U.S. v. Hinkle, 93-5137

Decision Date21 September 1994
Docket NumberNo. 93-5137,93-5137
PartiesUNITED STATES of America, Plaintiff-Appellee, v. Charles Michael HINKLE, Defendant-Appellant.
CourtU.S. Court of Appeals — Tenth Circuit

Gordon B. Cecil, Asst. U.S. Atty. (Stephen C. Lewis, U.S. Atty., and Kevin C. Leitch, Asst. U.S. Atty., with him on the briefs), Tulsa, OK, for appellee.

Keith Ward (Ann Dooley, with him on the briefs) of Tilly & Ward, Tulsa, OK, for appellant.

Before ANDERSON and HOLLOWAY, Circuit Judges, and OWEN, * District Judge.

OWEN, District Judge.

Appellant, Charles Hinkle, practiced general dentistry in Tulsa, Oklahoma, from 1991 until January 11, 1993. On that date he was convicted of 134 counts of mail fraud and conspiracy to commit mail fraud in violation of 18 U.S.C. Secs. 1341 and 371 on charges of misrepresenting and thereby overcharging for dental procedures in bills sent to his patients' dental insurance companies. He was sentenced to concurrent twelve months prison terms on all counts, and $27,553.71 in fines were imposed. Two employees indicted with him were acquitted.

The jury concluded that Hinkle mailed "super bills," or invoices to insurers, falsely claiming that he had performed procedures that were more time consuming and expensive than the ones actually performed. The procedures at issue are catalogued in a publication distributed by the American Dental Association, the American Dental Association CDT-1 Current Dental Terminology, First Edition 1990-1995: A User's Manual. This publication contains descriptions of dental procedures, assigning them identification numbers (ADA codes) to be used for invoices and records. As is customary in the profession, Dr. Hinkle utilized the ADA codes in his super bills to advise the insurance companies what he was seeking payment for.

Following a lengthy trial at which the prosecution called twenty-eight witnesses and introduced over 600 exhibits, the jury found that Hinkle performed prophylaxis on children and billed the insurance companies for more severe periodontal "root scaling," and performed applications of sealants on children's teeth while billing for more complex "composite resin restorations." The evidence was partly documentary--a comparison of the patients' records kept in his office and the super bills sent to the insurance companies--and partly testamentary. There was testimony that patient charts were altered to reflect more expensive procedures. Expert witnesses testified to finding no evidence that these procedures were performed on the patients in question. Hinkle endeavored to put the foregoing in dispute. He testified on his own behalf and called six witnesses.

On appeal, Hinkle asserts several grounds of reversal.

First, he contends that the evidence was insufficient to support the verdict. "[T]he relevant question is whether, after viewing the evidence in the light most favorable to the prosecution, any rational trier of fact could have found the essential elements of the crime beyond a reasonable doubt." Jackson v. Virginia, 443 U.S. 307, 319, 99 S.Ct. 2781, 2789, 61 L.Ed.2d 560 (1979) (emphasis in original). There was ample evidence to support the verdict, and we accept the jury's resolution of claimed conflicts in the evidence and their assessment of the credibility of witnesses. United States v. Youngpeter, 986 F.2d 349, 353 (10th Cir.1993).

The charge of mail fraud, 18 U.S.C. Sec. 1341, requires proof of a scheme to defraud and use of the mails in furtherance of the scheme. United States v. Allen, 554 F.2d 398, 408 (10th Cir.), cert. denied, 434 U.S. 836, 98 S.Ct. 124, 54 L.Ed.2d 97 (1977). The conspiracy charge, 18 U.S.C. Sec. 371, requires proof of an agreement among two or more persons to commit an offense against the United States, an overt act in furtherance of the conspiracy, and knowing participation in the conspiracy by the defendant.

The jury found beyond a reasonable doubt that Dr. Hinkle and some of his staff fraudulently billed for more expensive procedures than were actually performed. As earlier stated, the billings were for procedures designated and assigned numbers in the publication American Dental Association CDT-1 Current Dental Terminology. Hinkle's first attack is that the edition used on the trial, that of 1990-1995, had not been published at the time Hinkle did the billings at issue here. Hinkle argues that there are important differences between the 1991 edition used at trial and the 1987 edition in effect at the time Hinkle's super bills were prepared. However, the 1991 edition admitted at the trial without objection contains the identical code numbers and descriptions of all of the procedures that were at issue here--prophylaxis, scaling, sealant and resin--as did the 1987 version extant at the time Hinkle prepared the fraudulent super bills. 1 Significantly, no revisions were indicated as to the relevant ADA procedure codes between the sixth revision to the code published in March 1987, and the seventh revision published in January and March 1991.

Accordingly, the jury received appropriate evidence concerning the nature of the dental procedures both as performed and as later billed and ADA's classification of such dental procedures applicable at all times involved in the charges. Further, Hinkle, in his testimony, having referred to and been questioned about the edition in evidence at the trial and having not taken issue with its accuracy or relevance at the time, cannot do so now. 2...

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    • United States
    • American Criminal Law Review Vol. 46 No. 2, March 2009
    • March 22, 2009
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    • American Criminal Law Review Vol. 47 No. 2, March 2010
    • March 22, 2010
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