Labor & Employment Law Daily Wrap Up, WHITE-COLLAR CRIME—5th Cir.: Sufficient evidence supported conviction for $1.55M hospice fraud scheme, (Dec 18, 2025)

By Martin A. Steinberg, J.D.

Provider paid medical directors and directed falsified documentation to certify non-terminal patients for hospice and billed Medicare.

The Fifth Circuit affirmed the convictions of a hospice founder for conspiracy to commit healthcare fraud and three substantive counts of healthcare fraud arising from Angel Care Hospice’s Medicare billing practices. The court detailed evidence that the defendant recruited and compensated medical directors who certified patients as terminally ill despite medical records showing they were stable or treatable, directed staff to document patients as if they were on their “worst day,” avoided costly curative care by discharging and later readmitting patients, and, in at least one instance, instructed the backdating of hospice records. The panel held that this evidence was sufficient for a rational jury to find that the defendant knowingly and willfully caused false Medicare claims to be submitted, notwithstanding the acquittal of her physician codefendants. The court also rejected her argument that the government should have been judicially estopped from arguing that the conspiracy could include hospice employees, concluding that the government had not taken plainly inconsistent positions, that the district court had adopted no limiting position, and that the defendant failed to show unfair prejudice or reliance. Assuming without deciding that judicial estoppel could apply against the government in a criminal case, the court held that the doctrine’s elements were not satisfied and affirmed the district court’s denial of post-trial motions for acquittal and a new trial (U.S.A. v. Glover-Wing, No. 24-30431 (5th Cir. Dec. 12, 2025)).

Factual background. Defendant Kristal Glover-Wing founded Angel Care Hospice (ACH) in 1999 as a Medicare provider. She later recruited physicians to serve as medical directors who referred patients with chronic, but not terminal, conditions to ACH and certified them as terminally ill for hospice eligibility. These certifications conflicted with patients’ active functioning and with Medicare’s requirement that terminal-illness certifications serve as a prerequisite to hospice reimbursement.

The investigation focused on 24 patients for whom ACH received approximately $1.55 million in hospice reimbursements, despite evidence that they did not require hospice care. ACH’s operational practices under the defendant’s direction, including compensating medical directors who steered patients exclusively to ACH, instructing nurses to chart patients “on their worst day,” discouraging discharges, avoiding costly curative care by temporarily discharging patients during hospitalizations, and, in at least one instance, directing the backdating of records. These practices formed the factual basis for the conspiracy charge and the healthcare-fraud counts tied to specific hospice patients.

Procedural history. Following a whistleblower complaint, a federal grand jury indicted the defendant and two physicians for conspiracy and substantive healthcare fraud arising from ACH’s Medicare billing. During deliberations, a jury question prompted the defendant to argue that the government should be judicially estopped from pursuing a conspiracy theory involving her employees. The district court rejected that argument, relied on the indictment’s express language that the conspiracy was not limited to named defendants, and instructed the jury to rely on the original charge. The jury convicted the defendant on all counts while acquitting the physician codefendants. The district court later denied her post-verdict motions for acquittal and a new trial, rulings she challenged on appeal, arguing that the evidence was insufficient and that the court erred in denying judicial estoppel.

Sufficiency of the evidence. The court first addressed the defendant’s challenge to the adequacy of the proof supporting her conspiracy and healthcare-fraud convictions and applied the highly deferential standard of review governing motions for judgment of acquittal. The court held that, viewing the evidence in the light most favorable to the verdict, a rational jury could find beyond a reasonable doubt that she knowingly and willfully participated in a scheme to defraud Medicare. The court emphasized that the testimony and records showed that she recruited and compensated medical directors who certified patients as terminally ill despite contrary medical indicators, directed nurses to document patients as if they were on their “worst day,” avoided financially burdensome curative care, and, in at least one instance, instructed the backdating of hospice readmissions.

Regarding the conspiracy count, the court rejected the defendant’s argument that the acquittal of her physician codefendants defeated the charge, reiterating settled precedent that inconsistent verdicts do not undermine a conspiracy conviction where the evidence otherwise supports an agreement and knowing participation. The court concluded that the record demonstrated a coordinated scheme involving medical directors and staff under the defendant’s supervision, and that the jury was entitled to credit that evidence notwithstanding competing interpretations urged by the defense.

Judicial estoppel. The court next rejected the defendant’s judicial-estoppel argument, explaining that even if the doctrine could apply against the government in a criminal case, it did not apply on these facts. The court assumed, without deciding, that review was de novo and that judicial estoppel might be available, but held that she failed to establish the doctrine’s core elements.

First, the panel found no “plainly inconsistent” positions: the government’s earlier statements, which the district court noted were unrecorded, suggesting the absence of unindicted co-conspirators, were made in the narrow evidentiary context of arguing for the admissibility of statements under the co-conspirator hearsay exception and did not purport to limit the scope of the charged conspiracy. Those statements did not contradict the indictment, which expressly alleged that the conspiracy was not limited to the named defendants.

Second, the court concluded that the district court did not accept any prior position in a manner that would bind the government, as there was no ruling adopting a narrower conspiracy theory.

Third, the court rejected the defendant’s claim of prejudice or unfair advantage, emphasizing that the indictment’s language and the jury instructions put her on notice that the conspiracy could include others, including employees. Because these elements were not met, the court held that judicial estoppel did not apply and, consistent with prior precedent, declined to resolve the broader unresolved question of whether judicial estoppel may ever be asserted against the government in a criminal prosecution.

The case is No. 24-30431.

Judge: Wiener, J.

Attorneys: Michael A. Rotker, U.S. Department of Justice, for the U.S. Kristal Glover-Wing, pro se.

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