Petition for Writ of Certiorari — Javaid Perwaiz, Petitioner v. United States

Supreme Court briefSep 5, 2024

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NO. __________________

In the

Supreme Court of the United States

JAVAID PERWAIZ,

Petitioner,

UNITED STATES OF AMERICA,

Respondent.

APPENDIX A

TO PETITION FOR WRIT OF CERTIORARI

TO THE UNITED STATES COURT OF APPEALS

FOR THE FOURTH CIRCUIT

Wesley P. Page

Federal Public Defender

Jonathan D. Byrne

Appellate Counsel

Counsel of Record

OFFICE OF THE FEDERAL PUBLIC DEFENDER

Southern District of West Virginia

300 Virginia Street, East, Room 3400

Charleston, West Virginia 25301

304/347-3350

jonathan_byrne@fd.org

Counsel for Petitioner

United States v. Perwaiz, Not Reported in Fed. Rptr. (2024)

2024 WL 2891327

Only the Westlaw citation is currently available.

United States Court of Appeals, Fourth Circuit.

UNITED STATES of America, Plaintiff – Appellee,

Javaid PERWAIZ, Defendant – Appellant.

No. 21-4255

Submitted: January 5, 2024

Decided: June 10, 2024

Amended: June 10, 2024

Appeal from the United States District Court for the Eastern District of Virginia, at Norfolk.

Rebecca Beach Smith, Senior District Judge. (2:19–cr–00189–RBS–DEM–1)

Attorneys and Law Firms

ON BRIEF: Wesley P. Page, Jonathan D. Byrne, OFFICE OF THE FEDERAL PUBLIC

DEFENDER, Charleston, West Virginia, for Appellant. Jessica D. Aber, United States Attorney,

Joseph Attias, Assistant United States Attorney, Richmond, Virginia, E. Rebecca Gantt, Assistant

United States Attorney, Elizabeth M. Yusi, Assistant United States Attorney, OFFICE OF THE

UNITED STATES ATTORNEY, Norfolk, Virginia, for Appellee.

Before DIAZ, Chief Judge, and NIEMEYER and RICHARDSON, Circuit Judges.

Opinion

Affirmed by unpublished opinion. Chief Judge Diaz wrote the opinion, in which Judge Niemeyer

and Judge Richardson joined.

Unpublished opinions are not binding precedent in this circuit.

DIAZ, Chief Judge:

*1 After a nearly five-week trial, a jury convicted Javaid Perwaiz of 52 counts of healthcare fraud

and making false statements in relation to healthcare matters. The district court then sentenced

him to 708 months’ imprisonment.

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United States v. Perwaiz, Not Reported in Fed. Rptr. (2024)

Perwaiz now asserts two evidentiary challenges from his trial and an ineffective assistance of

counsel claim. But because any evidentiary error would be harmless considering the overwhelming

evidence of Perwaiz's guilt, we affirm his convictions. And because any ineffective assistance by

Perwaiz's counsel doesn't “conclusively appear[ ] in the trial record,” United States v. Mandello,

426 F.2d 1021, 1023 (4th Cir. 1970), we affirm his sentence.

Javaid Perwaiz was a Virginia-licensed OB/GYN who regularly treated pregnant patients and

performed procedures such as colposcopies, 1 hysteroscopies, 2 and hysterectomies 3 on other

patients. Perwaiz contracted with healthcare benefit companies, including private insurers (like

Anthem and Optima) and public insurers (like Medicare and Medicaid), that would pay or

reimburse Perwaiz for his services. To be certified as a “participating provider,” J.A. 626:6, and to

bill for the care he provided, Perwaiz had to enroll (and periodically reenroll) with these insurers.

A colposcopy is a procedure used to examine a patient's cervix that is generally done after

an abnormal Pap smear or human papillomavirus test. J.A. 549:25–550:17.

A hysteroscopy is a procedure used to examine a patient's uterine cavity to detect, among

other things, cancer, fibroids, or polyps. J.A. 562:15-24.

A hysterectomy is an irreversible procedure removing a patient's uterus because of a benign

condition such as uterine fibroids, or a malignant condition such as cancer. J.A. 572:15–

573:2.

During the respective enrollment processes, Perwaiz had to agree to certain terms and conditions

—such as a 30-day waiting period between obtaining a Medicaid patient's signature consenting to

sterilization and conducting the procedure—and to verify certain information—such as listing any

type of adverse employment action that had been taken against him or any felony convictions. And

once these insurers approved Perwaiz's enrollment, they would only reimburse him for services

or procedures that met the appropriate “medical standard of care,” J.A. 523:12-19, and were

“medically necessary,” J.A. 1155:23–1156:2.

In 2018, the FBI received a tip from one of Perwaiz's former colleagues alleging that he had

performed unnecessary surgeries on unsuspecting patients. As the FBI investigated Perwaiz, it

found that this wasn't the first instance of his medical misconduct.

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United States v. Perwaiz, Not Reported in Fed. Rptr. (2024)

In 1983, for example, Maryview Hospital in Portsmouth, Virginia, temporarily terminated

Perwaiz's clinical privileges “due to poor clinical judgment, unnecessary surgery, lack of

documentation, and discrepancies in recordkeeping.” J.A. 7484. The Hospital recited that Perwaiz

performed eleven hysterectomies on patients, “contrary to sound medical judgment.” J.A. 7484–

86. The Virginia Board of Medicine 4 then “[c]ens[u]red” Perwaiz in a separate proceeding based

on these findings, citing a “lack of documentation.” J.A. 7488. The Board didn't recommend any

other disciplinary action, but it noted that his censure would “become part of [his] permanent

record for future reference.” J.A. 7488.

At the time, Virginia's medical licensing authority was called the “Department of Health

Regulatory Boards.”

*2 Perwaiz resumed practicing medicine when Maryview reinstated his privileges. But about a

decade later, he was charged with six counts of federal felony tax evasion. He ultimately pleaded

guilty to two of those counts. The district court sentenced Perwaiz to five years’ probation. Because

of those convictions, the Virginia Board of Medicine briefly suspended Perwaiz's medical license.

Perwaiz once more resumed practicing medicine, operating a solo OB/GYN practice with access

to the operating room at Chesapeake Regional Medical Center. But between 2017 and 2019, he

repeatedly failed to report and falsely denied his earlier disciplinary and criminal history when he

enrolled to be a provider in public and private healthcare benefit programs.

Perwaiz's fraud didn't end there.

