UNITED STATES of Am., Plaintiff-Appellee, v. Peter LARM, M.D., & Haruko Larm, Defendants-Appellants, 824 F.2d 780 (9th Cir. 1987). · Go Syfert
UNITED STATES of Am., Plaintiff-Appellee, v. Peter LARM, M.D., & Haruko Larm, Defendants-Appellants, 824 F.2d 780 (9th Cir. 1987). Cases Citing This Book View Copy Cite
38 citation events (9 in the last 25 years) across 8 distinct courts.
Strongest positive: Commonwealth v. Stirlacci (mass, 2020-01-08)
Treatment trajectory · 1987 → 2026 · click a year to view as-of
1987 2006 2026
Top citers, strongest first. 20 distinct citers.
discussed Cited as authority (rule) Commonwealth v. Stirlacci
Mass. · 2020 · confidence medium
See Singh, 390 F.3d at 177 (sufficient evidence of knowingly false statement where defendant was aware that his chosen billing code required physician's involvement based on explicit language on billing form); Larm, 824 F.2d at 782-783 (sufficient evidence of knowingly false claim where defendant previously had been informed that he was using improper codes).
discussed Cited as authority (rule) United States v. Gerald Bainbridge
9th Cir. · 2014 · confidence medium
However, the panel did not address whether 18 U.S.C. § 3583 (e)(2) itself, or the advisory committee notes accompanying Rule 32.1(c), required a finding of changed circumstances before a district court could modify a defendant’s supervised release conditions. 6 .“Absent some good reason to do so, we are disinclined to create a direct conflict with another circuit.” United States v. Larm, 824 F.2d 780, 784 (9th Cir. 1987). 7 .
discussed Cited as authority (rule) R.J. Reynolds Tobacco Co. v. McKenna
W.D. Wash. · 2006 · confidence medium
Absent some good reason to do so, the Ninth Circuit is disinclined to create a direct conflict with another circuit, United States v. Larm, 824 F.2d 780, 784 (9th Cir.1987), especially in an area of federal law which calls for uniformity.
discussed Cited as authority (rule) State v. Wolland (2×)
Fla. Dist. Ct. App. · 2005 · confidence medium
U.S. v. Laughlin, 26 F.3d 1523, 1525 (10th Cir.1994) (citations omitted); United States v. Larm, 824 F.2d 780, 782 (9th Cir.1987)(observing that "to prove Medicaid fraud, the government must show a knowingly false statement of material fact made in an application for benefits from a federally approved state Medicaid plan"). [9] Subsection 409.920(2)(a) is, therefore, in harmony with the principles applicable to prosecutions under the federal false claims enactments.
discussed Cited as authority (rule) ca9 1996
9th Cir. · 1996 · confidence medium
We need not resolve this dispute, however; even if MacQuown 's holding is not dicta, we have recognized that we will not "create a direct conflict with other circuits" "absent a strong reason to do so." United States v. Chavez-Vernaza, 844 F.2d 1368, 1374 (9th Cir.1987) (citing United States v. Larm, 824 F.2d 780, 784 (9th Cir.1987), cert. denied, 484 U.S. 1078 , 108 S.Ct. 1057 , 98 L.Ed.2d 1019 (1988)).
discussed Cited as authority (rule) Finalco, Inc. v. Roosevelt
9th Cir. · 1996 · confidence medium
We need not resolve this dispute, however; even if MacQuown's holding is not dicta, we have recognized that we will not "create a direct conflict with other circuits” "absent a strong reason to do so.” United States v. Chavez-Vernaza, 844 F.2d 1368, 1374 (9th Cir.1987) (citing United States v. Larm, 824 F.2d 780, 784 (9th Cir.1987), ce rt. denied, 484 U.S. 1078 , 108 S.Ct. 1057 , 98 L.Ed.2d 1019 (1988)).
