Insys case to jury

In addition to Esformes, there is another huge health care trial that just went to the jury after 43 days of testimony.  It’s known as the Insys case and it involves John Kapoor, the CEO of Insys, in Boston federal court.  From NPR:

Kapoor, the founder of Insys Therapeutics, allegedly oversaw a marketing strategy that paid doctors more than $1 million to prescribe Subsys in high doses — often to patients who did not need it. Subsys is a highly addictive opioid painkiller up to 100 times stronger than morphine.

Then, prosecutors claim, Insys set up a call center to ensure the expensive medication was covered by insurers. At the call centers, Insys employees allegedly pretended to be from doctors' offices and fabricated diagnoses and other information necessary to get the medication approved.

"The decisions, the money, the strategy came from the top," Yeager said. The obligation of physicians to "first, do no harm, became: First, do what you're told."

Yeager showed the jury internal company spreadsheets detailing how much money Insys had paid each doctor and the ROI, or return on investment, from those payments. That is, exactly how much money the company was making back via prescriptions from each doctor it had paid. Yeager suggested it should be called ROB — "return on bribe."

***

Kapoor, the founder of Insys Therapeutics, allegedly oversaw a marketing strategy that paid doctors more than $1 million to prescribe Subsys in high doses — often to patients who did not need it. Subsys is a highly addictive opioid painkiller up to 100 times stronger than morphine.

Then, prosecutors claim, Insys set up a call center to ensure the expensive medication was covered by insurers. At the call centers, Insys employees allegedly pretended to be from doctors' offices and fabricated diagnoses and other information necessary to get the medication approved.

"The decisions, the money, the strategy came from the top," Yeager said. The obligation of physicians to "first, do no harm, became: First, do what you're told."

Yeager showed the jury internal company spreadsheets detailing how much money Insys had paid each doctor and the ROI, or return on investment, from those payments. That is, exactly how much money the company was making back via prescriptions from each doctor it had paid. Yeager suggested it should be called ROB — "return on bribe."

Philip Esformes verdict -- Hung on Health Care, convicted of other counts (UPDATED & EDITED)

The Philip Esformes jury came back this morning -- hung jury on the main counts of health care and found guilty of other counts (including the kickback and money laundering counts) after a hard fought trial and lengthy deliberation.

Both sides will claim victory (as is happening in the press). The defense can argue that it won because of a hung jury on the main health care counts after a long trial.  The defense will argue that the case was billed as the largest health care fraud case but it resulted in no health care fraud count convictions.  That may be true for the lawyers, but it will be a tough sell when Esformes is ultimately sentenced. And the government can certainly say that it won with lots of convictions and no acquittals.  It will be interesting to see what sentence is ultimately handed out.  (I’ve edited this paragraph of this post a few times after thinking about the verdicts and what they mean.)

The poor jury thought they were done with the case, but now have to come back on Monday to handle the forfeiture portion of the trial.

Update— actually, the jury knew it would have to come back. Judge Scola informed them that after phase 1, there would be a few more days of evidence.

Congrats to Judge Roy Altman

He was just confirmed, 66-33.

Senate goes nuclear over Roy Altman

There's a lot of political back and forth over Trump's recent judicial nominees.  Miami is always ground zero, and it was here too as Altman was the first judicial selection to test the nuclear option today.  And boom, the Senate did go nuclear, and the bottom line is that the final vote for Altman will be tomorrow (Thursday) at 11:45. He will very likely be our newest district judge.

Here's Roll Call explaining a little more about the process.  And here are some tweets by the Senate Cloakroom with what happened today:

• Votes Scheduled: At 11:45am TMRW the Senate will proceed to 2 votes: 1.Confirmation of Cal. #32 Altman to be U.S. District Judge for the Southern District of FL
• Invoked, 66-33: Motion to invoke cloture on Executive Calendar #32 Roy Altman to be U.S. District Judge for the Southern District of Florida 

Interestingly, because Altman will be confirmed first, he will have seniority over Ruiz and Smith.

In Defense of Joe Biden

That’s my latest piece in The Hill. The intro:

It’s official: The pendulum of #MeToo claims has now swung too far. When a friendly gesture with no sexual intent is labeled a reprehensible act that should be subject to public shaming and even disqualification from public office, it is time that we all recognize that we are starting to lose perspective.

Let’s be clear before I continue: I am not talking about the crass comments by the current President that it’s okay to “grab [women] by the pussy” or inappropriate sexual relations between then-President Clinton and an intern. Those are clearly beyond the pale. But the “allegations” against Joe Biden — that he touched Linda Flores’ shoulders and kissed the back of her head — are very different.

Biden is an affectionate guy, but in a grandfatherly sort of way. He explained: “In my many years on the campaign trail and in public life, I have offered countless handshakes, hugs, expressions of affection” and never intended to disrespect or cause any harm to Flores or anyone else. But Flores has gone so far as to say that Biden’s intent is irrelevant. Kelly Ann Conway has repeated this argument, saying that it does not matter what Biden intended.