First, Perwaiz falsified his pregnant patients’ estimated due dates so that he could induce labor

on a day he had standing operating room time at Chesapeake. Doing so ensured that Perwaiz

was the doctor who performed the deliveries and was therefore the doctor who was paid through

the patients’ insurance coverage. But doing so also meant that many of these elective inductions

occurred before 39 weeks’ gestation—that is, earlier than medically recommended—and without

any “medical indication[s].” J.A. 2247:13. This was contrary to the accepted standard of care, yet

Perwaiz still billed insurance companies for full-term or medically necessary deliveries.

Second, Perwaiz performed and billed for medically unnecessary surgeries, including

hysterectomies, based on fabricated symptoms. He falsely told several patients, for example, that

they had cancer (or would get cancer) and required surgery. He then documented this nonexistent

condition and used it as the basis for performing and billing for the eventual procedure.

Third, Perwaiz billed insurers for in-office diagnostic procedures like hysteroscopies and

colposcopies that (a) weren't performed, (b) were performed in a non-standard way, or (c) were

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United States v. Perwaiz, Not Reported in Fed. Rptr. (2024)

performed with broken instruments. He then routinely used the results from these procedures to

justify other, more invasive surgeries that he also billed for.

Fourth, Perwaiz falsified his Medicaid patients’ sterilization consent forms verifying that he had

abided by the required 30-day waiting period. He had these patients sign blank consent forms

but not date them. He then backdated the forms so that it appeared the patients signed them prior

to 30 days before the surgery. And Perwaiz billed Medicaid for the sterilizations, even when he

performed them within the 30-day period. 5

Several of these patients hadn't even been under Perwaiz's care for 30 days before he

performed the sterilizations.

A superseding indictment charged Perwaiz with committing healthcare fraud and making false

statements related to healthcare matters.

During trial, the government introduced two exhibits containing evidence of Perwaiz's suspension

from Maryview Hospital and his prior felony tax convictions. Perwaiz had moved in limine to

exclude those exhibits under Federal Rules of Evidence 403 and 404. Though the court found

the evidence was reliable, and intrinsic to two counts addressing Perwaiz's failure to disclose

his disciplinary history to a pair of insurance companies (Anthem and Optima), it didn't admit

the exhibits in full. The court allowed only the fact of the suspension and convictions, not the

underlying details. It redacted, for example, Perwaiz's indictment so that the jury saw only the two

charges to which Perwaiz pleaded guilty.

*3 The government introduced over 500 other exhibits and called 55 witnesses at trial. Six

witnesses were former patients who were referenced in the indictment's factual allegations but

weren't subjects of any count. They testified about Perwaiz's falsifying the sterilization consent

forms or falsifying symptoms to bill for unnecessary surgeries. Perwaiz didn't object to their

testimonies at trial. He did, however, testify in his own defense and admitted that he had backdated

the Medicaid sterilization consent forms.

The jury convicted Perwaiz on 23 counts of healthcare fraud and 29 counts of making false

statements in relation to healthcare matters.

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United States v. Perwaiz, Not Reported in Fed. Rptr. (2024)

Before sentencing Perwaiz, the district court considered Perwaiz's presentence investigation

report. The report put Perwaiz's guidelines range at life imprisonment, restricted to the statutory

maximum of 5,700 months’ imprisonment.

The district court also considered the sentencing memoranda Perwaiz and the government

submitted. And it received victim impact statements from over 60 women, many of whom

recounted their physical and emotional trauma. So too did the district court hear that Perwaiz's

fraudulent scheme caused over $18 million in losses to insurers.

At sentencing (as in his sentencing memorandum), Perwaiz maintained his innocence, so

his counsel objected only generally to the guidelines calculation and associated sentencing

enhancements. 6 And they requested no particular sentence. Rather, at sentencing, Perwaiz's

counsel stated that they had “every confidence that the Court will fashion a sentence ... that is

sufficient but not greater than necessary” under the

18 U.S.C. § 3553 factors. J.A. 3569:8-10.

Perwaiz was represented by two lawyers during his trial and sentencing.

Counsel noted, however, that Perwaiz was “71 years old” with “ongoing medical conditions.” J.A.

3569:22. Counsel also explained that Perwaiz had a limited prior criminal history, and that, for his

earlier felony convictions, he had completed his probationary sentence, paid back the funds, made

no effort to flee, and acknowledged his guilt. Counsel concluded by pointing out that Perwaiz no

longer had a medical license and wouldn't return to practicing medicine if he were released from

prison. The government, meanwhile, requested a prison sentence of 600 months (or 50 years).

The district court imposed a 708-month (or 59-year) sentence. It explained that the “nature

and circumstances of the offense and [Perwaiz's] history and characteristics” were the “most

important” factors it considered. J.A. 3571:15-18. The court also described the evidence of

Perwaiz's guilt as “overwhelming,” while chiding him for “abu[sing] the trust” that his patients

had placed in him and that his profession had placed in [him].” J.A. 3572:2, 11. And it noted that

Perwaiz had “expressed no remorse for such a callous disregard for the welfare of [his] patients

and the victims.” J.A. 3572:15-17.

This appeal followed.

II.

Perwaiz brings three challenges to his convictions and sentence. He asserts that during trial, the

district court erred in (1) admitting into evidence the exhibits concerning his suspension from

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United States v. Perwaiz, Not Reported in Fed. Rptr. (2024)

witnesses who weren't named in any count of the indictment. And he claims that during sentencing,

his lawyers were so ineffective that they all but abandoned him.

We address each argument in turn.

We begin with Perwaiz's evidentiary challenges. As he did at trial, Perwaiz mainly contends that the

evidence of his suspension and prior convictions violated the Federal Rules of Evidence because it

was unduly prejudicial and impermissibly went to his character rather than to the conduct at issue.

*4 We will overturn a “district court's decision to admit evidence over a Rule 403 objection”

only “under the most extraordinary circumstances, where [the district court's] discretion has been

plainly abused.” United States v. Williams, 445 F.3d 724, 732 (4th Cir. 2006) (cleaned up).

But evidentiary challenges have an additional—and here, dispositive—backstop: harmless error

review. See United States v. Walker, 32 F.4th 377, 394 (4th Cir. 2022).

“[A]n error is harmless if it's highly probable that it did not affect the judgment.” United States

v. Caldwell, 7 F.4th 191, 204 (4th Cir. 2021) (cleaned up). “The decisive factors to consider are

the closeness of the case, the centrality of the issue affected by the error, and the steps taken to

mitigate the effects of the error.” Id. (cleaned up). There's no dispute then that an error is harmless

“where there is a significant amount of evidence which inculpates a defendant independent of

the erroneous [evidence].” United States v. Johnson, 617 F.3d 286, 295 (4th Cir. 2010); see

also United States v. Scheetz, 293 F.3d 175, 186 (4th Cir. 2002) (finding an error harmless

where, “[m]ost importantly, absent [the error], the government's case against [the defendant] was

overwhelming” (cleaned up)).

