Case: 19-10402 Date Filed: 10/09/2019 Page: 1 of 8 [DO NOT PUBLISH] IN THE UNITED STATES COURT OF APPEALS FOR THE ELEVENTH CIRCUIT ________________________ No. 19-10402 Non-Argument Calendar ________________________ D.C. Docket No. 1:18-cr-20300-UU-3 UNITED STATES OF AMERICA, Plaintiff - Appellee, versus CESAR ALBERTO ROMERO CUZA, Defendant - Appellant. ________________________ Appeal from the United States District Court for the Southern District of Florida ________________________ (October 9, 2019) Before TJOFLAT, MARTIN, and JORDAN, Circuit Judges. PER CURIAM: Cesar Romero Cuza appeals his 92-month sentence for conspiracy to commit health care fraud and wire fraud. At sentencing, the district court imposed Case: 19-10402 Date Filed: 10/09/2019 Page: 2 of 8 a variance of 35 months above the United States Sentencing Guidelines range. Romero Cuza argues his sentence is procedurally and substantively unreasonable. After careful review, we affirm. I. In November 2018, Romero Cuza pled guilty to one count of conspiracy to commit health care fraud and wire fraud. As part of his plea, Romero Cuza admitted in writing that the government could prove he operated a fraudulent health clinic called Trusted Health Care from 2014 to 2015. Trusted Health Care billed patients’ insurance for medical services it never provided. All told, Trusted Health Care falsely billed over $5 million in services and received over $1 million in reimbursements. In preparation for Romero Cuza’s sentence hearing, the Probation Office compiled a presentence investigation report (“PSR”). The PSR detailed Romero Cuza’s previous convictions. First, the PSR described Romero Cuza’s 2007 conviction for health care fraud. In this earlier case, Romero Cuza set up a sham clinic to bill Medicare over $16 million for purported HIV/AIDS treatment and chemotherapy services. Romero Cuza used a retired physician’s Medicare identification information to pull off the scheme. Romero Cuza pled guilty to this offense and received a sentence of 46 months, followed by 3 years of supervised release. The PSR also listed Romero Cuza’s 2008 conviction for battery, for which 2 Case: 19-10402 Date Filed: 10/09/2019 Page: 3 of 8 he received a sentence of time served. Overall, the PSR assigned Romero Cuza a criminal history category of level III. Based on Romero Cuza’s criminal history and other factors, the PSR determined his total offense level under the Guidelines was 22. This resulted in a guideline range of 51 to 63 months in prison, with a statutory maximum sentence of 20 years. At sentencing, the district court heard arguments from Romero Cuza’s counsel and the government. Defense counsel argued Cuza’s 2008 conviction for battery was too minor to factor into his criminal history. Counsel asked the district court to reduce Romero Cuza’s criminal history category from category III to category II. The district court agreed, reducing Romero Cuza’s recommended guideline range to 46 to 57 months. Throughout the sentence hearing, the district court expressed concern about Romero Cuza’s repeated fraud. The district court described the Romero Cuza’s previous Medicare fraud as “brazen,” “outrageous,” and “exploit[ative].” The district court noted Romero Cuza had joined the Trusted Health Care conspiracy only ...
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