Professional Documents
Culture Documents
United States Court of Appeals, Eleventh Circuit
United States Court of Appeals, Eleventh Circuit
2d 1539
of Florida. For approximately ten weeks in 1984, Manocchio worked on a parttime basis at a facility known as Florida Medical Consultants. During his
employment, Manocchio supervised particular tests and medical procedures and
signed health insurance claims as required by the Medicare program.
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II. ISSUE
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in nature and violates the Double Jeopardy and Ex Post Facto Clauses of the
United States Constitution.
III. DISCUSSION
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We begin by noting that we exercise de novo review. Our standard of review is:
assuming the allegations of the complaint to be true, whether it appears beyond
doubt that the plaintiff can prove no set of facts in support of his claim that
would entitle him to relief. Matthews v. United States, 456 F.2d 395, 397 (5th
Cir.1972).
10 basic purpose of the Medicare and Medicaid Patient and Program Protection Act
the
is to improve the ability of the Secretary and the Inspector General of [HHS] to
protect Medicare, Medicaid, [and other social services programs] from fraud and
abuse, and to protect the beneficiaries of those programs from incompetent
practitioners and from inappropriate or inadequate care.
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S.Rep. No. 109, 100th Cong., 1st Sess. 1-2 (1987) (hereinafter Senate Report),
reprinted in 1987 U.S.C.C.A.N. 682. The committee report also states,
however, that the law "should provide a clear and strong deterrent against the
commission of criminal acts." Senate Report at 5, 1987 U.S.C.C.A.N. at 686.
While the desire to provide a deterrent is a punitive goal, we find that the
legislative history, taken as a whole, demonstrates that the primary goal of the
legislation is to protect present and future Medicare beneficiaries from the
abusers of these programs. Therefore, since the legislative intent of the
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In this case, because HHS did not assess monetary damages Halper's analysis
contrasting the amount of money damages with the amount the government lost
does not apply. See United States v. Reed, 937 F.2d 575, 578 (11th Cir.1991)
(holding that Halper does not apply when a monetary damage award has not
been imposed). Nevertheless, as we stated in Reed, Halper is "helpful in
framing our analysis." Reed, 937 F.2d at 577. In Halper, the Court stated
14 the defendant even remedial sanctions carry the sting of punishment. (citations
for
omitted) Rather, we hold merely that in determining whether a particular civil
sanction constitutes criminal punishment, it is the purposes actually served by the
sanction in question, not the underlying nature of the proceeding giving rise to the
sanction, that must be evaluated.
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In this case, Manocchio pleaded guilty to Medicare fraud. While his exclusion
from the Medicare system for five years undoubtedly carries the "sting of
punishment," the purpose his exclusion serves is still remedial. The purpose of
the exclusionary provision "is to enable the [HHS] inspector general to keep
[those who defraud the programs] out of the Medicare and Medicaid Programs.
They deprive patients of needed services or supplies, and they divert taxpayer
funds from their intended purposes." 133 Cong.Rec. 14,177 (statement of Rep.
Waxman, Chairman, House Subcommittee on Health and the Environment).
Further, the mandatory exclusionary period "strengthens the ability of the
Secretary of [HHS] to exclude from Medicare and Medicaid those health care
providers and practitioners who fail to provide quality health services or who
have engaged in fraud involving health care programs." 133 Cong.Rec. 20,922
(statement of Sen. Bentsen).
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For the foregoing reasons, we find that the mandatory exclusionary provision of
42 U.S.C. 1320a-7 is not punitive, but rather remedial in nature and purpose.
Therefore, we affirm the district court's dismissal of Manocchio's constitutional
challenges to the statute based on the Double Jeopardy Clause and the Ex Post
Facto Clause of the United States Constitution.
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AFFIRMED.
See Rule 34-2(b), Rules of the U.S. Court of Appeals for the Eleventh Circuit
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