discussed Cited as authority (rule) United States v. Manuel Maldonado-Valdez
9th Cir. · 1995 · confidence medium
See Jackson v. Virginia, 443 U.S. 307, 319 (1979); United States v. Larm, 824 F.2d 780, 782 (9th Cir.1987), cert. denied, 484 U.S. 1078 (1988). 5 Here, the evidence was more than sufficient to conclude beyond a reasonable doubt that Maldonado knowingly possessed cocaine and participated in a conspiracy to possess cocaine for distribution.
discussed Cited as authority (rule) United States v. Michael E. Gaudin
9th Cir. · 1994 · confidence medium
Ditto for false statements to grand juries, United States v. Prantil, 764 F.2d 548, 557 (9th Cir.1985) (construing 18 U.S.C. § 1623 ), United States v. Dipp, 581 F.2d 1323, 1328 (9th Cir.1978) (discussing information judge needs to make materiality determination under section 1623), United States v. Sisack, 527 F.2d 917 , 920 n. 2 (9th Cir.1975) (judge must decide materiality under section 1623), United States v. Percell, 526 F.2d 189, 190 (9th Cir.1975) (same); for false statements in applications for payments in federally-approved plans for medical assistance, United States v. Larm, 824 F.2…
discussed Cited as authority (rule) United States v. Oscar Ullyses-Salazar
9th Cir. · 1994 · confidence medium
We have emphasized that in a fair notice inquiry, “[i]t is the statute that must give sufficient notice of the proscribed conduct.” United States v. Larra, 824 F.2d 780, 784 (9th Cir.1987), cert. denied, 484 U.S. 1078 , 108 S.Ct. 1057 , 98 L.Ed.2d 1019 (1988).
discussed Cited as authority (rule) United States v. Leon Brady (2×)
9th Cir. · 1991 · confidence medium
United States v. Larm, 824 F.2d 780, 784 (9th Cir.1987), cert. denied, 484 U.S. 1078 , 108 S.Ct. 1057 , 98 L.Ed.2d 1019 (1988).
cited Cited as authority (rule) Thomas G. Carpenter v. Universal Star Shipping, S.A., a Foreign Corporation, and Sealaska Timber Corporation, a Foreign Corporation
9th Cir. · 1991 · confidence medium
U.S. v. Larm, 824 F.2d 780, 784 (9th Cir.1987), ce rt. denied 484 U.S. 1078 , 108 S.Ct. 1057 , 98 L.Ed.2d 1019 (1988).
discussed Cited as authority (rule) Casserino v. Sullivan
9th Cir. · 1990 · confidence medium
"Absent some good reason to do so, we are disinclined to create a direct conflict with another circuit." United States v. Larm, 824 F.2d 780, 784 (9th Cir.1987), cert. denied, 484 U.S. 1078 , 108 S.Ct. 1057 , 98 L.Ed.2d 1019 (1988). 22 AFFIRMED. * The panel finds this case appropriate for submission without oral argument pursuant to Ninth Circuit Rule 34-4 and Fed.R.App.P. 34(a)
discussed Cited as authority (rule) Casserino ex rel. Thomas v. Sullivan
9th Cir. · 1990 · confidence medium
“Absent some good reason to do so, we are disinclined to create a direct conflict with another circuit.” United States v. Larm, 824 F.2d 780, 784 (9th Cir.1987), cert. denied, 484 U.S. 1078 , 108 S.Ct. 1057 , 98 L.Ed.2d 1019 (1988).
discussed Cited as authority (rule) 54 Fair empl.prac.cas. 616, 55 Empl. Prac. Dec. P 40,464 United States of America v. Johnnie F. Clark, United States of America v. Theresa Jeffery
9th Cir. · 1990 · confidence medium
United States v. Flake, 746 F.2d 535, 537-38 (9th Cir.1984) (Flake), cert. denied, 469 U.S. 1225 , 105 S.Ct. 1220 , 84 L.Ed.2d 360 (1985); United States v. Larm, 824 F.2d 780, 783-84 (9th Cir.1987), cert. denied, 484 U.S. 1078 , 108 S.Ct. 1057 , 98 L.Ed.2d 1019 (1988).