Of course Biden’s intent is relevant. It’s the most important question here. That’s why Stephanie Carter, wife of secretary of Defense at the Pentagon, has had to publicly speak out about the picture of her and Biden that is making the rounds again. As Carter made clear, "The Joe Biden in my picture is a close friend helping someone get through a big day, for which I will always be grateful. So, as the sole owner of my story, it is high time that I reclaim it – from strangers, Twitter, the pundits and the late-night hosts."

Please read the whole thing and lemme know your thoughts...

"I'm saving her for Ginsburg."

That was your President, Donald Trump, when telling confidants his plans for Amy Coney Barrett.  I guess we should not be surprised by the crass comment.

From Axios:

As he was deliberating last year over replacing Supreme Court Justice Anthony Kennedy, President Trump told confidants he had big plans for Judge Amy Coney Barrett.

"I'm saving her for Ginsburg," Trump said of Barrett, according to three sources familiar with the president's private comments. Trump used that exact line with a number of people, including in a private conversation with an adviser two days before announcing Brett Kavanaugh's nomination.

***

Yes, but: There's no guarantee Trump will get another Supreme Court pick. It's very unlikely Ginsburg will retire while he’s in office. And though she's 86 and has had 3 bouts with cancer, she's on the bench now and appears healthy.

Barrett isn't a lock even if Trump does get to make another appointment, the people familiar with his thinking said.
Barrett has the inside track "in a very specific sense," said a source who's discussed Barrett with Trump. "She is the most known quantity right now amongst the women on the list. ... And she also has the inside track in the sense that she was kind of battle-tested for having gone through a confirmation already."
Between the lines: Trump changes his mind all the time, and Barrett would need to undergo a fresh round of vetting to review the rulings and public comments she's made since confirmed to the 7th Circuit Court of Appeals in 2017.

"The Supreme Court judicial selection process with the president is a very fluid one," said a source familiar with Trump's thinking on the subject. "He floats in and out of these discussions over a period of time."
Barrett's education didn't appeal to Trump, according to sources familiar with his thinking. She went to law school at Notre Dame, and Trump prefers candidates with Harvard and Yale on their resumes.

Why it matters: Trump has already pulled the court well to the right. If he gets to replace Ginsburg, especially with Barrett, he would cement a young, reliably conservative majority that could last for decades.

It’s closing time.

At 8:30am tomorrow morning in Judge Scola’s courtroom, the Esformes trial heads to closing arguments. It’s been a long and emotional trial.

It took all day to do the charge conference.

And the defense just filed this doozy of a motion of a dismiss, saying that because DOJ took the position that the entire ACA was unconstitutional. This would include, according to the defense, the provisions that criminalized health care fraud and kickbacks. Judge Scola is giving the government a chance to respond, but after closings.

***

In other (sad) news, Miami Beach legend Seymour Gelber passed away at 99. What an incredible life. The entire Herald obit is worth a read. Here’s the intro:

Former prosecutor, juvenile judge and Miami Beach Mayor Seymour Gelber was a local luminary. But by his own account, he was simply a streetwise kid from Brooklyn who used enough smarts and a little bit of luck to get ahead in life.

Gelber cut a self-effacing figure, disguising a shrewd legal mind that made him a heavyweight in jurisprudence who took his work seriously — but never himself.

“I never liked it,” he quipped about law school. “Never thought I would like to be a lawyer.”

His doubts faded as he ascended the ranks to become a respected jurist who shaped Miami-Dade’s juvenile justice system. He later served as mayor of Miami Beach while the city emerged from a tumultuous period rocked by corruption in the early 1990s. In the coda to his life of public service, Gelber provided a steady hand to guide City Hall.

Gelber died Thursday at age 99, his family said. He leaves behind a legacy that looms large in courtrooms and local government.

Can the President block Twitter users?

It seems like only this President would argue yes...

The Second Circuit seemed skeptical:

He had blocked many critics from his account, which prevents them from directly responding to his tweets.

U.S. District Judge Naomi Reice Buchwald ruled last May that this violated the users’ First Amendment rights, prompting Trump to unblock at least some of these accounts. The decision came in a lawsuit brought by the Knight First Amendment Institute at Columbia University and several Twitter users.

A lawyer for the U.S. Department of Justice, arguing for the president on Tuesday, urged three judges of the 2nd U.S. Court of Appeals in Manhattan to overturn Buchwald’s decision.

While Trump does use his Twitter account for government business, it was not a public forum, the attorney, Jennifer Utrecht, told the judges.

When Judge Barrington Parker asked why blocking users for their political views did not violate the First Amendment, Utrecht said blocking was akin to Trump walking away from a person trying to talk to him on the street.

The judges had fewer questions for Jameel Jaffer, the lawyer for the plaintiffs.

Jaffer said that although Twitter is a private platform, Trump was effectively inviting the public to participate in an open forum by using it for government purposes.

“The whole point of Twitter is to facilitate interactions between users,” Jaffer said.