United States Court of Appeals FOR THE DISTRICT OF COLUMBIA CIRCUIT Argued October 23, 2018 Decided June 11, 2019 No. 16-3066 UNITED STATES OF AMERICA, APPELLEE v. MICHAEL D. BIKUNDI, SR., APPELLANT Consolidated with 16-3067 Appeals from the United States District Court for the District of Columbia (No. 1:14-cr-00030-2) (No. 1:14-cr-00030-1) Andrew E. Goldsmith, appointed by the court, argued the cause for appellant Florence Bikundi. Steven R. Kiersh, appointed by the court, argued the cause for appellant Michael D. Bikundi Sr. With them on the joint briefs were Bradley E. Oppenheimer and Albert Pak, all appointed by the court. Katherine M. Kelly, Assistant U.S. Attorney, argued the cause for appellee. With her on the brief were Jessie K. Liu, U.S. Attorney, and Elizabeth Trosman, Suzanne Grealy Curt, 2 and Christopher B. Brown, Assistant U.S. Attorneys. Nicholas P. Coleman and Elizabeth H. Danello, Assistant U.S. Attorneys, entered appearances. Before: ROGERS, TATEL, and GRIFFITH, Circuit Judges. Opinion for the Court PER CURIAM. Concurring Opinion by JUDGE ROGERS. TABLE OF CONTENTS INTRODUCTION I. REGULATORY AND FACTUAL BACKGROUND II. SPEEDY TRIAL RIGHTS A. Speedy Trial Act B. Sixth Amendment III. SEVERANCE IV. ADMISSION OF EXHIBIT 439 V. SUFFICIENCY OF THE EVIDENCE A. Money Laundering and Conspiracy B. Exclusion-Based Health Care Fraud C. Health Care Fraud and Conspiracy VI. JURY INSTRUCTIONS A. Unanimity B. Aiding-and-Abetting Health Care Fraud VII. SENTENCING A. Restitution B. Forfeiture C. Sentencing Enhancements 1. Loss Amount 2. Abuse of Trust 3. Managerial Role 4. Violation of Administrative Order 3 PER CURIAM: Florence Bikundi and Michael Bikundi appeal their convictions by a jury of health care fraud, conspiracy to commit health care fraud, money laundering, and conspiracy to commit money laundering. Suggesting that the government’s case was premised on the misconduct of a handful of employees rather than an entire fraudulent business, appellants challenge the denial of Florence Bikundi’s motion to dismiss the indictment for violation of her statutory and constitutional rights to a speedy trial; the denial of Michael Bikundi’s motion to sever his trial pursuant to Rule 14(a) of the Federal Rules of Criminal Procedure; and the mid-trial admission of a government report pursuant to Rule 16 of the Federal Rules of Criminal Procedure. They also challenge their enhanced sentences, the forfeiture and restitution orders, and the denial of their motions for judgment of acquittal notwithstanding the verdicts pursuant to Rule 29(c) of the Federal Rules of Criminal Procedure. For the following reasons, we affirm. I. Florence and Michael Bikundi (hereinafter separately “Florence” and “Michael”) operated Global Healthcare, Inc. (“Global”) to provide home care services that were funded through the D.C. Medicaid program, which, in turn, is funded in part by the federal government, to provide free or low-cost health services to low-income individuals. See 42 U.S.C. § 1396-1; D.C. Code § 4-204.05; 42 C.F.R. §§ 435.900– 435.965. A. The D.C. Department of Health Care Finance (“DHCF”) administers the D.C. Medicaid program. D.C. Code § 7- 4 7701.07. Home care service entities assist D.C. Medicaid beneficiaries in performing daily living ...
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