United States v. Starks

Andrew Siegel (defendant) was the president of Future Steps, a corporation that developed and operated drug addiction treatment programs. Future Steps contracted with a Florida hospital that participated in the Medicaid program, to operate a chemical dependency unit for pregnant women. Siegel initialed each page of the contract, including a provision explicitly forbidding Future Steps from making any payment for patient referrals in violation of the federal anti-kickback statute. Angela Starks (defendant) and Barbara Henry (defendant), Florida Department of Health and Rehabilitative Services employees, were assigned to a federally-funded research project advising pregnant women about drug abuse treatment options. Starks and Henry were informed that they were prohibited from accepting outside employment that might be a conflict of interest with their work on the project. Siegel offered to pay Starks and Henry $250 each for every patient they referred. For nearly one year, Starks and Henry discretely accepted money for referring 18 women to Future Steps from Siegel. At trial, several of the referred women testified that Starks and Henry made threats that the state would take away their babies if they did not receive treatment from Future Steps. A jury found Starks, Henry, and Siegel guilty for violating the anti-kickback statute and each appealed. On appeal, it was argued that the district court erred by refusing to instruct the jury on the proper mens rea standard of the statute and that the statute was unconstitutionally vague.