he was paid only $20, 000 in checks from Sardar Ashrafkhan. (Dkt. # 1181, Pg. ID 8587.) But conspiracy convictions do not require conspirators to have received any particular share of the illicit proceeds. Patel, 579 Fed.Appx. at 460-61 (describing the elements of drug and health care fraud conspiracy). Further, the jury heard testimony that Defendant received cash payments for signing charts and blank prescriptions for ...

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