United States v. Ronald Kielar , 791 F.3d 733 ( 2015 )


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  •                                In the
    United States Court of Appeals
    For the Seventh Circuit
    ____________________
    No. 14-1390
    UNITED STATES OF AMERICA,
    Plaintiff-Appellee,
    v.
    RONALD KIELAR,
    Defendant-Appellant.
    ____________________
    Appeal from the United States District Court for the
    Northern District of Illinois, Eastern Division.
    No. 1:10-cr-00691-1 — Robert M. Dow, Jr., Judge.
    ____________________
    ARGUED DECEMBER 4, 2014 — DECIDED JUNE 29, 2015
    ____________________
    Before BAUER, RIPPLE, and SYKES, Circuit Judges.
    RIPPLE, Circuit Judge. Ronald Kielar was convicted in the
    United States District Court for the Northern District of Illi-
    nois on charges arising out of a scheme to defraud two
    health insurance companies by submitting fraudulent claims
    for the prescription drug Procrit. He now appeals his convic-
    tion, alleging several procedural and evidentiary errors. For
    the reasons set forth in this opinion, we affirm the judgment
    of the district court.
    2                                                       No. 14-1390
    I
    BACKGROUND
    Ronald Kielar was a licensed pharmacist at the Cartagena
    Pharmacy in Chicago, Illinois. Many of Mr. Kielar’s patients
    came from the medical practice of Dr. Camilo Barros, whose
    office was located in the same building as the Cartegena
    Pharmacy. Starting in November 2004, Mr. Kielar began de-
    frauding two health insurance companies, Blue Cross and
    Blue Shield of Illinois (“BCBS”) and United Food and Com-
    mercial Workers Union and Employers Midwest Health
    Benefit Fund (“UFCW”), by submitting fraudulent claims for
    the prescription drug Procrit. 1 In particular, Mr. Kielar
    forged prescriptions for Procrit under Dr. Barros’s name and
    then submitted those prescriptions to BCBS and UFCW for
    payment. He knew at the time that Procrit had neither been
    prescribed, nor provided, to any of the individuals under
    whose policies he sought reimbursement. His scheme con-
    tinued over roughly six years and resulted in losses to BCBS
    and UFCW of approximately $1,678,549.
    In August 2010, Mr. Kielar was indicted on five counts of
    health care fraud in violation of 18 U.S.C. § 1347. This in-
    dictment also contained a forfeiture allegation, pursuant to
    18 U.S.C. § 982(a)(7), for any proceeds of Mr. Kielar’s fraudu-
    lent scheme. This allegation specifically identified three of
    Mr. Kielar’s properties as subject to forfeiture, including a
    property located at 
    12786 N.W. 75th
    Street, Parkland, Florida
    (the “Florida Property”).
    1 Procrit is an intravenous drug used to treat patients suffering from
    chronic kidney failure, cancer, or HIV infection.
    No. 14-1390                                                   3
    Later that month, the Government filed a notice of lis
    pendens for the Florida Property based on the indictment’s
    forfeiture allegation. Shortly thereafter, Mr. Kielar filed a
    motion requesting permission to sell the Florida Property,
    stating that he needed the proceeds of the sale in order to
    pay his attorneys’ legal fees. In its response, the Government
    stated that it did not object to the sale, provided that
    Mr. Kielar deposit the sale proceeds in an escrow account
    with the United States Marshals Service.
    In October 2010, the district court granted Mr. Kielar’s
    motion to release the lis pendens and allow for the sale of his
    Florida Property. Consistent with the Government’s request,
    however, the court ordered that the proceeds of the sale be
    placed in an escrow account with the United States Marshals
    Service. Shortly after doing so, Mr. Kielar filed another mo-
    tion asking the district court to vacate its earlier order and
    allow him to use the sale proceeds “for taxes, legal fees and
    other expenses.” 2 After several rounds of briefing, the dis-
    trict court denied Mr. Kielar’s request and, shortly thereafter,
    also denied his motion for reconsideration.
