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United States v. Mittal
Citation: 36 F. App'x 20Docket: Docket No. 01-1318
Court: Court of Appeals for the Second Circuit; June 10, 2002; Federal Appellate Court
The District Court's judgment against Brij Mittal, M.D., has been affirmed following his conviction for participating in a conspiracy to solicit and receive illegal kickbacks related to Medicare referrals. Charged in a four-count indictment, Mittal was found guilty after a jury trial that lasted three weeks. The charges stemmed from an arrangement between Mittal and Niranjan Patel, co-owner of Ganesh Surgical Supplies, Inc., involving cash payments to Mittal in exchange for patient referrals for Medicare-covered services from 1990 to 1996. On appeal, Mittal argued that the jury should have been instructed that it needed to find he specifically knew of and intended to violate the Medicare anti-kickback statute (42 U.S.C. 1320a-7b). Instead, the jury was told that it must find Mittal acted "knowingly and willfully," with definitions provided for both terms. The court stated that knowledge of the specific statute was not a requisite for conviction. The appellate court acknowledged a split among circuits regarding whether knowledge of the specific statute is necessary but chose not to resolve this issue, determining that any potential error in the jury instruction was harmless due to the clear evidence of Mittal's knowledge of the anti-kickback statute. Testimony from Dr. Pritpal Kang confirmed that Mittal had sought legal advice concerning the legality of their arrangements in 1993, indicating his awareness of the law. Mittal was sentenced to thirty months in prison and three years of supervised release following his conviction on April 17, 2000. The letter detailed the Medicare anti-kickback statute, which prohibits any remuneration for patient referrals to physicians for Medicare or Medicaid services, with violators facing civil and criminal penalties. It outlined available 'safe harbors' and included testimony from Dr. Kang affirming the letter’s accuracy and its discussions with Mittal regarding the statute's illegality. The defense did not contest evidence of Mittal’s awareness of the law. The jury was instructed that Mittal could only be found guilty if he knew his actions were unlawful, rendering any alleged instructional deficiencies harmless. Mittal contested the venue of his prosecution, asserting his actions occurred in Brooklyn, outside the Southern District of New York. The court applied a 'substantial contacts' test, examining the nature of the crime and its effects, and noted that offenses initiated in one district and completed in another can be prosecuted in either. Evidence showed that Mittal’s referrals to Patel, which included payments from Patel for patient referrals, involved communications that reached the Southern District of New York, establishing proper venue. Patel testified about the referral process, confirming that Mittal or his staff made calls from Brooklyn to Westchester County, where subsequent Medicare forms were processed. The three counts of indictment against Mittal involved payments for specific referrals, classified as solicitations under the anti-kickback statute. Venue was deemed appropriate since these solicitations involved communication across district lines. Mittal also claimed ineffective assistance of counsel, which the District Court rejected when addressing his motion for a new trial. The appellate court affirmed the District Court’s judgment based on its detailed reasoning.