discussed Cited as authority (rule) Department of Health & Human Services v. Federal Labor Relations Authority
9th Cir. · 1990 · confidence medium
"Absent some good reason to do so, we are disinclined to create a direct conflict with another circuit,” United States v. Larm, 824 F.2d 780, 784 (9th Cir.1987), especially in “an area of federal law which calls for uniformity.” Ward v. Department of Labor, 726 F.2d 516 , 518 (9th Cir.1984); see also United States v. Gwaltney, 790 F.2d 1378 , 1388 n. 4 (9th Cir.1986) (citing cases); cf. USA Petroleum Co. v. Atlantic Richfield Co., 859 F.2d 687 , 697 n. 15 (9th Cir.1988), cert. granted, — U.S. -, 109 S.Ct. 2446 , 104 L.Ed.2d 1001 (1989) (We "give respectful attention to the views of the…
discussed Cited as authority (rule) ca9 1990
9th Cir. · 1990 · confidence medium
We have considered carefully the views of the Seventh and District of Columbia Circuits and the arguments of the parties herein, and conclude the other circuits' interpretation of the statute is correct. 1 3 The order of the FLRA is REVERSED. 1 "Absent some good reason to do so, we are disinclined to create a direct conflict with another circuit," United States v. Larm, 824 F.2d 780, 784 (9th Cir.1987), especially in "an area of federal law which calls for uniformity." Ward v. Department of Labor, 726 F.2d 516 , 518 (9th Cir.1984); see also United States v. Gwaltney, 790 F.2d 1378 , 1388 n. 4 …
discussed Cited as authority (rule) USA Petroleum Company v. Atlantic Richfield Company (2×)
9th Cir. · 1988 · confidence medium
In U.S. v. Larm, 824 F.2d 780, 784 (9th Cir.1987), we said “absent some good reason to do so, we are disinclined to create a direct conflict with another circuit.” We did not intend by that statement to surrender our authority to decide important issues of first impression or to suggest that we would adopt the view of the first circuit to consider such issues in every instance.
discussed Cited as authority (rule) United States v. Jose Carlos Chavez-Vernaza, AKA Jose Chavez, AKA \Pepe\"" (2×)
9th Cir. · 1988 · confidence medium
United States v. Larm, 824 F.2d 780, 784 (9th Cir.1987); United States v. Gwaltney, 790 F.2d 1378 , 1388 n. 4 (9th Cir.1986) (Gwaltney ), cert. denied, --- U.S. ----, 107 S.Ct. 1337 , 94 L.Ed.2d 187 (1987).
discussed Cited "see" United States v. Jerry Nichols and Charlotte Nichols
6th Cir. · 1992 · signal: see · confidence high
See United States v. Larm, 824 F.2d 780, 784 (9th Cir.1987) (materiality under section 1396h(a)(1) [predecessor to 42 U.S.C. § 1320a-7b] is question of law), cert. denied, 484 U.S. 1078 (1988); United States v. Brown, 763 F.2d 984, 993 (8th Cir.), cert. denied, 474 U.S. 905 (1985) (same).
cited Cited "see, e.g." United States v. Anthony Meyers, A/K/A Tony Meyers
9th Cir. · 1988 · signal: see, e.g. · confidence medium
See, e.g., United States v. Larm, 824 F.2d 780, 783 (9th Cir.1987), cert. denied, — U.S. -, 108 S.Ct. 1057 , 98 L.Ed.2d 1019 (1988).
18 soc.sec.rep.ser. 513, Medicare&medicaid Gu 36,438 United States of America
v.
Peter Larm, M.D., and Haruko Larm
85-1348.
Court of Appeals for the Ninth Circuit.
Aug 12, 1987.
824 F.2d 780
Peter L. Yee, Honolulu, Hawaii, for plaintiff-appellee., Richard K. Perkins and Renee M.L. Yuen, Honolulu, Hawaii, for defendants-appellants.
Wallace, Kennedy, Wiggins.
Cited by 28 opinions  |  Published
Reporter's Syllabus — editorial summary, not part of the Court's opinion

