United States v. Arvinder Singh, Rosanna Cerone and Toni Coons

Rule of Law:

Probable cause for a search warrant may be established by information that is several months old if it depicts ongoing criminal activity, and a federal statute allowing forfeiture of a medical license used to facilitate a drug felony does not violate the Tenth Amendment, particularly when it directly serves the purpose of federal drug enforcement laws.

Facts:

• Dr. Arvinder Singh owned and operated Diagnostic Interventional Pain Management & Rehabilitation Services, Inc. (the "Practice") in Albany, New York, specializing in chronic pain management from 1996-1999.
• Singh employed other physicians and non-physician medical personnel, including nurses Margaret Peruzzi, Pamela Madej, and Rosanna Cerone, and billing clerk Toni Coons.
• Singh developed a scheme where he and other physicians pre-signed entire books of triplicate Schedule II Controlled Substance prescription forms and provided them to non-physician personnel to fill out and issue to patients without physician involvement.
• Nurses routinely saw established patients for follow-up office visits without a physician present, evaluating conditions based on oral information and "body sheets" but not performing physical examinations.
• The Practice routinely submitted claims to health care benefit programs for these nurse-only visits using CPT codes 99212 through 99215, which are designated for physician 'evaluation and management' and require face-to-face physician involvement.
• Singh instructed Nurse Madej to include information in her dictation notes that would falsely suggest his involvement in her nurse-only visits to obtain reimbursement, and told Nurse Cerone to alter patient charts after a state investigator visit.
• Data showed Singh billed the vast majority of nursing visits under CPT codes 99214 or 99215, resulting in $459,670.89 worth of claims for nurse-only visits billed under the higher codes.
• Billing clerks at the Practice, including Toni Coons, frequently "upcoded" the level of CPT codes on superbills before generating claim forms for submission.

Procedural Posture:

• On July 22, 1999, Magistrate Judge Smith issued a warrant authorizing the search of the Practice suite and Dr. Arvinder Singh’s home.
• On July 23, 1999, Magistrate Judge Yanthis issued a warrant authorizing the search of Singh’s office in Port Chester.
• On July 27, 1999, the Government submitted an amended application, affidavit, and search warrant to Magistrate Judge Sharpe, who authorized supplemental language for computer seizures but stated he would not have issued the warrant for Singh's home based on the original information.
• On July 27, 1999, federal agents executed search warrants at Singh’s offices in Albany and Port Chester and at his home.
• In September 2001, a federal grand jury returned a sixty-five-count superseding indictment charging Singh with health care fraud, conspiracy to distribute controlled substances, and causing/aiding illegal distribution of controlled substances.
• Prior to trial, Singh moved to suppress the items seized during the execution of the search warrants and for a Franks v. Delaware hearing, both of which were denied by the district court.
• Prior to trial, co-defendant Rosanna Cerone pled guilty to participating in the fraud scheme and the drug conspiracy and testified as a cooperating witness at trial.
• Prior to trial, co-defendant Toni Coons pled guilty to participating in the "up-coding" fraud scheme.
• A jury trial was held in the United States District Court for the Northern District of New York (Scullin, C.J.), which resulted in Singh's conviction on sixteen health care fraud counts and all drug counts.
• The district court denied Singh’s post-trial motion for a judgment of acquittal on the drug counts or, in the alternative, for a new trial on the fraud and drug counts.
• The district court sentenced Singh to forty-six months’ imprisonment, ordered restitution of $227,127.82, and ordered forfeiture of his New York medical license.