Sherley Beaufils, a nurse practitioner, worked for telemedicine companies that participated in a nationwide Medicare fraud scheme known as 'Operation Brace Yourself.' The scheme involved brokers selling patient information to telemedicine companies, which then generated prescriptions for durable medical equipment like braces without proper patient examinations. Beaufils was tasked with reviewing patient charts on a platform called DMERx and electronically signing orders for braces. She was paid $25 per chart. The government proved that Beaufils signed thousands of orders for patients she never met, including a deceased patient and a patient with an amputated leg. She was indicted on multiple counts including health care fraud, making false statements, and aggravated identity theft. A jury acquitted her of conspiracy but convicted her on sixteen other counts. At sentencing, the district court applied a two-level enhancement for obstruction of justice, finding she committed perjury during her trial testimony, and sentenced her to 87 months in prison.
The Eleventh Circuit addressed four main issues. First, regarding sufficiency of the evidence, the court applied a de novo standard, viewing the evidence in the light most favorable to the government. The court found ample proof of Beaufils's knowledge and intent. Evidence showed she signed attestations claiming she personally examined patients, even though she admitted she never called or saw them. The orders contained impossible details, such as braces for a deceased woman and an extra-large brace for a woman weighing under 100 pounds. Beaufils's own testimony that she was merely reviewing charts prepared by other doctors was contradicted by the platform's design, which required her to complete examination fields, and by the testimony of the company owner, Charlene Frame, who stated Beaufils was the sole provider. Second, the court analyzed the failure to give a requested jury instruction on 'deliberate ignorance.' While the court acknowledged this was plain error because the judge failed to inform the parties of its ruling as required by Federal Rule of Criminal Procedure 30(b), it found no prejudice. The district court's general instructions correctly stated that the government must prove knowledge beyond a reasonable doubt and that lawyers' arguments were not evidence. The court reasoned that the absence of the deliberate ignorance instruction actually harmed the government by removing one avenue to prove knowledge, and the jury was properly instructed on the actual knowledge standard. Third, the court upheld the obstruction of justice enhancement. Under U.S.S.G. § 3C1.1, a defendant may be punished for perjury if they make a false, material statement under oath with willful intent. The district court found Beaufils lied by claiming she reviewed charts prepared by other physicians, a claim rebutted by Frame's testimony. The court also noted inconsistencies between Beaufils's trial testimony and her earlier statements to the FBI, where she claimed she had called patients. The appellate court deferred to the district court's credibility determinations. Finally, the court affirmed the denial of Beaufils's motion for a new trial. The motion was untimely, filed well past the 14-day deadline. Beaufils argued excusable neglect due to her trial counsel's failure to file. The court held that an attorney's misunderstanding of the law or active decision not to file a motion does not constitute excusable neglect under the relevant federal rules.
Sherley Beaufils's convictions and 87-month sentence stand. The decision reinforces that telemedicine providers who sign off on medical orders without performing the required examinations can be held criminally liable for fraud. It clarifies that while a failure to give a specific jury instruction on deliberate ignorance is error, it will not automatically reverse a conviction if the jury was otherwise properly instructed on the element of knowledge. The ruling also solidifies that an attorney's legal error or strategic decision not to file a motion does not excuse a missed deadline for a new trial motion.