Whether Medicare beneficiaries are 'victims' for purposes of sentencing enhancements

QUESTIONS PRESENTED (1) Whether the Medicare beneficiaries whose health care treatments form the basis of fraudulent Medicare claims fit the definition of “victims” for purposes of base offense level sentence enhancements under Section 2B1.1(b)(2)(A)(i) of the Federal Sentencing Guidelines when the record shows no evidence of financial, pecuniary, or intangible harm to the beneficiaries and where the beneficiaries were paid in exchange for their consent to authorize Medicare documents. (2) Whether, following a conviction for health care fraud, a sentencing court may consider discrete, readily identifiable and traceable, separate acts and omissions taking place in different time frames, through different corporate entities operating in different industries with different co-conspirators and different corporate principals, as part of the “same course of conduct or common scheme or plan as the offense of conviction” for purposes of “relevant conduct” under Section 1B1.3(a)(2) of the Federal Sentencing Guidelines. (3) Whether a sentencing court may calculate the loss under Section 2B1.1(b)(1) of the Federal Sentencing Guidelines as the aggregate monetary amount of all Medicare claims submitted by a health care company in which the defendant was not a principal or “shadow owner” when the government admitted evidence into the record showing a “reasonably practicable” means of separating legitimate from fraudulent claims and where the record reflects no effort by the government or the sentencing court to articulate a basis for instead considering all of the submitted claims to be fraudulent. i