Unlicensed Doctor Convicted of Insurance Fraud and Other Crimes

After Patrick E. Usanga (Usanga) was convicted for many crimes of fraud he appealed his convictions unsuccessfully and then filed Post Conviction Relief Act motion to set aside the conviction in Commonwealth of Pennsylvania v.  Patrick E. Usanga, J-S29031-20, No. 1946 EDA 2019, Superior Court of Pennsylvania (July 13, 2020).Usanga appealed pro se (proving the old saying that he had a fool for an attorney) from the order denying his first petition filed pursuant to the Post Conviction Relief Act (PCRA) in the Court of Common Pleas of Philadelphia County (PCRA court).

FACTS

The court took the following factual background and procedural history from our independent review of the record, this Court’s August 16, 2017 opinion, and the PCRA court’s December 16, 2019 opinion. A previous panel of this Court set forth the relevant factual background of this matter as follows: [Usanga], a Nigerian-born United States citizen [,] obtained a medical degree from the University of Guadalajara in Mexico in 1982. He took the board examination to be a licensed medical doctor in Pennsylvania several times in the 1980s and [19]90s, but did not pass. On May 19, 2009, he filed the necessary paperwork to incorporate a health care facility, Northeast Behavioral Medicine, Inc., with himself as the sole officer of the corporation. . .. He applied for and received a license to operate a psychiatric clinic soon after incorporation. At all times during the period of time Northeast Behavioral Medicine was in business and seeing patients, [Usanga] was the only provider at the facility.

During that period, he saw patients for various mental health and substance abuse issues. Several of his former patients testified that he told them that he was either a psychologist or a psychiatrist. As a result of the services provided by the Appellant, he billed various insurance companies including Aetna and Blue Cross, for his services.  Usanga billed Aetna $24,950.00 and received $5,036.38 as an out-of-network provider. Blue Cross paid a total of $15,763.84 to him. That money was deposited in a TD Bank account owned by Usanga. Concurrently to the period of time that Usanga was operating Northeast Behavioral Medicine, he was also collecting unemployment compensation and Social Security disability benefits. However, Usanga was not entitled to unemployment benefits once he incorporated his business and became self-employed. The Pennsylvania Department of Labor determined that the Appellant was paid $52,000.00 in unemployment compensation that he was not entitled to receive. On August 15, 2013, the Commonwealth charged Usanga with twenty-seven counts of Insurance Fraud, eleven counts of Tampering with Public Records, four counts of Theft by Deception, two counts of Attempted Theft, two counts of Harassment and one count of Making False Statements Regarding an Unemployment Compensation Claim. On March 16, 2015, Usanga appeared for a jury trial. On the fifth day of trial, March 23, 2015, he failed to appear and trial continued without him. On March 26, 2015, a jury convicted him of twenty-three counts of Insurance Fraud, four counts of Theft by Deception and eight counts of Tampering with Public Records.  The court convicted him of one count of Making False Statements Regarding an Unemployment Compensation Claim.

On May 20, 2015, the court sentenced him to an aggregate term of incarceration of not less than six nor more than twelve years, plus five years’ reporting probation. After his post-sentence motions were denied, Usanga appealed, and this Court affirmed his judgment of sentence on August 16, 2017. He did not seek further review in the Pennsylvania Supreme Court. On June 5, 2018, Usanga filed his first PCRA petition pro se. Usanga raised ten issues for review which included eight claims of trial court error, a claim of ineffective assistance of counsel, and a discretionary aspects of sentence challenge. He maintains that the trial court erred. To be eligible for relief, a petitioner must plead and prove by a preponderance of the evidence that he has been convicted of a crime and that his conviction resulted from one or more of the enumerated circumstances identified in the statute, including:

1.A violation of the Constitution of this Commonwealth or the Constitution or laws of the United States which, in the circumstances of the particular case, so undermined the truth-determining process that no reliable adjudication of guilt or innocence could have taken place.

2.Ineffective assistance of counsel which, in the circumstances of the particular case, so undermined the truth-determining process that no reliable adjudication of guilt or innocence could have taken place.

3.A plea of guilty unlawfully induced where the circumstances make it likely that the inducement caused the petitioner to plead guilty and the petitioner is innocent.

4.The improper obstruction by government officials of the petitioner’s right of appeal where a meritorious appealable issue existed and was properly preserved in the trial court.

5.Deleted.

6.The unavailability at the time of trial of exculpatory evidence that has subsequently become available and would have changed the outcome of the trial if it had been introduced.

7.The imposition of a sentence greater than the lawful maximum.

8.A proceeding in a tribunal without jurisdiction. [42 Pa.C.S. § 9543(a)(2)]. To be eligible for relief under the PCRA, a petitioner must also prove by a preponderance of the evidence that his claims have not been previously litigated or waived. It is well-settled in Pennsylvania that allegations of trial court error are waived at the collateral review stage because they could have been raised on direct appeal. Put another way, where a defendant could have raised claims of trial error in his direct appeal but failed to do so, they are waived for the purpose of PCRA review and can afford a defendant no basis for relief. In this case, Usanga could have raised his claims of trial court error and his challenge to the discretionary aspects of his sentence on direct review but failed to do so. Therefore, they are waived and cannot form the basis for PCRA relief. Usanga, as a last effort, claimed his counsel was ineffective.  To establish an ineffectiveness claim, a defendant must prove: 1)the underlying claim has arguable merit; 2)no reasonable basis existed for counsel’s actions or failure to act; and 3)appellant suffered prejudice as a result of counsel’s error such that there is a reasonable probability that the result of the proceeding would have been different absent such error. Failure to prove any prong of this test will defeat an ineffectiveness claim. Since Usanga’s claims were meritless the court will refuse to find counsel ineffective for failing to raise a meritless claim. Other than alluding to the ineffectiveness prongs in his heading to the prejudice prong in his claim about trial counsel’s cross-examination of a witness. Instead, he merely lists each allegation of error without framing them as ineffective assistance of counsel claims. Usanga has failed to meet his burden to plead and prove any of the three ineffectiveness prongs and he is due no relief. The PCRA court’s order dismissing Usanga’s PCRA petition was affirmed.

ZIFL OPINION

Those who defraud insurers are people with unmitigated gall and even when they have been caught, have been tried, and convicted by a jury of their peers, they will continue to bother and annoy the court system until they get so annoyed that they let him out of jail.

The court refused to honor the stupidity of the claim for PCRA relief but still had to take the time to review the pleadings and briefs and write an opinion. If he has any of his ill-gotten gains still available, he should be assessed sanctions to remove from his control all of the monies he took from the insurers and pay indemnity to those who allowed him to treat them as if he was a licensed physician.