    In March 2013, a grand jury returned a ten-count super-
    seding indictment against Mr. Kielar, charging him with six
    counts of health care fraud, in violation of 18 U.S.C. § 1347;
    three counts of aggravated identify theft, in violation of 18
    U.S.C. § 1028A(a)(1); and one count of using false records to
    impede a federal investigation, in violation of 18 U.S.C.
    § 1519. Like the initial indictment, the superseding indict-
    ment also contained a forfeiture allegation pursuant to 18
    U.S.C. § 982(a)(7).
    2   R.36 at 2.
    4                                                              No. 14-1390
    Following a week-long jury trial, Mr. Kielar was convict-
    ed on all charges. 3 He timely appealed. 4
    II
    DISCUSSION
    Mr. Kielar contends that the district court erred on three
    separate grounds: (1) by failing to hold an evidentiary hear-
    ing on his request to release his escrowed funds, (2) by limit-
    ing his cross-examination of Dr. Barros, a key government
    witness, and (3) by preventing him from calling Fernando
    Perez as a defense witness. We address these issues in turn.
    A.
    We begin with Mr. Kielar’s contention that the district
    court erred by failing to hold an evidentiary hearing on his
    request to release his escrowed funds. Because this conten-
    tion concerns the scope of Mr. Kielar’s rights under the Due
    Process Clause, our review is de novo. United States v.
    Kirschenbaum, 
    156 F.3d 784
    , 792 (7th Cir. 1998).
    1.
    Mr. Kielar first requested that the district court release
    his escrowed funds in November 2010, shortly after the sale
    of his Florida Property. In particular, Mr. Kielar filed a mo-
    tion asserting that the restraint on his access to those funds
    3   The district court’s jurisdiction was premised on 18 U.S.C. § 3231.
    4   Our jurisdiction over this appeal is secure under 28 U.S.C. § 1291.
    No. 14-1390                                                    5
    impeded his ability to pay his attorneys’ legal fees in viola-
    tion of his Sixth Amendment right to counsel. Notably, this
    motion contained neither documentary evidence nor specific
    factual allegations demonstrating Mr. Kielar’s need for the
    sale proceeds to finance his defense.
    The Government opposed the motion. It submitted that
    the restraint on Mr. Kielar’s assets did not violate his Sixth
    Amendment right to counsel because he had not shown,
    “beyond the conclusory statements in his reply,” a “bona
    fide need” for the assets. 5 The Government’s brief also ex-
    plained how it could trace the proceeds of Mr. Kielar’s
    fraudulent scheme from the corporate bank account of the
    Cartegena Pharmacy to mortgage payments on the Florida
    Property.
    In December 2010, the district court held a status hearing
    at which defense counsel stated that Mr. Kielar’s motion
    “may require a more detailed hearing.” 6 Counsel then re-
    quested that the district court allow for additional briefing
    on the issue. The district court granted the request.
    In January 2011, Mr. Kielar submitted a brief in support
    of his November 2010 motion. Although the brief contained
    several legal arguments, the only allegations in the brief con-
    cerning Mr. Kielar’s need for the funds to pay his legal fees
    were as follows:
    Over the past four and a half months, De-
    fendant Kielar has fallen behind in payments
    to his attorneys and is now in arrears for a sub-
    5   R.40 at 4.
    6   R.168 at 4.
    6                                                   No. 14-1390
    stantial sum. Defendant Kielar’s inability to
    pay is due to the forfeiture clause which the
    Government included in the Indictment.…
    ….
    …Defendant Kielar has demonstrated a bona
    fide need for those funds because his attorneys
    can no longer afford to represent him on an es-
    sentially pro bono basis. Defendant Kielar’s
    counsel has invested immense time and sub-
    stantial money in his defense. To prevent the
    release of funds in escrow to Defendant
    Kielar’s attorneys would be to force them to
    withdraw from this case. As such, the court is
    essentially depriving Defendant Kielar of his
    Sixth Amendment right to the counsel of his
    choice and such a deprivation cannot stand.
