United States v. Akula

── United States v. Akula ── Court: Court of Appeals for the Fifth Circuit Date: June 08, 2026 Category: Direct Criminal Case: 24-30315 Document: 199-1 Page: 1 Date Filed: 06/08/2026 United States Court of Appeals for the Fifth Circuit ____________ United States Court of Appeals Fifth Circuit No. 24-30315 ____________ FILED June 8, 2026 United States of America, Lyle W. Cayce Clerk Plaintiff—Appellee, versus Shiva Akula, Defendant—Appellant. ______________________________ Appeal from the United States District Court for the Eastern District of Louisiana USDC No. 2:21-CR-98-1 ______________________________ Before Smith, Wiener, and Higginson, Circuit Judges. Stephen A. Higginson, Circuit Judge: A jury convicted Dr. Shiva Akula of twenty-three counts of health care fraud due to his company’s fraudulent Medicare billing practices. On appeal, Dr. Akula challenges the district court’s decision not to certify his witness as an expert on Medicare billing and coding, the sufficiency of the evidence supporting his convictions, and his above-Guidelines sentence. Finding no error, we AFFIRM. Case: 24-30315 Document: 199-1 Page: 2 Date Filed: 06/08/2026 No. 24-30315 I. Since 1993, Dr. Akula, an infectious disease doctor in New Orleans, has owned a healthcare company known as Canon Healthcare, LLC (“Canon”). Canon maintained locations throughout Louisiana and Mississippi, with its New Orleans office as its primary location. As a hospice business, Canon treated patients with terminal illnesses likely to die within six months. Canon contracted with doctors from Ochsner Health System to provide medical care to Canon’s hospice patients. Dr. Akula directed Canon’s daily operations, including its Medicare billing. Beyond overseeing billing, his responsibilities included hiring nurses, nurse practitioners, and administrative staff, including office administrators Sue May, Kelly Anderson, and Joshua Bruce. Dr. Akula also employed and supervised members of his family to handle Medicare billing in Canon’s New Orleans office: his sister Krishna Biyyam and brother-in-law Raj Biyyam. At all relevant points, Dr. Akula signed Canon’s Medicare enrollment documents, agreeing that he was bound to comply with all the rules and regulations surrounding the program. Canon primarily billed Medicare for four different levels of hospice care, which were reimbursed at per diem rates: Routine Care, which is the default rate, under which a patient receives home hospice care; Respite Care, the rate for a five-day-maximum care period in which patients enter a facility while their caregivers rest; General Inpatient Care (“GIP”), a rate used for patients who suffer an acute event that can only be addressed in an inpatient setting; and Continuous Care, the rate used when a patient is in medical crisis and must be cared for around-the-clock until their condition improves. Continuous Care is reimbursed at the highest rate, while GIP holds the second highest reimbursement rate. Canon maintained a practice of 2 Case: 24-30315 Document: 199-1 Page: 3 Date Filed: 06/08/2026 No. 24-30315 uniformly billing patients at the GIP rate, making sure to keep the inpatie