No. 19-5016
Appeal from the United States District Court
for the Western District of Kentucky at Louisville.
No. 3:15-cr-00054-5—Rebecca Grady Jennings, District Judge.
Argued: December 5, 2019
Decided and Filed: February 21, 2020
Before: ROGERS, STRANCH, and THAPAR, Circuit Judges.


THAPAR, Circuit Judge. Four men from Miami drove to Louisville with a plan to set up chiropractic clinics. But Oskel Lezcano (who all agree was the mastermind) had another, more lucrative idea: file false claims with the patients’ insurers and get paid for treatments that never happened. The other men involved—Ledinson Chavez, Sergio Betancourt, and Yuriesky Diaz— joined in.

The plan worked (for a while). One reason for its success: aggressive marketing. The conspirators recruited and paid patients both to come to the clinics and to recruit others. Many of the patients worked at a shipyard called Jeffboat. Jeffboat (through its claim administrator, United Healthcare) paid the clinics more than $1 million for fake injections of a muscle relaxant.

Eventually, the government discovered the scheme and brought criminal charges against the four men. Chavez went to trial. He claimed that he was innocent and had no idea that Lezcano was cooking the books. But to no avail. The jury found Chavez guilty of healthcare fraud, conspiracy to commit healthcare fraud, aggravated identity theft, and conspiracy to commit money laundering for purposes of concealment.

Chavez now appeals those convictions and his 74-month sentence. He alleges a host of trial errors, which fall into three groups: (1) two challenges to the sufficiency of the evidence and a related challenge to the prosecutor’s closing argument, (2) two hearsay arguments, and (3) three objections to the jury instructions. He also raises one sentencing argument. We affirm.