Dr. Lawrence Alexander was convicted of making false statements to Medicare after he and business partner Jeremy Waxman listed Alexander's mother as the sole owner of their durable medical equipment company Silent Hill Bracing and Orthopedic Supplies on a 2019 Medicare enrollment form. The company ceased operations in April 2019 after Medicare suspected fraud. Alexander was sentenced to 33 months in prison and ordered to pay $315,704 in restitution and forfeit $125,000.
Writing for a three-judge panel, Circuit Judge William H. Pryor Jr. found sufficient evidence supported Alexander's conviction under 18 U.S.C. ยง 1035, noting that false ownership information "was capable of influencing the decisionmaker" even though the form wasn't used for initial enrollment. The court rejected Alexander's venue and sufficiency challenges, finding overwhelming circumstantial evidence the crime occurred in the Southern District of Florida where Silent Hill operated and both defendants lived.
Alexander was acquitted of conspiracy charges but convicted on the false statement count after a nine-day jury trial. He challenged seven issues on appeal including venue, sufficiency of evidence, jury instructions on materiality and deliberate ignorance, and the forfeiture and restitution orders. The district court had denied his pre-trial motion to dismiss and three motions for judgment of acquittal.
However, the appeals court found the restitution order lacked sufficient evidence of actual reliance by Medicare on the false statement. "Nothing in the record suggests that the Medicare provider ever reviewed or acted on the January 2019 form," Wilson wrote, distinguishing the case from conspiracy convictions where broader restitution may be warranted. The case highlights the different evidentiary standards between criminal convictions and restitution awards in healthcare fraud cases.