Even if we assume the district court erred (which seems unlikely), 7 the evidence against Perwaiz

was overwhelming. Scores of witnesses—former patients and employees, including nurses, billers,

and ultrasound technicians; Chesapeake personnel; OB/GYN and insurance experts; and insurance

company representatives—testified about Perwaiz's fraudulent conduct. And the government

introduced documents to support this testimony and each aspect of Perwaiz's fraudulent scheme.

We're inclined to agree with the government that the challenged exhibits were intrinsic to

the two counts charging Perwaiz with lying to insurers about his disciplinary history.

The government, for example, introduced recordings wherein Perwaiz told a patient that he would

falsify her records for insurance purposes, and misrepresented to another patient that she was

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United States v. Perwaiz, Not Reported in Fed. Rptr. (2024)

suffering from tumors when a subsequent ultrasound found no such tumors. Perwaiz also admitted

at trial to regularly backdating the Medicaid sterilization consent forms.

This evidence related to Perwaiz's present fraudulent scheme and not to his past disciplinary

history. And the district court redacted or otherwise limited the challenged exhibits, mitigating

the prejudicial effect the evidence might have on the jury. As Perwaiz concedes, “[e]vidence that

is highly probative invariably will be prejudicial to the defense.” Appellant's Br. at 24 (quoting

United States v. Grimmond, 137 F.3d 823, 833 (4th Cir. 1998)). The exhibits’ probative value

easily outweighs any potential unfair prejudice.

In short, we have no trouble holding that any evidentiary error by the district court was harmless,

considering the extensive evidence of Perwaiz's fraudulent conduct.

Turning to Perwaiz's second evidentiary challenge against the patient-witnesses’ testimony, we

could reject it too on harmlessness grounds. In any event, Perwaiz all but concedes in his reply

brief that our decision in United States v. Bajoghli, 785 F.3d 957 (4th Cir. 2015), not only controls

this issue but also forecloses his argument on appeal. See Reply Br. at 10–12.

*5 In Bajoghli, which involved a similar healthcare fraud scheme, we held that “the district court

abused its discretion in limiting the government's proof to that which is directly relevant to one

or more of the 53 executions charged in the indictment, without taking into account the relevance

of uncharged conduct to the alleged overarching scheme.” 785 F.3d at 964 (emphasis added). We

explained that “in a large and complex healthcare-fraud case where the defendant's criminal intent

is placed at issue,” uncharged but relevant evidence is “intrinsic to the ‘scheme’ element” and is

therefore admissible. Id. (cleaned up).

The patient-witnesses’ testimony fits squarely within Bajoghli’s holding given that the proof of a

scheme to defraud was a required element of the healthcare fraud counts. The testimony in turn

spoke directly to the existence of such a scheme and was thus intrinsic and admissible. So we can't

find that the district court erred in allowing the testimony.

Finally, we address Perwaiz's argument that his counsel's performance at sentencing was

ineffective. An ineffective-assistance claim is permitted on direct appeal (rather than a motion to

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United States v. Perwaiz, Not Reported in Fed. Rptr. (2024)

vacate under 28 U.S.C. § 2255) only “where it conclusively appears in the trial record itself that the

defendant was not provided with effective representation.” Mandello, 426 F.2d at 1023. Perwaiz

makes no such showing, nor does he attempt to argue that his counsel's performance prejudiced

him.

Relying on United States v. Cronic, 466 U.S. 648 (1984), Perwaiz maintains that his counsel's

performance during sentencing was so deficient that we can presume prejudice. Otherwise,

Perwaiz would have to adhere to the traditional two-pronged showing of deficient performance

and prejudice under

Strickland v. Washington, 466 U.S. 668 (1984).

Cronic permits such a shortcut in limited “circumstances that are so likely to [have] prejudice[d]

the accused that the cost of litigating their effect in a particular case is unjustified.” 466 U.S.

at 658. One such circumstance is the “complete denial of counsel,” where “the accused is denied

counsel at a critical stage of his trial,” or where “counsel entirely fails to subject the prosecution's

case to meaningful adversarial testing.”

Id. at 659.

Cronic’s exception—which results in a structural error—requires “an extremely high showing,”

United States v. Ragin, 820 F.3d 609, 618 (4th Cir. 2016) (cleaned up), and is “exceedingly

narrow,”

United States v. Theodore, 468 F.3d 52, 56 (1st Cir. 2006). To illustrate, we have held

Cronic satisfied where defense counsel slept through substantial portions of the trial. Ragin, 820

F.3d at 620. But even there, the defendant raised his ineffective assistance of counsel claim on a

§ 2255 motion.

Id. at 613.

Here, Perwaiz's lawyers submitted a sentencing memorandum, were present (and awake) during

sentencing, and spoke on Perwaiz's behalf regarding the § 3553(a) factors. Even if (in Perwaiz's

eyes) counsel didn't do enough, he can't argue that they did nothing. At bottom then, any ineffective

assistance rendered by Perwaiz's counsel doesn't “conclusively appear[ ] in the trial record.”

Mandello, 426 F.2d at 1023. Postconviction proceedings are therefore a better vehicle for that

claim.

***

For these reasons, we affirm the district court's judgment. And we dispense with oral argument

because the facts and legal contentions are adequately presented in the materials before this court

and argument would not aid in the decisional process.

AFFIRMED

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United States v. Perwaiz, Not Reported in Fed. Rptr. (2024)

All Citations

Not Reported in Fed. Rptr., 2024 WL 2891327

End of Document

A-9 9

NO. __________________

In the

Supreme Court of the United States

JAVAID PERWAIZ,

Petitioner,

UNITED STATES OF AMERICA,

Respondent.

APPENDIX B

TO PETITION FOR WRIT OF CERTIORARI

TO THE UNITED STATES COURT OF APPEALS

FOR THE FOURTH CIRCUIT

Wesley P. Page

Federal Public Defender

Jonathan D. Byrne

Appellate Counsel

Counsel of Record

OFFICE OF THE FEDERAL PUBLIC DEFENDER

Southern District of West Virginia

300 Virginia Street, East, Room 3400

Charleston, West Virginia 25301

304/347-3350

jonathan_byrne@fd.org

Counsel for Petitioner

Case 2:19-cr-00189-RBS-DEM Document 223 Filed 06/08/21 Page 27 of 58 PageID# 5489

If they don't appear, Your Honor, that is all we have for

victim statements.

