United States v. Njoku

United States Court of Appeals
for the Fifth Circuit
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No. 25-20374
Summary Calendar
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United States of America,

Plaintiff—Appellee,

versus

Paul Njoku,

Defendant—Appellant.
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Appeal from the United States District Court
for the Southern District of Texas
USDC No. 4:21-CR-37-1
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Before Haynes, Graves, and Ramirez, Circuit Judges.
Per Curiam:
*

Paul Njoku was convicted of conspiracy to commit Medicare fraud,
making false statements in matters involving Medicare, and aggravated
identity theft. He argues for the first time on appeal that the evidence was
insufficient to support his conviction for aggravated identity theft.

*
This opinion is not designated for publication. See 5th Cir. R. 47.5.
United States Court of Appeals
Fifth Circuit
FILED
August 18, 2026

Lyle W. Cayce
Clerk
Case: 25-20374 Document: 61-1 Page: 1 Date Filed: 08/18/2026

No. 25-20374
2
Aggravated identity theft requires proof that Njoku, during and in
relation to Medicare fraud, knowingly “use[d], without lawful authority, a
means of identification of another person.” 18 U.S.C. § 1028A(a)(1). The
Supreme Court has clarified that not every use of another person’s means of
identification “during” fraud is also “in relation to” the fraud such that it
qualifies as aggravated identity theft. Dubin v. United States, 599 U.S. 110,
114 (2023).
Njoku’s argument that the use of patient identifying information was
not at the crux of his fraud misses the mark, as his aggravated identify theft
conviction was based on his forging of a nurse’s signature on Medicare billing
submissions. While we have not yet determined whether forging a nurse’s
signature falls within the ambit of aggravated identify theft in relation to
healthcare fraud, the lack of precedent and Njoku’s complete failure to
challenge the government’s theory of the case demonstrates the lack of plain
error. See United States v. Yusuf, 57 F.4th 440, 444 (5th Cir. 2023); United
States v. Gonzalez, 792 F.3d 534, 538 (5th Cir. 2015); United States v.
Scroggins, 599 F.3d 433, 446-47 (5th Cir. 2010).
AFFIRMED.
Case: 25-20374 Document: 61-1 Page: 2 Date Filed: 08/18/2026