In United States v. Enriquez, --- F.4th ---, No. 23-4424 (9th Cir. 2025), the Court affirmed the denial of Enriquez’s motion to dismiss an indictment charging him with conspiracy to receive healthcare kickbacks in violation of 18 U.S.C. § 371 and receiving prohibited payments in violation of the Anti-Kickback Statute (AKS). Here are some important points from the opinion:
On appeal, Enriquez contends the district court erred in denying his motion to dismiss the indictment because it failed to state an offense or, alternatively, was insufficiently specific. Both arguments rely on expanding the reach of Ruan v. United States, 597 U.S. 450 (2022), which held that Controlled Substances Act (“CSA”) Section 841’s exception for authorized prescriptions must be proven beyond a reasonable doubt. Enriquez argues that under Ruan’s logic, any “facially applicable” exception must be treated as a “quasi-element” and alleged in the indictment. More specifically, he argues that because his indictment alleged an employee-employer relationship, the government was required to plead facts alleging why the AKS bona fide employment relationship safe harbor did not apply. Because his indictment failed to allege the safe harbor’s inapplicability, Enriquez argues, the indictment failed to state an offense and the district court therefore erred by denying his motion to dismiss the indictment. We disagree that Ruan supports Enriquez’s position, and we affirm the denial of his motion to dismiss.Congress chose to include each AKS safe harbor in a subsection full of statutory exceptions distinct from the prohibited conduct specified in Sections 1320a7b(b)(1) and (b)(2). That choice is consequential because it puts the AKS within the “settled rule” that statutory exceptions are treated as affirmative defenses when they are contained in “a proviso or other distinct clause, whether in the same section or elsewhere[.]”[C]ourts have repeatedly concluded that the AKS’s bona fide employment relationship safe harbor is an affirmative defense[W]e read Ruan’s holding more narrowly than Enriquez suggests. Ruan does not treat Section 841’s authorization exception “like an element” for every purpose.[E]ven if Ruan (and not just Ninth Circuit precedent) required the government to allege Section 841’s authorization exception in an indictment, the same does not follow for the AKS’ safe harbors, which no court has ever deemed to be an element or a “quasi-element” of the statute.We decline to extend Ruan to (a) the AKS and (b) pleading requirements. Because Ruan provides no reason to stray from the bedrock principle that indictments need not allege affirmative defenses, McKelvey, 260 U.S. at 357, we affirm the denial of Enriquez’s motion to dismiss for failure to state an offense.An indictment must satisfy certain minimal standards of specificity to avoid being dismissed under Rule 12(b)(3)(B)(iii). Even if an indictment has pled each of an offense’s essential elements, it still lacks requisite specificity if it “fails to allege sufficient facts to facilitate the proper preparation of a defense and to ensure that the defendant[] [is] prosecuted on facts presented to the Grand Jury.”“The test for sufficiency of the indictment is not whether it could have been framed in a more satisfactory manner, but whether it conforms to minimal constitutional standards.”Because all elements of the conspiracy crime were pled in adequate detail, we affirm the district court’s denial of Enriquez’s motion to dismiss the indictment for insufficient specificity under Rule 12(b)(3)(B)(iii).We find no reason to stretch Ruan beyond its logical limits. Because the government is not required to plead affirmative defenses in an indictment, and it pleaded all elements of the conspiracy offense in detail, count nine of the indictment was sufficient. Accordingly, the district court properly denied Enriquez’s motion to dismiss for failure to state an offense and lack of specificity.