THE COURT:

A.M.?

MS. GANTT:

A.M.

THE COURT:

And J.P.?

MS. GANTT:

Yes, ma'am.

That's all I have, Your Honor.

THE COURT:

overflow courtroom?

Have we checked?

COURT SECURITY OFFICER:

Are either one in the

Yes, ma'am.

He just

notified me they weren't in the overflow courtroom.

THE COURT:

A.M. and J.P. are not here.

If you see

them, please let the Court know.

officer in the overflow courtroom, and that individual has

said neither of the two that you have named are in that

courtroom.

There is a court security

Other than the victim impact statements, is there

anything else for the Court to consider, other than the

argument?

MS. YUSI:

No, Your Honor, just argument.

Thank you, Your Honor.

As the Court is aware, the

government is requesting a sentence of 600 months or 50

years for Javaid Perwaiz.

appropriate under the factors of 18 U.S.C. 3553, as well as

it would be a sufficient but not greater sentence than

We believe such a sentence is

JODY A. STEWART, Official Court Reporter

JA3558

B-1

Case 2:19-cr-00189-RBS-DEM Document 223 Filed 06/08/21 Page 28 of 58 PageID# 5490

necessary to achieve the purposes of sentencing.

We understand the defendant is approximately 69 or

71 years old, depending on the date of birth that is being

used, and this is equivalent to a life sentence.

based on the evidence this Court saw at trial, and the

damage the defendant has caused to so many women, and the

complete lack of remorse, Your Honor, we believe 50 years is

entirely appropriate in this matter.

However,

The Court and the jury sat through almost four

weeks of testimony for this case, and I understand the

Court's very aware of the facts underlying the defendant's

convictions, and so we are not going to rehash all of those

that the Court already saw and that are contained at least

in part in the PSR.

But while the government has covered the 3553

factors in its position sentencing paper, we wanted to touch

on a few of the factors the government avers are

particularly compelling.

general deterrence is an important factor which this Court

needs to consider in fashioning a sentence for the

defendant.

As we discussed in our position,

Typically, just by having the title of doctor, you

command respect and trust, and with this trust patients feel

safe, and they understand that their best interests are

being looked after by the doctors or nurses.

Typically,

JODY A. STEWART, Official Court Reporter

JA3559

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patients follow the advice and directions of their

caregivers, knowing it's the right thing for them and their

family.

This case, Your Honor, has turned that concept of

trust on its head.

Not only have the women who were

defendant's patients all started questioning the care by

Dr. Perwaiz, that this case has also been a shock to the

community and public at large, and a call to many to start

questioning the trust that they have had in their doctors

and medical caregivers.

Not only do the victims in this case deserve the

defendant to receive a lengthy sentence of imprisonment, I

believe the community deserves to know that this type of

crime, healthcare fraud, that directly affected the health

and bodies of these women, just for the defendant's

financial gain, will not be tolerated by the Court and the

law.

The community deserves to know that the medical

establishment is not above the law.

The government also

believes the nature and circumstances of the offense and the

history and characteristics of the defendant are extremely

vital in its decision-making on the sentence and believe

that the nature and circumstances of the offense and the

history and characteristics of the defendant go hand in

hand.

JODY A. STEWART, Official Court Reporter

JA3560

B-3

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The only way Javaid Perwaiz was able to get away

with and perpetrate this fraud and damage over so many years

was because of who he is or, rather, who he purported to be.

As for who he purported himself to be, as the Court heard

from the victims at trial and from the defendant himself,

Dr. Perwaiz was extremely confident in his abilities as a

doctor and surgeon.

hours talking about his alleged skills and experience,

bragging about his abilities.

He sat up on that witness stand for

He stated repeatedly that his vast experience

supported all of his medical decisions.

about it.

government about his shortcomings, and when questioned by

Your Honor about why he didn't bother buying a $3 bottle of

vinegar in order to properly perform a colposcopy, he just

stated he didn't need to because he knew better because of

his vast experience.

He was unequivocal

He even became indignant when questioned by the

As for who Javaid Perwaiz really is, he was a

master manipulator.

were sick or that they had cancer or that they were going to

get cancer or that the baby was ready to be born or that

they would be able to have more children if they let him

sterilize them.

He would lie to these women that they

Then what he actually did, he would take these

women, perform unnecessary surgeries on them, remove organs,

JODY A. STEWART, Official Court Reporter

JA3561

B-4

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take away their ability to have children, put them at risk

for infection and complication, put their babies at risk by

forcing them to be born too early.

Honor, the government is going to rely on what these women

have told the Court about what happened to them and how they

feel, which is far more powerful than anything the

government can say today.

What it caused, Your

What the 63 women who wrote impact statements to

the Court, and the women who spoke in terms of the damage

the defendant has caused to them, is just stunning, Your

Honor.

crime that caused physical and emotional damage to countless

women, and some women have permanent damages to their

bodies.

the bathroom ever again without being reminded of what

Javaid Perwaiz did to them.

because of the physical pain due to these unnecessary

surgeries and procedures, and emotionally, as the Court has

heard, many of the victims are now questioning the entire

medical establishment.

They don't trust what they're being told is true anymore by

the doctors.

This is not clearly a monetary crime.

They can't have more children.

This was a

They can't go to

Some can't be intimate anymore

They're scared to go to doctors.

One question that got there is why did the

defendant do all of these things?

The easy answer is that

the defendant wanted to make as much money as possible.

JODY A. STEWART, Official Court Reporter

JA3562

B-5

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wanted to continue to buy and have luxurious cars, expensive

watches, nice clothes, sunglasses, jewelry, to keep his

paramours comfortable.

and out greed.

He committed these crimes due to all

But, Your Honor, the government believes the better

question to ask is how could he do these things?

crime to be arrogant, it's not a crime to want nice things,

but it is a crime to be so callous in greed that you

repeatedly lie to women's faces, tell them there is

something wrong with them, scare them into agreeing to

surgeries and procedures or early birth, lying to insurance

companies, all for money or the feeling of power and

complete disregard for the fact that these are human beings.

It's not a

From the jail calls that this Court has heard

during trial and knows about from our position paper, the

defendant appears to have an actual general disgust for

these women who were his patients, who he claimed to be

helping for decades.

maintaining his innocence.

innocence and still feel empathy or at least a general

recognition for these women's lives and feelings, and not

the defendant.

Not once did the defendant admit that he did

something wrong.

Not once did he pause to consider that

what he revealed as skilled and experience was actually

reckless, dangerous, and criminal.