    This Court must allow the release of sale pro-
    ceeds from the Florida Property in order to al-
    low the defendant to continue to retain his
    chosen counsel.[ 7]
    Mr. Kieler did not submit any documentary evidence to sub-
    stantiate these claims.
    In response, the Government again submitted that
    Mr. Kielar’s motion should be denied because he had failed
    to demonstrate a bona fide need for the assets at issue. The
    Government further asserted that, assuming that Mr. Kielar
    had shown a bona fide need, it had already demonstrated
    adequately the basis for its forfeiture allegation.
    7   R.42 at 2, 4 (emphasis in original).
    No. 14-1390                                                          7
    In reply, Mr. Kielar submitted a one-and-a-half-page af-
    fidavit in which he swore to the following facts: (1) that the
    combined pharmacy salaries for him and his ex-wife (with
    whom he lived) were only enough to pay minimal living ex-
    penses, (2) that he derived the down payment for the Florida
    Property from refinancing his house in Illinois, which was
    purchased in 1999, (3) that he owned a 2002 automobile with
    200,000 miles, (4) that he owned two Met Life insurance pol-
    icies with limited equity, and (5) that he was unable to pay
    his attorneys’ fees without the release of funds. Mr. Kielar
    did not submit any further documentary evidence to sub-
    stantiate these assertions.
    In February 2011, the district court denied Mr. Kielar’s
    request to release the proceeds from the sale of his Florida
    Property. In doing so, the district court relied on our deci-
    sion in United States v. Moya-Gomez, 
    860 F.2d 706
    (7th Cir.
    1988), as setting forth the relevant legal standard for as-
    sessing Mr. Kielar’s claim:
    [A] defendant whose assets may be subject to
    forfeiture may make out a Sixth Amendment
    right-to-counsel claim only if (1) he can estab-
    lish “a bona fide need to utilize assets subject to
    the restraining order to conduct his defense”
    and (2) the Government fails to “demonstrate
    the basis for its assertion, contained in the in-
    dictment, that the assets are subject to forfei-
    ture.”[ 8]
    8R.46 at 2 (quoting United States v. Moya-Gomez, 
    860 F.2d 706
    , 730 (7th
    Cir. 1988).
    8                                                 No. 14-1390
    With regard to the first prong of this test, the district
    court noted that the only evidence of a bona fide need sub-
    mitted by Mr. Kielar was his one-and-a-half-page affidavit.
    Although the court acknowledged that this “affidavit
    lack[ed] detail and [was] not supported by any additional
    materials (e.g., bank statements, pay stubs, etc.) that might
    make a more convincing showing of need,” it nonetheless
    “assume[d], without deciding, that Defendant [had] shown a
    bona fide need for the restrained assets to support his de-
    fense.” 9 From there, the court went on to conclude that the
    Government had offered sufficient evidence to show that the
    seized assets at issue were subject to forfeiture and, accord-
    ingly, that Mr. Kielar was not entitled to the release of his
    escrowed funds. In a footnote to this discussion, the court
    noted that Mr. Kielar had “not requested a formal eviden-
    tiary hearing on this issue,” yet concluded that such a hear-
    ing was unnecessary given that Mr. Kielar had been afforded
    “ample opportunity to present argument (in four briefs) and
    evidence (in the form of his affidavit).” 10
    At a subsequent status hearing, Mr. Kieler requested that
    the district court reconsider its February 2011 order. The dis-
    trict court agreed to do so and suggested additional briefing.
    Shortly afterward, Mr. Kielar filed a written motion for re-
    consideration. However, he still did not submit any further
    evidence to substantiate his need for the escrowed funds to
    finance his defense, nor did he request an evidentiary hear-
    ing on the issue. Notably, however, his motion did state that
    he, as the defendant, did “not bear the burden to request a
    9   
    Id. at 3.
