## Facts

- The United States filed a criminal case against Dr. Krishnaswami Sriram alleging mail fraud and health-care fraud connected to Medicare billings.
- In connection with the criminal matter, the government filed a parallel civil action seeking equitable relief, including an injunction under 18 U.S.C. § 1345 to stop ongoing fraud and to preserve assets allegedly derived from the fraud.
- The civil complaint sought, among other remedies, False Claims Act relief (civil penalties and treble damages) and common-law recovery theories (including unjust enrichment and fraud), along with injunctive relief to prevent dissipation of proceeds.
- On August 16, 2000, the court entered an ex parte temporary restraining order that barred further fraudulent activity, required preservation of records, and froze multiple assets, including several bank accounts and three parcels of real estate that the government valued collectively at more than $4 million.
- The government later amended its civil complaint to increase the amount of alleged fraudulent Medicare receipts to at least $1,651,527.05.
- The court held an evidentiary hearing on the government’s request to convert/extend the TRO into a preliminary injunction continuing the prohibition on fraudulent billing and maintaining an asset freeze.
- The government’s evidence included Medicare billing data and witness testimony suggesting billing for services not provided, billing patterns so high that they were not realistically possible, and claims submitted for services allegedly rendered to patients who were deceased.
- Before the civil preliminary-injunction hearing, the government notified the defense that it intended to call Dr. Sriram’s wife, Ms. Sriram, as a witness.
- The government refused to assure that it would not use Ms. Sriram’s testimony (or information derived from it) in the related criminal case; Ms. Sriram invoked the federal spousal testimonial privilege and declined to testify adversely against her husband.

## Issues

1. Whether the government met the requirements for a preliminary injunction under 18 U.S.C. § 1345 and Rule 65 to bar future Medicare fraud and continue freezing assets tied to the alleged fraud.
2. What amount of Dr. Sriram’s assets could be frozen based on the government’s showing that particular assets were traceable to proceeds or profits of the alleged Medicare fraud.
3. Whether Ms. Sriram could be compelled to provide adverse testimony in the civil preliminary-injunction hearing when her testimony could be used, directly or indirectly, in the parallel criminal prosecution and the government would not provide assurances against such use.

## Decision

- The court granted the government’s motion for a preliminary injunction in substantial part.
- The court enjoined Dr. Sriram from submitting false or fraudulent claims to Medicare and from related conduct that would continue the alleged scheme.
- The court continued an asset freeze but limited the freeze to $1,651,527.05, the amount the court found sufficiently supported as traceable to the alleged fraud on the record developed at the hearing.
- The court did not compel Ms. Sriram to give adverse testimony against her husband at the civil injunction hearing after she invoked the spousal testimonial privilege and the government declined to provide protection against use of the testimony in the criminal case.

## Legal Principles

- A preliminary injunction under Rule 65 requires a showing that supports equitable relief, including a strong merits showing, risk of harm absent relief, a favorable balance of harms, and consistency with the public interest.
- Under 18 U.S.C. § 1345, the United States may seek injunctive relief to stop health-care fraud and may obtain an order restraining property that constitutes, or is derived from, proceeds or profits of the alleged fraud.
- An asset freeze must be tied to a supported amount of fraud proceeds; the government must present evidence permitting the court to identify and quantify assets traceable to the alleged scheme, rather than freezing property without a supported connection.
- Federal privileges are governed by federal common law through Federal Rule of Evidence 501; recognized marital privileges include the adverse spousal testimonial privilege and the marital communications privilege, with distinct rationales and scope.
- When the government seeks adverse spousal testimony in a civil proceeding that is closely connected to a pending criminal prosecution, and refuses to assure that the testimony (or its fruits) will not be used in the criminal case, the spousal testimonial privilege may bar compelled testimony to prevent an end run around the privilege.

## Conclusion

In *United States v. Sriram*, the court issued a preliminary injunction under 18 U.S.C. § 1345 prohibiting further fraudulent Medicare billing and continued an asset freeze, but limited the frozen amount to $1,651,527.05 based on traceability evidence; the court also allowed Dr. Sriram’s wife to refuse adverse testimony at the civil hearing under the spousal testimonial privilege given the parallel criminal prosecution and the government’s refusal to restrict criminal use of her testimony.


United States v. Sriram, 2001 WL 59055 (2001)