Lopez conspired with three others between 2019 and 2020 to submit fraudulent claims for medical equipment to Medicare. His companies billed the federal program for equipment that was not medically necessary, having paid healthcare marketers for doctors' prescriptions. The scheme resulted in nearly $2.6 million in fraudulent claims, with Medicare paying more than $900,000.
While running this scheme, Lopez also obtained a $105,000 Economic Injury Disaster Loan from the Small Business Administration. His loan application falsely stated that his company was not engaged in illegal activity, allowing him to receive a $7,000 advance. He pleaded guilty to healthcare fraud, wire fraud, conspiracy, and kickback charges without a plea agreement.
At sentencing, the district court used the intended loss amount of roughly $2.7 million to calculate Lopez's guideline range, rejecting his argument that the range should be based on the actual loss of about $910,000. The Eleventh Circuit affirmed this decision, noting that the fraud guideline defines loss as the greater of actual or intended loss.
The critical error occurred regarding the acceptance-of-responsibility reduction. The presentence report recommended a three-level reduction, which the government did not initially object to. However, at the sentencing hearing, the government argued for only a two-level reduction, claiming Lopez had delayed the hearing multiple times.
The district court accepted the government's position, adjusting Lopez's offense level to reflect only a two-level reduction. This adjustment raised his guideline range to sixty-three to seventy-eight months, though the court ultimately sentenced him to forty-eight months.
The Eleventh Circuit held that the government's claim about the delays was an inaccuracy. The government later conceded it did not sufficiently justify withholding the three-level reduction. Because the record showed Lopez did not delay the hearing, both sides agreed the denial of the third level was error.
The appellate court rejected the government's argument that the error was harmless. It held that the government failed to prove beyond a reasonable doubt that the district court would have imposed the same sentence without the miscalculation. The court vacated the sentence and remanded for resentencing with the correct guideline range.