I understand that the defendant is

However, you can maintain your

JODY A. STEWART, Official Court Reporter

JA3563

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Your Honor, if the defendant was allowed to go out

that door today, he has shown that he would go right ahead

and continue these crimes today.

that be a possibility.

during trial, and he blamed his former partners from the

1980s for his problems then.

throughout his practice for his continued problems.

blamed the hospitals.

he turned the mirror on himself, nor does the government

ever expect him to do so.

can listen to the evidence and hear from these women and not

think twice or feel anything.

The sentence cannot let

Javaid Perwaiz stood on that stand

He blamed jealous doctors

He blamed the victims.

Not once had

It's just unfathomable how anyone

I understand, and the government understands, that

a long sentence of imprisonment will not heal these women or

solve all of these problems, Your Honor, but perhaps it can

at least help with the healing process.

Honor, we believe that a sentence of 600 months is

appropriate in this matter.

Thank you.

THE COURT:

Therefore, Your

When you say 600 months, Ms. Yusi, but

a Court just doesn't say 600 months.

You've got a number of

counts here, and so you set forth just a number, 600 months.

There are counts, and they involve different matters.

Court can't sentence or just say under federal law you get

600 months.

So a

The statutory maximum is 240 months on counts

JODY A. STEWART, Official Court Reporter

JA3564

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8, 14 through 16, 18 through 22 and 24, and the maximum is

120 months on each of the counts 1 through 7, 9, 10, 17, 23,

25 and 26, and there is a five-year maximum on the remaining

counts of making the false statement, five years on making a

false statement on healthcare.

So when a Court sentences, and as far as I'm

concerned, every human being that is part of this case,

particularly those for which the jury found beyond a

reasonable doubt that they were a victim and found that some

were a victim that incurred serious bodily injury, so there

has to be some distinction made because a Court can't just

go in and blanket sentence.

say this also so that the victims and individuals

understand.

together, that the sentence be 50 years.

You have to separate them.

I know you're asking, when you do all of that

MS. YUSI:

Yes, Your Honor.

I understand that.

apologize that we did not break it out further, Your Honor.

What the government was trying to do was compare some of the

white collar cases, which this is technically a white collar

case and what the court and courts have provided and what

the government had asked for for that compared to drug

sentences, compared to child exploitation sentences, and

looking at that as a whole as to what we believe would be

sufficient, Your Honor, and I apologize for not breaking it

down between the different counts.

JODY A. STEWART, Official Court Reporter

JA3565

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THE COURT:

I know that it may be confusing for

some, but the guidelines here set forth different amounts of

years, as I've indicated, and if you look at the guidelines

as calculated, and this would be difficult, I know, for many

people to understand, but if you look at the guidelines, and

they were calculated without what's called a restricted

range, it would be life in prison.

I just said what the maximum sentence is, 240 months on

certain counts, 120 months on certain counts, five years on

certain counts.

record and for those involved in the case, it may sound

strange, but a sentence for a term of months or years under

the law is considered below a sentence of life.

However, under the law,

Given that, I want to make it clear on the

So, consequently, a Court can never sentence an

individual for longer than the statutory maximum.

So even

if you did a full guidelines calculation here, it would come

out to life in prison.

a statutory maximum of years, and even though ultimately it

well may work out to a life sentence, you still have to

render it in terms of years or months and not life.

Each of the counts themselves carry

I just want that to be clear so everyone realizes

his offense level is 43 with a criminal history category of

one.

maximums for each, which life is not one of them, but you're

arguing for, in effect, life.

We start the sentencing, and I just read the statutory

JODY A. STEWART, Official Court Reporter

JA3566

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MS. YUSI:

That's correct, Your Honor.

THE COURT:

You compared in your position papers, I

think you referred to the Madoff case as well as to another

physician.

MS. YUSI:

Dr. Fata.

THE COURT:

Dr. Fata.

was sentenced to 45 years.

MS. YUSI:

I believe in Fata's case he

He was, Your Honor, and pled guilty

through a plea agreement and did not go to trial.

THE COURT:

Exactly.

You pointed out those

differences, that he pled guilty, he did not go to trial.

Again, his guideline sentence would have been life but for

the statutory maximums in years on each of the counts.

was sentenced to 45 years.

should receive a higher sentence than that because Dr. Fata

pleaded guilty and did express remorse for his crimes.

You argued that Dr. Perwaiz

So, consequently, for Dr. Perwaiz, there should be

some consideration for the lack of remorse and putting the

victims through what they've been through.

you argue for that higher sentence.

Madoff case, and I'm saying a lot of this to help whoever is

arguing, Ms. Munn, Mr. Woodward, the argument was that it

didn't make sense in the Madoff case to sentence somebody

beyond their life expectancy.

Consequently,

Then I believe on the

I believe Judge Chin was the judge there who

JODY A. STEWART, Official Court Reporter

JA3567

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indicated that you had to follow the law and sentence in

terms of years, even though you realize it's past the life

expectancy, because it also carries a symbolic message of

deterrence to anyone else inclined, as well as to vindicate

the victims.

So I did read the two transcripts, although they're

different cases, and they're different sentencing, but you

argued them to avoid unwarranted sentencing disparity.

You've cited the Madoff case and the Fata case.

MS. YUSI:

I did, Your Honor.

THE COURT:

Ms. Munn.

MS. MUNN:

Thank you, Judge.

Thank you.

At the outset I will

say that Dr. Perwaiz and Mr. Woodward and myself stand on

its position paper.

and the Court has acknowledged, reserve his right to

maintain his innocence, and I will say that his lack of

testimony today, and I expect his lack of allocution to the

Court, is in no way affront to the Court's authority or

disrespect to the Court.

He does, as the government mentioned,

To the contrary, he would acknowledge his respect

for the system and for the process.

fact that the Court gave him the right to proceed to trial

and to assert his innocence, which is his constitutional

right.

He is grateful for the

The Court was committed to providing him with a

JODY A. STEWART, Official Court Reporter

JA3568

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safe trial during a very difficult time in this courthouse

and in the United States.

The Court provided him with a

trial.

He testified.

ability and exerted his right to confront his accusers, and

he is grateful for that process and for the Court's

commitment to that.

We brought a jury.

He had the

I would note that while Mr. Woodward and

Dr. Perwaiz and I have every confidence that the Court will

fashion a sentence, understanding all of that, that is

sufficient but not greater than necessary pursuant to 18

U.S.C. 3553, I would note that it's impossible for us to

compare to other cases, given that all cases that are tried

in courts are so fact specific.

transcripts for Dr. Fata or for Mr. Madoff.