    10   
    Id. at 4
    n.1.
    No. 14-1390                                                   9
    formal evidentiary hearing on this issue as the court [previ-
    ously had] indicate[d].” 11
    In May 2011, the district court again denied Mr. Kielar’s
    request to release his escrowed funds. Once again, the court
    assumed without deciding that Mr. Kielar had established a
    bona fide need for the assets at issue. Turning to the second
    step of the Moya-Gomez analysis, the court determined that
    the Government adequately had demonstrated the factual
    basis for its forfeiture assertion and that “[a]t no time in any
    of the written submissions or hearings before the
    Court…ha[d the] Defendant come forward either with ar-
    gument or evidence to rebut the Government’s conten-
    tions.” 12 Further, the court again noted that Mr. Kielar had
    not “at any time, including at the most recent status hear-
    ing…, requested an evidentiary hearing to challenge the
    Government’s analysis or develop the factual basis for a
    counterargument.” 13
    At a subsequent status hearing, defense counsel asserted
    that the district court’s order “le[ft] open a couple of ques-
    tions” including “whether [Mr. Kielar] would be seeking an
    evidentiary hearing.” 14 In response, the district court noted
    that Mr. Kielar had neither previously requested a hearing
    nor offered any argument or evidence to dispute the Gov-
    ernment’s showing of traceability. This being the case, the
    court asked what would happen at a hearing beyond the
    11   R.52 at 3.
    12   R.55 at 2.
    13   
    Id. 14 R.165
    at 3.
    10                                               No. 14-1390
    Government’s simply presenting the same evidence that it
    already had provided in its briefs. Defense counsel initially
    responded that if an evidentiary hearing were held,
    Mr. Kielar would not present any evidence because it was
    not his burden to do so. Defense counsel then acknowledged
    that he and Mr. Kielar had not yet decided how to pursue
    this issue and therefore asked for “some time to go over this
    with Mr. Kielar.” 15 The district court granted this request
    and gave defense counsel thirty days to confer with his cli-
    ent.
    At the next status hearing on July 8, 2011, defense coun-
    sel stated that he had conferred with Mr. Kielar and that
    they would “not be asking for an evidentiary hearing con-
    cerning the funds.” 16
    2.
    Mr. Kielar now contends that the district court erred by
    failing to order, sua sponte, an evidentiary hearing on his
    request to release his escrowed funds. Specifically, he con-
    tends that the court’s failure to do so “violated his Fifth
    Amendment due process rights by depriving [him of] his
    liberty interest under the Sixth Amendment to obtain coun-
    sel of his choice.” 17
    With regard to certain federal criminal offenses, includ-
    ing the health care fraud offense at issue here, a district
    15   
    Id. at 11.
    16   R.166 at 2.
    17   Appellant’s Br. 12.
    No. 14-1390                                                    11
    court, upon the filing of an indictment containing a forfei-
    ture allegation, may enter a protective order to preserve the
    availability of a defendant’s assets that are subject to forfei-
    ture. See 18 U.S.C. § 982(a)(7), (b)(1); 21 U.S.C. § 853(e)(1)(A).
    In 
    Moya-Gomez, 860 F.2d at 730
    , we held that a defendant in
    such circumstances has a limited due process right to contest
    the Government’s forfeiture allegation if the pretrial seizure
    of his assets would prevent him from hiring the counsel of
    his choice. In particular, Moya-Gomez held that if “the de-
    fendant presents a bona fide need to utilize assets subject to
    the restraining order to conduct his defense” and “the dis-
    trict court finds that the defendant does not have other as-
    sets from which such payments can be made,” the court
    “then must require the government to demonstrate the basis
    for its assertion, contained in the indictment, that the assets
    are subject to forfeiture.” 
