⚖ Oral Arguments, with Context

The Fifth Circuit considers the financial consequences of a healthcare kickback conviction. The defendant ran a company that marketed genetic laboratory tests. Distributors were paid a share of the money laboratories collected for testing, including Medicare reimbursements. Part of the operation redirected patient samples to a different laboratory by changing test-order paperwork without the ordering doctors' knowledge. In an earlier appeal, the court upheld the conspiracy conviction based on that diversion scheme. But it set aside the sentence and forfeiture calculation because they also counted payments whose illegality had not been established. Now the dispute is how much money can properly be counted. One calculation concerns the value of the bribes for sentencing; another concerns criminal proceeds that must be surrendered through forfeiture. The defense will argue that bank transfers alone do not show how much was paid for illegal diversion, and that legitimate marketing payments must be separated out. The government will argue that the intermediary was a sham and that the trial record supports counting the payments as part of jointly undertaken criminal activity. Listen for which company received each payment, what ties it to the offense, and why the sentencing and forfeiture totals differ. The judges must assess the evidence supporting those amounts while giving appropriate deference to the district court's factual findings.

USA v. Donofrio (No. 25-40537) — U.S. Court of Appeals for the Fifth Circuit, argued November 3, 2026.