We don't have the trial

Both of those cases were high publicity, but

Dr. Perwaiz nor Mr. Woodward and I were able to watch those

victims testify to understand what evidentiary objections

there were pretrial or during the trial.

for us to make an argument about where Dr. Perwaiz's

sentence should fall among two other unrelated cases with

very different facts and very different testimony.

What we can note for the Court is that Dr. Perwaiz

is 71 years old.

He does have no prior criminal history.

So it's difficult

He does have ongoing medical conditions.

THE COURT:

He does have the one conviction in this

JODY A. STEWART, Official Court Reporter

JA3569

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court for tax evasion.

MS. MUNN:

Yes, ma'am.

That's correct.

complete that probationary period.

funds to the United States.

avoid that process.

it.

believed he was guilty, and he agreed.

He did

He did pay back the

He made no effort to flee or to

He faced that obligation and satisfied

He acknowledged his guilt in a case for which he

I would say that, to respond to Ms. Yusi's argument

that if Dr. Perwaiz were allowed to walk out this door there

is every indication that he wouldn't stop, I would note for

the record today, Your Honor, that Dr. Perwaiz has no

license to practice medicine.

or attempted to do so since he was taken into custody.

been in jail since November of 2019.

He has not practiced medicine

He's

There is no expectation, and I will just say that

I'm sure the Court -- this should go without saying, but

there is no expectation if Dr. Perwaiz were released from

custody at any point that he would resume the practice of

medicine.

has no malpractice insurance.

practice.

believe that he wouldn't follow the terms of probation as he

did in the tax case.

He will have no offices.

He has no staff.

He has no license to

There is no reason, based on his history, to

So, Judge, again, I would just stand on our

position paper.

I would tell you that Dr. Perwaiz is

JODY A. STEWART, Official Court Reporter

JA3570

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grateful for the opportunity to proceed to trial.

preserve all of his objections and his right to appeal to

the Fourth Circuit, and does preserve his innocence, as is

his right.

He does

Thank you.

THE COURT:

Dr. Perwaiz, is there anything you'd

like to say before the Court pronounces sentence?

THE DEFENDANT:

THE COURT:

No, Your Honor.

In sentencing you, Dr. Perwaiz, as the

Court does in every federal sentencing, it has to follow the

federal criminal sentencing statute for imposition of

sentence, and that is found at 18 United States Code Section

3553(a), and the Court has to consider the factors

thereunder to determine a sentence that is sufficient but

not greater than necessary.

The first factor under this statute is the nature

and circumstances of the offense and your history and

characteristics as a defendant.

factor is one of the most important for the Court to

consider in this case.

of the victims, but I was the trial judge, and so I heard

the victims testify upon which the convictions are based.

Obviously, this particular

I'm not going to go back through all

There have been 63 victim impact statements

submitted to the Court, and the victims that testified here

today, there have been four more that did not submit victim

impact statements.

There have been e-mails that were

JODY A. STEWART, Official Court Reporter

JA3571

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attached to the position paper.

There were 12 from former

patients who believe they are victims.

the number of victims, the procedures that were performed,

and the healthcare fraud that was perpetrated not only upon

the victims but upon the insurance entities and the public

because ultimately when there is this kind of fraud and

action, the victims are not only the individuals and the

healthcare providers but the public.

position of trust that you were in and you had, I agree with

the United States, that it's particularly difficult because

you abused the trust that your patients had placed in you,

that your profession had placed in you.

it is a very serious matter.

It's overwhelming

Because of the

So, consequently,

It's a bit overwhelming to encounter a defendant

that has expressed no remorse for such a callous disregard

for the welfare of the patients and the victims.

no remorse for these patient victims but also the only

reason that one can determine from all of this is that it

was done for greed and to enhance a very lavish lifestyle.

In the Court's mind this conduct is simply unconscionable.

I do agree that there is no way for many of these

Not only

victims to recover their certain losses, but each human

being has dignity and worth, and, hopefully, they will be

able to go on and recover in the long run their dignity and

at least their mental well-being.

JODY A. STEWART, Official Court Reporter

JA3572

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The nature and circumstances of the offense are

overwhelming.

Your history and characteristics as a

defendant, it's disturbing to the Court that you had this

tax conviction in this court, I was not the judge, but that

you had this tax conviction that was a fraudulent

conviction.

probationary sentence, and you got through that, but the

Court still looks at your criminal history.

your history and characteristics as a defendant.

So even then, I know that you served your

That's part of

Then this case involves falsified hysteroscopies

and colposcopies and procedures that weren't necessary and

that were physically damaging to individuals.

to go back through all the trial evidence and the

presentence report, which re-captures it, and all of the

victims' statements, but you falsified patient symptoms,

their diagnosis.

point that they were willing to subject themselves to

unnecessary surgery that prevents them from ever proceeding

naturally and normally with their life in terms of their

child-bearing and their other incidents of life.

I'm not going

You gave people false cancer scares to the

You falsified the sterilization consent forms.

You

not only did that, but you misrepresented on provider

applications.

this, it's tremendous.

it's over $18 million that's in restitution, $18,563,323.18.

So, consequently, when you look at all of

You look at the restitution here,

JODY A. STEWART, Official Court Reporter

JA3573

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I'll get to the restitution in a moment, but the

overwhelming amount of fraud at every point in the process

from representations to victims to falsifying forms to

making the statements to providers, all of that goes into

this crime.

repetitive over so many years.

many counts involved in this case.

go through it count by count in terms of the sentencing.

It's also sad that you were able to come to this

So it wasn't a one-time occurrence.

It was

That's why there were so

When I sentence, I will

country and then not take advantage of education or the

medical profession here to practice your profession with

honesty.

difficult circumstances, and you came here, and you achieved

at what other people would look at as great levels of

success.

lot of this fraud and the actions that you were taking.

Yes, you came from a difficult background and

The sad thing is that this success was hiding a

So I just can't overlook the length of time, the

number of victims, the depth of the fraud, the depth of the

misrepresentation not only to the patients but for

reimbursement, and then no remorse at all.

I think this was something that the United States

wrote in the position paper, with which I agree, you acted

"without remorse or hesitation" and you "lied to the Court

and the jury and blamed everyone but yourself," and you

still continue to do that.

You blame everybody else but

JODY A. STEWART, Official Court Reporter

JA3574

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yourself.

that anyone can determine, was for financial gain to fund a

lavish lifestyle, and there doesn't seem to be any motive

for good.

Court.

The only motive, as the United States put forward

Consequently, that is very disturbing to the

Moving on to some other factors is the seriousness

of the offense.