    Id. With regard
    to the specific pro-
    cess that was due, we held that such a defendant was enti-
    tled to “an immediate, postrestraint, adversary hearing” up-
    on making the requisite showing of bona fide need. 
    Id. at 731.
    In subsequent cases, we have clarified that in order to
    demonstrate a “bona fide need” a defendant must do more
    than “submit[] a bare-bones affidavit asserting that he per-
    sonally lack[s] sufficient funds to obtain counsel of his
    choice.” 
    Kirschenbaum, 156 F.3d at 792
    .
    The Government submits that Mr. Kielar waived his
    right to a hearing under Moya-Gomez when, on July 8, 2011,
    his counsel informed the district court that Mr. Kielar would
    “not be asking for an evidentiary hearing concerning the
    funds.” 18 Further, the Government contends that, waiver
    18   R.166 at 2.
    12                                                No. 14-1390
    aside, Mr. Kielar was not entitled to an evidentiary hearing
    because he never presented sufficient evidence to establish a
    bona fide need for the assets at issue.
    The Government’s assertion of waiver is correct. Indeed,
    the waiver here hardly could have been clearer. After having
    thirty days to confer with his counsel over whether to re-
    quest an evidentiary hearing, Mr. Kielar expressly declined to
    request one. The record contains, moreover, no indication
    that this decision was not a knowing and voluntary one. Nor
    does Mr. Kielar contend otherwise. This decision thus falls
    squarely within the definition of waiver: it was “the inten-
    tional relinquishment of a known right.” United States v. Ro-
    driguez-Gomez, 
    608 F.3d 969
    , 972 (7th Cir. 2010).
    Mr. Kielar now attempts to avoid this conclusion by as-
    serting that the hearing right described in Moya-Gomez is
    mandatory and nonwaivable. In his view, any time a crimi-
    nal defendant is entitled to an evidentiary hearing under
    Moya-Gomez, the district court must hold such a hearing on
    its own initiative even in the absence of a request from the
    defendant. Mr. Kielar offers no reason why any value pro-
    tected by the Due Process Clause would require a mandato-
    ry hearing in this context. Rather, he merely contends that
    our decision in Moya-Gomez mandates this result.
    This argument is without merit. The defendant in Moya-
    Gomez specifically requested a pretrial evidentiary hearing.
    
    See 860 F.2d at 717
    . Nowhere in our opinion did we state or
    suggest that the due process right that we acknowledged
    was immune from the ordinary rules of waiver. “Constitu-
    tional rights like other rights can be waived, provided that
    the waiver is knowing and intelligent, as it was here.” United
    No. 14-1390                                                                13
    States v. Barnett, 
    415 F.3d 690
    , 691 (7th Cir. 2005). We there-
    fore consider the issue waived.
    Even if this objection had been preserved, Mr. Kielar has
    not presented sufficient evidence to demonstrate a bona fide
    need for the assets at issue. He has offered no documentary
    evidence, other than an unsubstantiated affidavit, to demon-
    strate that the restrained assets were needed to conduct his
    defense. In Moya-Gomez, we stressed that the right to a hear-
    ing was “very limited” and required as a prerequisite that
    “the district court find[] that the defendant does not have
    other assets from which” he could pay for his 
    defense. 860 F.2d at 730
    . Mr. Kielar’s one-and-a-half-page affidavit does
    not provide enough information, much less enough reliable
    information, to allow the district court to make this finding.
    See 
    Kirschenbaum, 156 F.3d at 792
    . Accordingly, even if we
    were to presume that Mr. Kielar had preserved this objec-
    tion, he still would not have been entitled to an evidentiary
    hearing. 19
    19 In his opening brief, Mr. Kielar offers a secondary argument concern-
    ing his right to a post-indictment hearing on the pretrial restraint of his
    assets. He contends that, regardless of his right to counsel of choice, he
    nonetheless has a “general right” to a post-indictment, pretrial hearing
    before being deprived of his property.
