Oliver Jenkins and Sherry-Ann Jenkins v. United States

I. Whether the deliberate-ignorance doctrine may supersede the mens rea (willful knowledge) element for criminal intent in healthcare fraud and conspiracy offenses when the defendant acted throughout the entire alleged criminal period at the direction of and in reliance upon written authorizations from the designated institutional compliance and risk management director — who identified the legal and compliance guardrails, directed that services be billed as physician services under specific CPT codes, and installed the EMR computer credentials enabling the challenged services — a scenario structurally incompatible with the willful blindness the doctrine is designed to address. This question is squarely presented by Ruan v. United States, 597 U.S. 450 (2022), which held that the government must prove a defendant knowingly or intentionally acted in an unauthorized manner — a standard the deliberate-ignorance instruction, as applied here, directly undermines by permitting an inference of knowledge from conduct that written institutional authorization expressly sanctioned. II. Whether the good-faith reliance defense is defeated as a matter of law by post-investigation, yearslater witness recollections contradicting full disclosure established by contemporaneous documentary evidence — where the institution’s own COO initiated the billing arrangement in writing; the institution’s own compliance and risk management director installed the EMR computer credentials enabling PET scan and laboratory test ordering six months before operations began; the government’s own lead investigator testified the institution’s administration knew the defendant’s unlicensed status throughout; the institution’s board of directors unanimously approved the Cognitive Center after viewing a PowerPoint presentation explicitly showing PET scans and laboratory referrals; the institution’s own COO admitted he “made mistakes, clearly,” that he “missed the flags,” and that “it’s obvious we screwed this up;” and the Court of Appeals resolved this conflict under sufficiency-review credibility-deference without first conducting Napue v. Illinois analysis of materially inconsistent government witness testimony.