United States v. Njoku

Case: 25-20374 Document: 61-1 Page: 1 Date Filed: 08/18/2026

United States Court of Appeals for the Fifth Circuit United States Court of Appeals ____________ Fifth Circuit FILED No. 25-20374 August 18, 2026 Summary Calendar Lyle W. Cayce ____________ Clerk United States of America, Plaintiff—Appellee, versus Paul Njoku, Defendant—Appellant. ______________________________ Appeal from the United States District Court for the Southern District of Texas USDC No. 4:21-CR-37-1 ______________________________ 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.

Case: 25-20374 Document: 61-1 Page: 2 Date Filed: 08/18/2026

No. 25-20374

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, (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.