I won't belabor that.

I can't imagine

anything more serious than performing these procedures that

result in bodily harm to an individual, and the jury found

that beyond a reasonable doubt on certain counts.

You have not shown respect for the law in terms of

the false information that you've put on forms, your lack of

remorse.

and to persist in the not guilty plea, but a Court sentences

you based upon the trial and the jury's verdict, and that's

where we are now.

You are, obviously, entitled to plead not guilty

You do have to be justly and properly punished with

a sentence that is sufficient but not greater than

necessary.

that deterrence here is a very important factor.

to be deterrence for you, to protect the public from you for

further crimes, but also deterrence in terms of the

professional obligations that doctors, all professionals

have when someone comes to you, and they put their trust in

you.

The Court has to look at deterrence, and I agree

You're in the position of trust.

There has

Rather than treating

JODY A. STEWART, Official Court Reporter

JA3575

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them honestly and legitimately, you engage in criminal

conduct.

tolerated from anyone, but they're licensed professionals,

and they're licensed in states, and they are licensed in

their profession.

That can't be tolerated.

It shouldn't be

When you go to someone, you should be able to rely

on that professionalism and that licensure.

So I do have to

look at deterrence here.

Greed can't overcome your professional ethics, your

professional creeds, and the law.

very important.

It's a very important factor.

That's something that is

The Court does have to look at any needed

rehabilitation or medical care, and certainly I will direct

that while he is incarcerated that he undergo a full medical

and mental health evaluation and receive any and all

appropriate medical care and any and all appropriate mental

health counselling.

I also have to look at all of the kinds of

sentences available, and I'll go through that in a moment.

I do have to look at the victims involved, and that is a

very important aspect of this case.

I do have to be aware

of unwarranted sentencing disparity.

It's very difficult

because, thankfully, there are not that many cases that

would be comparable.

mean, most comparable in terms of what occurred factually

I agree with what Ms. Munn said, I

JODY A. STEWART, Official Court Reporter

JA3576

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would be Dr. Fata's case, but there were differences there

in pleading guilty and showing remorse, not that you have

to, but those are factors that both Ms. Munn and

Mr. Woodward and any of the lawyers in the courtroom know

about is acceptance of responsibility.

important factor in determining a sentence under the

guidelines and also for rehabilitation purposes in the long

run.

That is a very

So with all that being said, I've indicated the

statutory maximums on this, but I would say if all of the

sentences were running consecutive, which they could run

that way, it would be 5,700 months or 475 years.

note that.

that, and I will sentence and explain my sentence as I go

along.

So I would

Now, I know the United States is not asking for

As I indicated earlier, a life sentence, while that

certainly is more than any life sentence, life under the law

is considered a different sentence than a sentence in years.

I won't go back through that again.

on the various counts, I do have to indicate the amount of

years or months.

But in sentencing you

So I will go through my sentences.

I'll start with

the healthcare fraud sentences, and I will say the counts on

the healthcare fraud sentence.

sentence there is 120 months on a count.

The maximum statutory

On the healthcare

JODY A. STEWART, Official Court Reporter

JA3577

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fraud counts, count 1 is the healthcare fraud relating to

patient A.B., I impose the 120 months maximum sentence

there.

With respect to count 2, healthcare fraud relating

to patient C.L., I impose a sentence of 120 months.

Count 3, with respect to the healthcare fraud

relating to L.R., I impose a sentence of 120 months.

Count 4, with respect to count 4, this is the

healthcare fraud relating to A.C., again, 120 months or ten

years.

With respect to count 5, the healthcare fraud

relating to H.M., 120 months or ten years.

With respect to counts 6, healthcare fraud relating

to patient B.P., I impose 120 months or 10 years.

With respect to count 7, healthcare fraud relating

to A.B., I impose -- that's a different -- I know there are

two A.B. initials here, but we made that clear during the

trial.

MS. GANTT:

Your Honor, counts 1 and 7, as Your

Honor may recall, is the same individual but she had two

deliveries.

THE COURT:

That's right.

MS. GANTT:

There is an A.M.B. later.

THE COURT:

I know there are two there, but I'm

Okay.

only going to use initials here.

JODY A. STEWART, Official Court Reporter

JA3578

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Count 7, healthcare fraud relating to A.B., again,

120 months or ten years.

With respect to count 9, healthcare fraud relating

to patient A.N., that would be 120 months or ten years.

With respect to count 10, healthcare fraud relating

to A.M.B., that would be 120 months or ten years.

With respect to count 17, healthcare fraud relating

to patient S.N., that would likewise be 120 months or ten

years.

Count 23, with respect to that count of healthcare

fraud as to patient A.F., that would be 120 months or ten

years.

With respect to count 25, healthcare fraud relating

to L.G., that would be 120 months or ten years.

With respect to count 26, healthcare fraud relating

to L.G., that would be, again, 120 months or ten years.

I would run all of those 10 years concurrently.

it will be 120 months or 10 years running concurrently on

the counts that I just went through, 1 through 7, 9 through

10, 17, 23, and 25 through 26.

Now in regard to the counts that were healthcare

fraud that the jury found unanimously that the healthcare

fraud resulted in serious bodily injury, and the maximum

sentence on those counts are 240 months on each count or 20

years.

JODY A. STEWART, Official Court Reporter

JA3579

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On count 8, with respect to the healthcare fraud

relating to patient W.B. resulting in serious bodily injury,

I impose a sentence of 240 months or 20 years.

On count 14, with respect to healthcare fraud

relating to patient M.F., which also the jury found

unanimously resulted in serious bodily injury, I impose the

20 years, 240 months.

With respect to count 15, that's the healthcare

fraud relating to patient D.P., which also the jury found

resulted in serious bodily injury, I impose the 20 years or

240 months.

Count 16, with respect to healthcare fraud relating

to patient D.P., which the jury found resulted in serious

bodily injury, I impose a sentence of 240 months or 20

years.

With respect to count 18, that was the healthcare

fraud relating to patient S.N. in which the jury also found

it resulted in serious bodily injury, I impose 240 months or

20 years.

With respect to count 19, that's the healthcare

fraud with W.H.W., which the jury unanimously found resulted

in serious bodily injury, I impose the maximum of 240 months

or 20 years.

With respect to count 20, the healthcare fraud

relating to patient A.G., which the jury unanimously found

JODY A. STEWART, Official Court Reporter

JA3580

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resulted in serious bodily injury, I impose 240 months or 20

years.

With respect to count 21, that's the healthcare

fraud relating to patient A.G., which the jury further found

resulted in serious bodily injury, I impose the maximum

sentence of 20 years or 240 months.

