Determining the Proper Standard of Causation to Support a Conviction Under 18 U.S.C. § 1347 When Healthcare Fraud 'Results in Death

Author:Laura A. Feldman
Position:J.D., The University of Iowa College of Law, 2013
Pages:2061-2086
SUMMARY

The circuit courts of appeals are currently divided as to the appropriate standard of causation required by the "results in death" language of the healthcare-fraud statute, 18 U.S.C. § 1347. Because the Sixth Circuit’s proximate-cause standard respects fundamental principles of causation, acknowledges the key distinctions between this statute and narrower drug statutes, and comports with other... (see full summary)

 
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2061
Determining the Proper Standard of
Causation to Support a Conviction Under
18 U.S.C. § 1347 When Healthcare Fraud
“Results in Death”
Laura A. Feldman
ABSTRACT: The circuit courts of appeals are currently divided as to the
appropriate standard of causation required by the “results in death”
language of the healthcare-fraud statute, 18 U.S.C. § 1347. Because the
Sixth Circuit’s proximate-cause standard respects fundamental principles of
causation, acknowledges the key distinctions between this statute and
narrower drug statutes, and comports with other courts’ interpretations of
penalty-enhancing statutes, this Note argues that Congress should clarify the
statutory language or the Supreme Court should resolve the matter by
explicitly adopting the Sixth Circuit’s proximate-cause standard.
I. INTRODUCTION .................................................................................... 2063
II. BACKGROUND ...................................................................................... 2063
A. HEALTHCARE FRAUD: CONDUCT AND COSTS .................................... 2064
B. THE HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT
OF 1996 ........................................................................................ 2066
C. ELEMENTS AND CAUSATION UNDER 18 U.S.C. § 1347 ..................... 2069
III. THE CIRCUIT COURT APPROACHES TO THE CAUSATION
REQUIREMENT ..................................................................................... 2071
A. THE SIXTH CIRCUITS PROXIMATE-CAUSE STANDARD IN UNITED
STATES V. MARTINEZ .................................................................... 2071
B. THE ELEVENTH CIRCUITS CAUSE-IN-FACT STANDARD IN UNITED
STATES V. WEBB ............................................................................ 2074
IV. THE “RESULTS IN DEATH LANGUAGE IMPLIES A PROXIMATE-CAUSE
STANDARD ............................................................................................ 2077
A. PROBLEMS WITH THE COMPARISON TO 21 U.S.C. § 841(b)(1)(C) .... 2077
* J.D., The University of Iowa College of Law, 2013; M.P.H., The University of Iowa
College of Public Health, 2013; B.A., American University, 2008.
2062 IOWA LAW REVIEW [Vol. 98:2061
1. Inapplicability of a Drug-Statute Framework ..................... 2079
2. Problems with Strict Liability .............................................. 2081
B. A MORE APPROPRIATE COMPARISON: STATUTES WITH “RESULTS IN
DEATH LANGUAGE THAT REQUIRE PROXIMATE CAUSE ................... 2083
C. POLICY BENEFITS OF PROXIMATE CAUSE .......................................... 2084
V. CONCLUSION ....................................................................................... 2086

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