Peter L. Yee, Honolulu, Hawaii, for plaintiff-appellee.

Richard K. Perkins and Renee M.L. Yuen, Honolulu, Hawaii, for defendants-appellants.

Appeal from the United States District Court for the District of Hawaii.

Before WALLACE, KENNEDY and WIGGINS, Circuit Judges.

KENNEDY, Circuit Judge:

Lead Opinion

KENNEDY, Circuit Judge:

Peter Larm, M.D., and his wife Haruko Larm, appeal from their convictions for violations of 42 U.S.C. § 1396h(a)(l) (false statements in an application for payments in a federally-approved plan for medical assistance). We conclude there was sufficient evidence to support the convictions, and that the district court did not otherwise err. We affirm.

Dr. Larm is an allergist and was an approved provider of Medicaid Services under Hawaii’s Medicaid Program from July 1979 to June 1983. Mrs. Larm was his office manager during that period. The Hawaii Department of Social Services and Housing administers the program, and the Hawaii Medical Service Association (HMSA) handles the claims. The HMSA claim forms have a coding system to allow for prompt, uniform determination of the services provided and the appropriate reimbursement. A code book contains a brief explanation of the service to be matched with the codes on the claim form.

In 1984 the grand jury indicted the Larms on ninety-eight counts of Medicaid fraud. Counts 1-84 (office visit counts) alleged that the Larms submitted claims to the HMSA for “office visits” although Dr. Larm neither saw the patients nor personally rendered the services. Counts 85-94 (administration counts) alleged that the Larms not only claimed false office visit charges, but also administration charges for injections which the patients administered themselves. Counts 95-98 (allergy counts) alleged that the Larms falsely submitted claims for allergy shots. The total of the excess charges was $882.21.

The jury convicted Dr. Larm on seventeen counts which involved claim forms he signed, and acquitted him on the other charges. The jury convicted Mrs. Larm, who oversaw all the billing, on all but the allergy counts.

The Larms principal contention is there was insufficient evidence of guilt. To prevail on this argument, they must show that no rational jury could find guilt beyond a reasonable doubt. See Jackson v. Virginia, 443 U.S. 307, 324, 99 S.Ct. 2781, 2791, 61 L.Ed.2d 560 (1979). To prove Medicaid fraud, the government must show a knowingly false statement of material fact made in an application for benefits from a federally approved state Medicaid plan. See 42 U.S.C. § 1396h(a)(l).

The Larms’ most serious attack on the office visit counts is that the statements were not false. It is undisputed that in each of the office visit counts (and the administration counts) the Larms used billing code 90040. Code 90040 is defined as a “[bjrief examination, evaluation and/or treatment, same or new illness.” This is further defined as “including] a brief or interval history, examination, discussion of finding and/or rendering of service.” The treatment given in each case was a routine allergy shot administered by a nurse, when[*783] Dr. Larm was not in the office. The Larms argue that this treatment fits within the meaning of the definition, and the evidence of falsity was thus insufficient.

Two factors converge to convince us of the sufficiency of the evidence of falsity. The first is that code 90030, appearing on the same page as 90040, is defined as follows: “Minimal service: injections, minimal dressings, etc., not necessarily requiring the presence of a physician.” This code fits exactly the service rendered in the office visit counts. Since each code corresponds to a different billing amount, it is clear that these codes are intended to be exclusive of each other. The snug fit between 90030 and the service actually rendered forecloses any argument that 90040 was the correct code.

The second factor is that an HMSA representative testified that he twice informed the Larms that a 90040 billing required the physician’s presence. Although the Larms attack the credibility of this testimony, the jury was entitled to believe the HMSA representative. The evidence of falsity on the office visit counts was sufficient.

The Larms next argue that they did not knowingly and willfully make the false statements. We have explained why the evidence supports a finding that the statement was false. It remains to be shown also that the Larms knew of the falsity, for an element of the crime is the specific intent to make a false statement. United States v. Crooks, 804 F.2d 1441, 1448 (9th Cir.1986).

There is ample evidence of knowledge of falsity. Mrs. Larm managed the office and oversaw the billing process. Dr. Larm signed all the claims that formed the bases for his convictions. The testimony that an HMSA representative called the Larms’ attention to the point is also relevant. These facts were sufficient to allow the jury to find the Larms knew that code 90040 was being used.

The Larms argue that the government failed to prove that the claims were part of a federally approved program. However, an HMSA official testified that the federal government oversees the program, and therefore the Larms’ argument is meritless.

We turn now to the sufficiency of the evidence on the administration counts. The administration counts combine a charge that the Larms used code 90040 falsely, as well as charging for the administration of injections that the patients administered themselves. For the reasons we discussed above, the jury could properly find that the use of code 90040 was knowingly false. The testimony established that the patients did in fact self-administer the serum, and the Larms knew that an administration charge was inappropriate. The evidence was sufficient on the administration counts.

