Appeals court overturns convictions of doctor, company owner in Medicare fraud case

Jan. 31--Citing a lack of evidence, an appeals court on Tuesday overturned the conviction of a New Orleans doctor and health care company owner who were accused of roles in a Medicare fraud scheme.

A three-judge panel of the 5th U.S. Circuit Court of Appeals reversed the convictions of Dr. Pramela Ganji and Elaine Davis, who were convicted last year of health care fraud and conspiracy to commit health care fraud.

Their eight-day trial was overseen by U.S. District Judge Kurt Engelhardt, who has been nominated by President Donald Trump for a seat on the same appeals court.

Ganji was accused of bilking the government by making bogus referrals for home health care as a medical director for Christian Home Health Care. Davis owned the company, which received $28.2 million in payments from the Medicare program between 2007 and 2015.

The fraud scheme operated in New Orleans and surrounding communities, prosecutors alleged.

The appeals court judges said that even though the government produced a series of cooperating witnesses, including doctors and nurses who admitted to Medicare fraud, none of them directly implicated either Ganji or Davis.

Ganji worked in New Orleans, but the most crucial witnesses were based 50 miles away in Ponchatoula. Meanwhile, several medical professionals who pleaded guilty said they never discussed Medicare fraud with Davis, who also worked in New Orleans.

The judges called the government's reliance on witnesses from the north shore "peculiar."

"Unlike other salient cases involving conspiracy to commit health care fraud, here the government presented 18 witnesses, none of whom could provide direct evidence of their alleged co-conspirators' actions because the witnesses never acted with the defendants," the judges said.

Instead, the government mounted a circumstantial case against both women. Prosecutors pointed out that Ganji's referrals through the company jumped from one in 2008 to 123 in 2010, after she became medical director.

The judges said it was not surprising that Ganji began referring more patients through Christian Home Health Care after she affiliated with the company.

Meanwhile, the judges said, the government's case amounted to an argument that Davis "should have known" her business was involved in Medicare fraud. The judges said that prosecutors needed to show she was actually aware of it.

"Although the government presented a plausible scheme of fraudulence, it did not implicate Davis in the scheme with proof beyond a reasonable doubt," the appeals panel said.

The case was heard by Judges Carl Stewart, Carolyn Dineen King and Edith H. Jones. Stewart wrote the unanimous opinion.

Ganji's attorneys said they were thrilled with the ruling.

"We are over the moon happy for Dr. Ganji and her family. Dr. Ganji is innocent and dedicated her life to helping her patients. The judiciary rightfully checked the executive branch from its overreaching here," said attorneys David and Mona Markus.

Ganji was sentenced to six years and is incarcerated at a federal prison in Alabama. Davis received an eight-year sentence and is in a prison in Florida.

David Markus said the 5th Circuit's decision will be final in 30 days. He is asking for Ganji to be released on bail in the meantime.

"Hopefully, she will be released within the next 24 to 48 hours," he said. "Once the 30 days runs, she is a free woman."

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