WPC$ `RT:`B.~ a0!md0MJbǡ ĪW*IJ@kBJy)$IU%¯u"۴BO U-3}}{y|/TR%Xן#P/@IfgaPU2Hk@ʑV1nPWY z Rn_xNxmoeo>]VN\0.(@9`4ZъNN_3de+do WhKR7?t/ l)>qwf)׋ʒpbgdZÐڍ Vy{*XW{܊S$|*w=}jEݗى(W_-Q@s2xr"͕/^%>U0Ŕ:\g5WZ }9q!`S9௪w%25looA/N|jA !?+ޕn{ JZ# % ^ 0G UF` U 8 UB ^ w, 40 bD NL N ] 0c_ 0 m 0w 0$ 0 0N 0 0 0 0D 1 0D` 1u4 72U@1E4fa################################################# B#HP LaserJet 2100 PCL6,,,,,,,,0XL:\JUDGES\Boudin\TEMPLATE\OPINIONS\ALDRICH.WPT(.$XXXXԶL 9Z+.Courier New Regular<4 9Z+ Courier New <6X9`(*Courier 12pt10cpi`B9Z d8 :i+00- -3|x(;3$2#  0  .3  0  ((2$ .!XqXXX    =qXXdd=    0  U(O;$0  2#  a  .3  0` (#(#(b$0  0` (#(#2#   .3  0 ` (#` (#(xir$0  0` (#(#0 ` (#` (#2#(  0  )3  0 (# (#($0  0` (#(#0 ` (#` (#0 (# (#2#(  a  )3  0h(#(#(F$0  0` (#(#0 ` (#` (#0 (# (#0h(#(#2#(   )3  0h(#h(#($0  0` (#(#0 ` (#` (#0 (# (#0h(#(#0h(#h(#2#  0  )3  0(#(#({$0  0` (#(#0 ` (#` (#0 (# (#0h(#(#0h(#h(#0(#(#2#  a  )3  0p(#(#(F$0  0` (#(#0 ` (#` (#0 (# (#0h(#(#0h(#h(#0(#(#0p(#(#2#     )3  0p(#p(# xGaeimquy}Bullet ListBullets List(#$  0    $XXXX  =XXdd=    1    __ԀThosewhodesireamorecomprehensivetreatmentofthe  backgroundfactsmayconsultourprevioustwodecisionsinthis  matter.SeeUnitedStatesv._Thurston_,358F.3d41(1stCir.2004) \ (_Thurston_ԀI);seealsoUnitedStatesv._Thurston_,456F.3d211(1st 2 Cir.2006)(_Thurston_ԀII).  $XXXX  =XXdd=    3    _ԀUnderthepreBookerfederalsentencingregimethenin  place,adistrictcourtwasrequiredtoimposeaguidelinesentence  unlessadownwarddeparturewaspermitted.See18U.S.C. \ 3553(b).Atthattime,ourreviewofadistrictcourt'sdecision 2 todepartdownwardwasdenovo.See18U.S.C.3742(e),as X amendedbyPub.L.No.10821,401.3#37=CIQYag1.a.i.(1)(a)(i)1)a)i)  (9 Z(Times New Roman  w $XXXX  =XXdd=    5    _ԀAsentenceisprocedurallysoundsolongasthedistrict  courtdidnotcommitaproceduralerrorinarrivingatthesentence  Examplesofproceduralerrorsinclude:"failingtocalculate(or \ improperlycalculating)theGuidelinesrange,treatingthe 2 Guidelinesasmandatory,failingtoconsiderthesection3553(a) X factors,selectingasentencebasedonclearlyerroneousfacts,or . failingtoadequatelyexplainthechosensentenceincludingan   explanationforanydeviationfromtheGuidelinesrange."Gall,    128S.Ct.at597. * $XXXX  =XXdd=    4    __ԀThecourtaddeda$25,000finewhichwasnotpartofthe  initialsentence.TABLE A  $XXXX  =XXdd=    2    __Ԁ_Thurston_'sadjustedoffenselevelof26establishedthis  sentencingrange.Asrehearsedin_Thurston_ԀI,therangewas  calculatedasfollows:Thecourtdeterminedthatthebaseoffense \ levelwassix,that_Thurston_ԀintendedtodefraudMedicareofmore 2 than$5,000,000(a14levelenhancement),thatthecrimeinvolved X morethanminimalplanning(atwolevelenhancement),andthat . _Thurston_Ԁwasanorganizerorleaderofextensivecriminalactivity   (afourlevelenhancement).358F.3dat61.Thecourtdenied   _Thurston_'srequestforanacceptanceofresponsibilityadjustment `  anddidnotruleonthegovernment'srequestforanobstructionof 6   justiceenhancement.  d .!XXXX  _  8XXdd8 *,X` XX*",US ,  (:!&), OY !X,XXX!XX!X,    UnitedStatesCourtofAppeals#!X,X!X7#  !OX!X,FortheFirstCircuit#!X,X!O# #XXX!X,#  AY#) ` dE< ` A   h  No.052271 K  @UNITEDSTATESOFAMERICA,  G  @*@%Appellant,   @tt)v. O  @"WILLIAM_THURSTON_, K  @<< Defendant,Appellee.  AY#) ` dE<R` A S @ APPEALFROMTHEUNITEDSTATESDISTRICTCOURT 8 @0 0 FORTHEDISTRICTOFMASSACHUSETTS 4 @ [Hon.MarkL.Wolf,U.S.DistrictJudge]  AY#) ` dE<;` A < @'Before !q @<< Lynch,ChiefJudge,    BoudinandHoward,CircuitJudges. y! AY#) ` dE<$!` A %!u#    ` _Dina_ԀMichael_Chaitowitz_,ChiefofAppeals,MichaelJ.  "Z% Sullivan,UnitedStatesAttorney,MichaelK._Loucks_,First "0& AssistantUnitedStatesAttorneyandSusanG.Winkler,Chief, #' HealthCareFraudUnit,onbriefforappellant. $(  ` MatthewD.BrownandCooley_Godward_Ԁ_Kronish_Ԁ_LLP_onbrief b% ) forappellee. 8&!*  ` *%Y&ddd Xdd Xdd X(#(#,( dd ,( dd ,( dd +  )$.)$  SI)D%/ @e@39722@e@SOctober2,2008 *&1  RHC+&2" @e@39722 @e@ R()D%3  (  |-(4  ` HOWARD,CircuitJudge .This,thethirdreviewofWilliam  _Thurston_'ssentence,wasnecessitatedbytheSupremeCourt's x decisioninUnitedStatesv.Gall,128S.Ct.586(2007).We $t affirmthesentence.      I.  |  v  ` Tosaythatthejourneyofthiscasehasbeenarduousfor D   thepartiesinvolvedwouldbeanunderstatement.Forpresent @  purposes,thebackgroundfactsmaybebrieflysketched._ #  1      _    ` Ajuryconvicted_Thurston_Ԁofconspiringtodefraudthe H  Medicareprogramofmorethanfivemilliondollars.At_Thurston_'s D sentencing,thedistrictcourtappliedthesentencingguidelines  whichyieldedarangeof63to78months'imprisonment._' #  2      _ԀThis L rangewastrumpedbya60monthstatutorymaximum.Departing H  downwardfromtheguidelines,thedistrictcourtsentenced_Thurston_  _tothreemonths'incarceration,followedby24monthsofsupervised  release. \   ` _Thurston_Ԁappealedhisconvictionandthegovernment X crossappealedthesentence.Weaffirmed_Thurston_'sconvictionbut   remandedfor_resentencing_Ԁafterconcludingthatthedistrictcourt `  erredingrantingthedownwarddeparture._Thurston_ԀI,358F.3dat  \  81. #  3      ׀Weinstructedthedistrictcourttoimposetheguideline   sentenceof60months'imprisonment.Id.at82. d   ` Followingthisdisposition,theSupremeCourtdecided `  UnitedStatesv.Booker,543U.S.220(2005),declaringthe   sentencingguidelinesadvisory.Accordingly,theCourtvacatedour h judgmentinthiscaseandremandedforfurtherconsideration. d _Thurston_v.UnitedStates,543U.S.1097(2005).Afterreceiving  andconsideringadditionalbriefing,weremandedthecasetothe l districtcourtfor_resentencing_. h  ` Aseconddistrictjudgeappliedthesentencingguidelines  andarrivedatarecommendedguidelinesentenceof60months' p  imprisonment.Afterconcludingthatalowersentencewas !l" appropriateunderthesentencingfactorssetforthin18U.S.C. "$ 3553(a),thedistrictcourtimposedasentencesignificantlybelow t$& therecommendedguidelinerangethreemonths'incarcerationwith  24monthsofsupervisedreleasethatmirroredthesentence \ imposedbytheoriginalsentencingcourt.$ #  4      ׀_Thurston_ԀII,456F.3d X at214215.Because_Thurston_Ԁreceivedcreditfortimeserved,he   wasnotrequiredtoservemoreprisontime.Id.at215. `   ` Thegovernmentappealed_Thurston_'ssentenceas  \  unreasonablylenient,arguingthatthe3553(a)factorsthecourt   reliedondidnotjustifythesteepdownwardvariancethecourt d  awarded.Weagreed,vacated_Thurston_'ssentence,andagain `  remandedfor_resentencing_._Thurston_ԀII,456F.3dat216220.The   SupremeCourtultimatelyvacatedthisdecisionaswell,thistime h pursuanttoitsdecisioninGall,andremandedthecasetousfor d reconsideration._Thurston_v.UnitedStates,128S.Ct.854(2008).  We,inturn,requestedbriefingontheeffectofGall. l    II.  h { ` AfterGall,ourreviewofsentenceshastwocomponents. 0 Wemustsatisfyourselvesthatthesentenceimposedisboth(_i_)   procedurallysound"< #  5      ׀and(ii)substantivelyreasonable.Gall,128 8!" S.Ct.at597(notingthatinconsideringthelatter,reviewing  courtsmusttakeintoaccountthe"totalityofthecircumstances"); \ seealsoUnitedStatesv.Martin,520F.3d87,92(1stCir.2008). X Ourreviewforsubstantivereasonablenessamountstoreviewforan   abuseofdiscretion.Gall,128S.Ct.at591. `   ` Weconcludedin_Thurston_ԀIIthatthedistrictcourtdid  \  notcommitproceduralerrorinarrivingat_Thurston_'ssentence.   _Thurston_ԀII,456F.3dat215.Thereisnoneedtorevisitthat d  determinationhere.Ourfocus,then,isonthesubstantive `  reasonablenessof_Thurston_'ssentence.    ` _Thurston_ԀarguesthatafterGall,ourholdingin_Thurston_ h II󀄄thatthesentenceimposedisunreasonablecannotstand. d Hecontendsthatourholdingfailstoaffordsufficientdeference  tothedistrictcourt'ssentencingdecisionandthatweshouldnow l affirmhissentence.Thegovernmentarguesthat,eveninlightof h Gall,thesentenceimposedissubstantivelyunreasonableandthat  weshouldreinstateourreasoning,vacate_Thurston_'ssentence,and p  remandfor_resentencing_.UnderstandingthatGallsendsaclear !l" messagetoreviewingcourtsthatthesentencingdecisionsof "$ districtcourtsshouldgenerallyberespected,weaffirmthe t$& sentence.  &p!(  ` Westartbystatingtheobvious.Inthiscasethe '#* variancefromtheguidelinesentencewasdramatic.Theguideline x)$, _sentence_Ԁwasfiveyearsofprisontime.Thedistrictcourt,  however,imposedasentenceofthreemonths'incarcerationfollowed \ by24monthsofsupervisedrelease. X  ` Tobesure,Gallteachesthatitiserrortoallowthe   dramaticnatureofavariancetoundulyinfluenceourreviewfor `  substantivereasonableness.Inparticular,inGalltheCourt  \  rejectedtheuseof"arigidmathematicalformulathatusesthe   percentageofadepartureasthestandardfordeterminingthe d  strengthofthejustificationsrequiredforaspecificsentence." `  Gall,128S.Ct.at595.    ` Butthedegreeofvariance,evenafterGall,isnot h withoutimport.Id.at597("If[thesentencingcourt]decides d thatanoutsideGuidelines_sentenceiswarranted,[it]must  considertheextentofthedeviationandensure_Ԁthatthe l justificationissufficientlycompellingtosupportthedegreeof h thevariance....Wefindituncontroversialthatamajor  departure[fromtheguidelines]shouldbesupportedby_amore p  significantjustification_Ԁthanaminorone.");seealsoMartin,520 !l" F.3dat91(notingthatevenafterGall"acertain'slidingscale' "$ effectlurksinthepenumbraofmodernfederalsentencinglaw."); t$& UnitedStates_v._ԀGrossman,513F.3d592,596(6thCir.2008)  &p!( ("[Gall]_permits...appellatecourts_Ԁtorequiresomecorrelation '#*  betweentheextentofthevarianceandthejustificationforit."). x)$,  OY       ` In_Thurston_ԀII,weexplainedindetailwhyweconsidered   _Thurston_'ssentence,theresultofadramaticvariancefromthe \ guidelinesentence,tobesubstantivelyunreasonable.456F.3dat X 21520.Inparticular,webelievedthelenientsentenceimposedby   thedistrictcourtfailedtoreflectboththeseriousnessofthe `  offenseandtheneedforgeneraldeterrence.SeeU.S.C.  \  3553(a)(2)(A),(a)(2)(B).Thesentencealso,inourview,treated   thedefendantunreasonablysimilarlytoacodefendantwhowas d  situateddifferently.Id.at3553(a)(6).EvenafterGall,we `  couldremandforreconsiderationofthesentenceinlightofthese   concerns.See,e.g.,UnitedStatesv.Tom,504F.3d89(1stCir. h 2007).Nevertheless,uponconsideringthesentenceinlightof d Gall,weconcludethataremandherewouldservelittlepurpose.   ` Inarrivingat_Thurston_'ssentencethedistrictcourt l reliedonahostof3553(a)factorsinadditiontotheones h detailedabove.Thecourtdiscussedhow_Thurston_'ssentenceserved  3553(a)'sgoalofspecificdeterrence,notingthat_Thurston_Ԁhad p  acceptedresponsibilityforhiscrime.Thecourtalsoconsidered !l" _Thurston_'s"charitablework,communityservice,generositywith "$ time,andspiritualsupportandassistancetoothers."See18 t$& U.S.C.3553(a)(1)(historyandcharacteristicsofthedefendant).  &p!( Althoughwemaydisagreethat_Thurston_'ssentenceservesother '#* goalsof3553(a),wemustultimatelytakeintoaccountthe x)$, "totalityofthecircumstances"whenreviewingadefendant's $+t&. _sentence_.Martin,520F.3dat92.Here,givenGall'sbroader  definitionofthedeferencegiventodistrictjudges'sentencing \ decisions,weaffirm. X  ` Soordered.