Dr. Larm also challenges the sufficiency of the evidence on the allergy counts. One of his nurses testified that on the occasions recited in the indictment, he charged for more expensive allergy serum when the medication actually given was less expensive bee extract serum. The nurse testified that she reported the overcharge to Dr. Larm, and he replied that his office "would make an adjustment.” No adjustment was ever made, and the jury was entitled to credit the nurse’s testimony. There was sufficient evidence on the allergy counts.

The Larms finally contend that the district court erred in not instructing the jury on the question whether the statements made were material, but rather deciding for itself that the statements were material as a matter of law. The Larms rely on United States v. Valdez, 594 F.2d 725 (9th Cir.1979). In Valdez the government charged that the defendants forged employment letters for the purpose of gaining aliens visas to enter the country, a violation of 18 U.S.C. § 1001. We concluded that the materiality of the letters was an issue of fact for the jury. However, we have since limited Valdez. In United States v. Flake, 746 F.2d 535 (9th Cir.1984), cert. denied, 469 U.S. 1225, 105 S.Ct. 1220, 84 L.Ed.2d 360 (1985), we concluded that the question of whether false statements[*784] on a tax return were material was for the judge. We discussed Valdez, and ultimately distinguished it solely on the grounds that we were “concerned with a different statute.” Flake, 746 F.2d at 537. In Flake we also noted that a long line of cases has applied or made mention of the rule that the materiality of a perjured statement is a question of law. See, e.g., Sinclair v. United States, 279 U.S. 263, 298, 49 S.Ct. 268, 273, 73 L.Ed. 692 (1929); United States v. Taylor, 574 F.2d 232, 235 (5th Cir.), cert. denied, 439 U.S. 893, 99 S.Ct. 251, 58 L.Ed.2d 239 (1978); United States v. Percell, 526 F.2d 189, 190 (9th Cir.1975); Carroll v. United States, 16 F.2d 951, 953 (2d Cir.) (cited with approval in Sinclair), cert. denied, 273 U.S. 763, 47 S.Ct. 477, 71 L.Ed. 880 (1927). We find no principled way to distinguish this case from the perjury cases. Both concern the question of whether a false statement is reasonably calculated to induce reliance. Further, the Eighth Circuit has concluded that materiality under section 1396h(a)(l) is a question of law, See United States v. Brown, 763 F.2d 984, 993 (8th Cir.), cert. denied, 474 U.S. 905, 106 S.Ct. 273, 88 L.Ed.2d 234 (1985). Absent some good reason to do so, we are disinclined to create a direct conflict with another circuit. We think, therefore, that the weight of the authority requires us to conclude that the district court properly treated the question as one of law. Even, however, if we were to reach the opposite result, we would conclude that the error was harmless, because the statements here undoubtedly were material, designed as they were to induce payment. See Valdez, 594 F.2d at 729 (overwhelming evidence of materiality made treating it as an issue of law harmless error).

The Larms make a due process challenge to their conviction. They point out that the code book was never adopted as a rule in conformance with the Hawaii Administrative Procedure Act. See Haw. Rev.Stat. §§ 91-3 to 91-15. They argue they lacked fair notice that their conduct was illegal.

This argument is without merit. The Larms were prosecuted under 42 U.S.C. § 1396h(a)(l), not the billing codes. The statute gives fair notice of the proscribed conduct. The codes only become relevant because they inform us on the question of whether the statements were false. The Larms knew that writing code 90040 on the claim form would cause the HMSA to act under the misapprehension that Dr. Larm had actually seen the patient, and the fact that code 90040 was not a formally adopted administrative regulation is irrelevant.

It is the statute that must give sufficient notice of the proscribed conduct, both through adequate promulgation and definiteness in its language. See United States v. Harriss, 347 U.S. 612, 617, 74 S.Ct. 808, 811, 98 L.Ed. 989 (1954). Here, the statute forbids knowingly false material statements, terms that are adequate to inform the ordinary person of its bounds. Any attack on the billing codes which formed the factual backdrop that made the statements false is ultimately an attack on the sufficiency of the evidence. See id. at 618, 74 S.Ct. at 812 (a statute is not void for vagueness despite the existence of borderline cases of applicability). If the Larms had proved that they did not know of the codes, or had proved that the' codes were too vague to be understood, then there could be no knowingly false statement. But the jury found that they understood the significance of the billing codes that they used, and the record supports this finding.

