First, the Court concluded that the court did not err by admitting at trial a signed factual basis for a plea agreement that the defendant entered before changing his mind and proceeding to trial. Although rules of evidence and procedure normally bar that admission, the defendant agreed to waive those rules in the plea agreement, and that waiver is enforceable if voluntary. The Court rejected the defendant's argument that the waiver was unenforceable, finding that the waiver was unambiguous, and the court did not clearly err by finding a voluntary waiver due to his attorney's failure to explain it.
Second, the Court concluded that the government did not violate Brady by failing to disclose an allegedly exculpatory report about a police interview. The Court found no reasonable probability of a different outcome from that report, but rather found that it would have had only some minimal impeachment value of a witness, and the evidence was overwhelming even without that witness' testimony.
Third, the Court concluded that the court did not constructively amend the indictment by instructing the jury on the conspiracy count. Despite the court's slightly different wording from the pattern instruction, the court correctly stated the law and its instruction tracked the pattern almost verbatim. It observed that cheating the government out of money or property, as charged, was indeed a kind of deceptive interference with the lawful functions of the government.
Fourth, the Court concluded that the court did not clearly err when calculating the guideline range. There was no ex post facto violation by sentencing him under the more recent version of the Guidelines because his offense continued after the amendment. There was no clear error by applying the sophisticated means enhancement. And there was no clear error in calculating the loss because it was supported by the evidence, including the signed factual basis of his plea agreement.
Lastly, as to the forfeiture order, binding precedent foreclosed the arguments that forfeiture statutes did not authorize personal money judgments, and that the Sixth Amendment required proof beyond a reasonable doubt. However, the Court found that the court erred under Honeycutt by imposing a forfeiture order that held the defendant jointly and severally liable for the proceeds of the conspiracy. Although Honeycutt involved a different statute, the same reasoning applied to the statute for health care fraud.