With respect to count 22, which is the healthcare

fraud relating to patient Y.S., which the jury found

resulted in serious bodily injury, I impose a sentence of 20

years or 240 months.

With respect to count 24, which was the healthcare

fraud relating to patient N.B., which the jury also found

resulted in serious bodily injury, I again impose the 240

months or 20 years.

In respect to these counts, which would be counts

8, 14 through 16, 18 through 22 and 24, those sentences

would run concurrently for the 240 months or 20 years.

Now I'm going to sentence on the counts of making a

false statement.

This would be count 27, which is the false

statement relating to healthcare matters to patient D.W.,

count 28 with respect to false statements relating to

healthcare matters to patient T.T., count 29 with all of

these are making false statements, and this would relate to

patient A.P.C., count 30 is a false statement relating to

healthcare matters for patient T.C., count 31 is a false

JODY A. STEWART, Official Court Reporter

JA3581

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statement relating to healthcare false statement with

patient A.B., count 33 is making false statement related to

healthcare matters for patient L.R., count 34 is with

respect to a healthcare false statement relating to patient

A.C., count 35 is with respect to making the false

statements relating to patient H.M., 36 is with respect to

making the false statements related to healthcare matters

for patient B.P., count 37 is with respect to making a false

statement relating to healthcare matters for patient A.B.,

Count 38 is with respect to making a false statement related

to healthcare matters for patient W.B., is with respect to

count 39, that's false statement related to healthcare

matters for patient A.N., count 40 is making a false

statement related to healthcare matters for patient A.M.B.,

Count 44 is with respect to making the false statement

related to healthcare matters relating to patient M.F.,

Count 45 is with respect to making false statement related

to healthcare matters for patient D.P., count 46 is with

respect to making a false statement relating to healthcare

matters for patient D.P., Count 47 relates to false

statement for healthcare matters for patient S.N., count 48

is with respect to making a false statement relating to

patient S.N., count 49 is with respect to making a false

statement for patient W.H.W., count 50 is with respect to

making a false statement on the healthcare matters related

JODY A. STEWART, Official Court Reporter

JA3582

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to patient A.G., count 51 is with respect to making a false

statement relating to healthcare matters for patient A.G.,

count 52 is with respect to making false statements on

healthcare matters with regard to patient Y.S., count 53 is

with respect to making a false statement related to

healthcare matters for patient A.F., count 54 is with

respect to making a false statement on healthcare matters

relating to N.B., and count 55 is with respect to making

false statements regarding patient L.G., count 56 is in

respect to making false statements in regard to patient

L.G., count 57 is with respect to making a false statement

on healthcare matters relating to patient D.B., count 58 is

with respect to making false statements related to

healthcare matters to an attestation to Anthem, and count 59

is with respect to making false statement related to

healthcare matters to attestation to Optima.

On those counts, that should be 29 counts, and

those are counts 27 through 31, 33 through 40, and 44

through 59, I impose a sentence of 12 months or one year for

each of the false statements counts, but that is to run

consecutively.

making the false statements.

So that would be a total of 29 years on

So in summary, the sentence is one of 708 months,

which is 59 years incarceration.

It would consist of the

240 months on the counts, and I say this repeatedly, I want

JODY A. STEWART, Official Court Reporter

JA3583

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to be sure that the clerk can get all of this down, but the

240 months on all of the counts that were related to the

healthcare fraud in regard to the patients that resulted in

serious bodily injury, and the 120 months is related to the

patients that had the healthcare fraud relating to them are

to run consecutively.

concurrent with each other but consecutive to the other

sentences.

but consecutive each other and to the other sentences.

29 years, one year on each of these healthcare frauds,

making a false statement, is consecutive to the other

sentences.

is 59 years when they are served consecutively in the three

different groups; concurrent within the first group,

concurrent within the second group, consecutive within the

third group, but each group is consecutive to the other.

that is the sentence itself, a total of 708 months or 59

years.

In other words, so the 120 months are

The 240 months are concurrent with each other

The

So that is a total sentence of 708 months, which

In terms of supervised release, there will be the

maximum of three years on each count of conviction, all to

be served concurrently.

recommended a fine because of the restitution amount, the

special assessment, and the forfeiture, which I will go

through.

The probation officer has not

I do waive the cost of the prosecution and the

JODY A. STEWART, Official Court Reporter

JA3584

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incarceration.

release in the case, the defendant will have to bear the

costs of any programs he's on if he's on supervised release.

To the extent that there is any supervised

In terms of the restitution, I will enter that

order that has been presented to the Court.

This is for

restitution in the total amount of $18,563,323.18.

interest is waived.

under the statute on this amount of money.

asked for it not to be waived; is that correct?

The

That is very difficult to calculate

You haven't

MS. YUSI:

Correct, Your Honor.

THE COURT:

I'm going to set the payments.

Right

now they are set at 1,000 a month.

Again, I don't know if

this will be able to be paid given the other, but I'm going

to set them at a thousand a month or 25 percent of net

income, whichever is greater.

after release from any period of confinement; however,

obviously, while you're incarcerated, it's subject to the

inmate financial responsibility program.

full amount of the restitution.

by the defendant and the attorneys.

the restitution will be paid to Optima and Anthem on a pro

rata basis, and TRICARE and Medicare and Medicaid then on a

pro rata basis.

for Optima, Anthem, Medicaid, Medicare, and TRICARE are

listed as an attachment to the order.

That would begin 60 days

I do order the

I believe that it's signed

Everyone agrees that

So that's all set forth in the restitution,

JODY A. STEWART, Official Court Reporter

JA3585

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NO. __________________

In the

Supreme Court of the United States

JAVAID PERWAIZ,

Petitioner,

UNITED STATES OF AMERICA,

Respondent.

APPENDIX C

TO PETITION FOR WRIT OF CERTIORARI

TO THE UNITED STATES COURT OF APPEALS

FOR THE FOURTH CIRCUIT

Wesley P. Page

Federal Public Defender

Jonathan D. Byrne

Appellate Counsel

Counsel of Record

OFFICE OF THE FEDERAL PUBLIC DEFENDER

Southern District of West Virginia

300 Virginia Street, East, Room 3400

Charleston, West Virginia 25301

304/347-3350

jonathan_byrne@fd.org

Counsel for Petitioner

Case 2:19-cr-00189-RBS-DEM Document 203 Filed 05/18/21 Page 1 of 20 PageID# 2190

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This is a copy of a public record, reproduced as it was published. It is not legal advice, and it may not be the version a court would rely on. Check the official source before you cite it.