The judgment of the district court is AFFIRMED.

Concurrence in Part

WIGGINS, Circuit Judge,

concurring in párt and dissenting in part:

I respectfully dissent from that portion of the opinion affirming the Larms’ convictions on the office visit counts. The Larms should not be criminally liable for making a false statement under 42 U.S.C. § 1396(h)(a)(l) when the statement they made was literally true under HMSA’s ambiguous published billing codes.

The Larms used code 90040 to bill HMSA for nurse-administered allergy shots when[*785] Dr. Lam was not in the office. This, the majority holds, is a false statement on an application for Medicaid because code 90040 requires that the physician personally have treated the patient. However, HMSA’s published guidelines defining code 90040 make no mention of the physician’s presence, requiring instead a “[b]rief examination, evaluation and/or treatment, same or new illness,” “including] a brief or interval history, examination, discussion of finding and/or rendering of service.” The Larms’ use of code 90040 was literally correct under HMSA’s definition. The administration of a shot is indisputably a “[b]rief ... treatment,” including a “rendering of service.”

I agree that an alternate code more closely tracked the type of service the Larms provided. The guidelines define code 90030 as “Minimal service: injections, minimal dressings, etc., not necessarily requiring the presence of a physician.” But the literal truth of the Larms' statement under code 90040 precludes a prosecution for making a false statement in an application for Medicaid under section 1396(h)(a)(l). See Bronston v. United States, 409 U.S. 352, 93 S.Ct. 695, 34 L.Ed.2d 568 (1973) (wily witness who succeeds in derailing questioner does not commit perjury so long as he speaks literal truth); United States v. Sainz, 772 F.2d 559, 662-65 (9th Cir.1985) (same); see also United States v. Poutre, 646 F.2d 685 (1st Cir.1980) (18 U.S.C. § 1001, prohibiting false statements to federal officials, cannot be invoked when an evasive statement is literally true).

When the government issues imprecise billing codes, physician-providers should not have to guess at their meaning at the risk of criminal prosecution under section 1396(h)(a)(l). If HMSA wishes to restrict the use of code 90040 to services physically provided by the physician, it can do so. But the government cannot subject a physician to prosecution for falsely stating that he complied with the physical presence requirement unless it precisely articulates that requirement. Bronston, 409 U.S. at 362, 93 S.Ct. at 601 (“Precise questioning is a predicate for the offense of perjury”); Sainz, 772 F.2d at 564 (a witness “cannot be forced to guess at the meaning of the question to which he must respond upon peril of perjury”).

Nor was the ambiguity cured by the HMSA claims examiner’s oral advise to the Larms that code 90040 was proper only if the physician personally treated the patient. A government employee’s oral advise on the interpretation of an unclear government regulation is too weak a foundation upon which to base a false statement prosecution. The inherent uncertainties of oral interpretations counsel against such a prosecution. The physician-provider has no basis to evaluate whether the employee’s interpretation is the agency’s official one. Indeed, it is conceivable that the physician could receive conflicting advise from different government employees on the interpretation of the regulation.

Absent an authoritative agency interpretation — preferably published — clarifying the agency’s ambiguous billing codes, it is improper to prosecute a doctor for pressing a reasonable code interpretation. See United States v. Dahlstrom, 713 F.2d 1423, 1428 (9th Cir.1983) (prosecution under 26 U.S.C. § 7206(2) for willful filing of false tax returns is inappropriate for a taxpayer’s advocating a tax shelter, the legality of which was “completely unsettled by any clearly relevant precedent”) (citing United States v. Garber, 607 F.2d 92, 100 (5th Cir.1979) (a criminal prosecution under section 7206 “is an inappropriate vehicle for pioneering interpretations of tax law”)), cert. denied, 466 U.S. 980, 104 S.Ct. 2868, 80 L.Ed.2d 835 (1984); see also Bell v. United States, 349 U.S. 81, 88-84, 75 S.Ct. 620, 622, 99 L.Ed. 905 (1955) (rule of lenity requires resolving ambiguity in criminal statute in favor of defendant).

The Larms’ use of code 90040 was literally true under HMSA’s ambiguous guidelines. The claims examiner’s oral advice did not cure the ambiguity. Consequently, the Larms’ convictions on the office visit counts should not stand.