    This issue need not detain us long. Because Mr. Kielar did not raise
    this issue before the district court, our review is for plain error. See Unit-
    ed States v. Borostowski, 
    775 F.3d 851
    , 865 (7th Cir. 2014). “An error is
    plain if it is clear or obvious.” 
    Id. Here, Mr.
    Kielar has acknowledged that
    whether the Due Process Clause requires a hearing in this context is an
    “open question.” Appellant’s Br. 18 (internal quotation marks omitted).
    Because any error, therefore, was not obvious, the plain error standard
    has not been met. See 
    Borostowski, 775 F.3d at 865
    .
    14                                               No. 14-1390
    B.
    We turn now to Mr. Kielar’s contention that the district
    court impermissibly limited his cross-examination of
    Dr. Barros.
    1.
    Dr. Barros was one of the Government’s key witnesses at
    trial. Prior to trial, the Government had produced records
    showing that the Illinois Department of Public Aid (“IDPA”)
    had recommended that Dr. Barros be terminated from par-
    ticipating in IDPA’s Medical Assistance Program, which
    consisted of Medicaid and other associated programs.
    Among the reasons cited for Dr. Barros’s termination were
    that he (1) had failed to obtain and document adequately pa-
    tient histories and physical examinations and (2) had pre-
    scribed medications without appropriate indications.
    In July 2013, the Government filed a motion in limine in
    which it sought two limitations on the cross-examination of
    Dr. Barros. First, it wanted to restrict any examination con-
    cerning his termination from the IDPA program to the sole
    ground of his recordkeeping. Second, it requested that cross-
    examination on Dr. Barros’s recordkeeping be permitted on-
    ly if the Government sought to introduce his records. In the
    Government’s view, the other grounds for Dr. Barros’s ter-
    mination were not probative of his character for truthfulness
    but rather only went to his qualifications and competency as
    a physician. In response, Mr. Kielar submitted that he should
    be able to cross-examine Dr. Barros about all of the grounds
    for termination from these programs because the infor-
    No. 14-1390                                                15
    mation was “relevant to show bias and self-interest in falsely
    testifying that he did not prescribe Procrit in this case.” 20
    The district court denied in part and granted in part the
    Government’s motion in limine. It precluded the introduc-
    tion of extrinsic evidence if that evidence was intended sole-
    ly to impeach Dr. Barros with regard to his character for
    truthfulness. The court, however, “decline[d] to categorically
    bar any cross-examination of [Dr. Barros] concerning the
    IDPA recommendations,” noting that some of Mr. Kielar’s
    “proposed lines of cross-examination may demonstrate bias
    or self-interest on the part of [Dr. Barros].” 21
    On the first day of trial, the Government and defense
    counsel informed the district court that they had “worked
    out a solution” in which Dr. Barros would “testify that he
    was terminated from Medicare and Medicaid in the early
    2000–2001 time period” “and then that [would] be the end of
    the issue as far as defense counsel and the government
    [were] concerned.” 22
    When asked by the district court whether this compro-
    mise would “essentially substitute” for any use of the IDPA
    recommendation to impeach Dr. Barros, defense counsel re-
    sponded, “We believe it will, Judge.” 23
    On direct examination, Dr. Barros testified that he had
    never written a prescription for Procrit and that all of the
    20   R.100 at 6.
    21   R.107 at 5–6.
    22   R.151 at 2.
    23   
    Id. at 3.
    16                                                No. 14-1390
    prescriptions submitted under his name to BCBS and UFCW
    contained forged signatures. He further testified that he was
    terminated as a provider by Medicaid in 2000 and Medicare
    in 2001.
    On cross-examination, defense counsel asked Dr. Barros
    a series of questions about these terminations. At that point,
    the Government objected. At a sidebar, it stated its under-
    standing that defense counsel had agreed not to cross-
    examine Dr. Barros on this topic. Defense counsel replied
    that he had “never agreed not to ask any questions on this
    issue.” 24 The court then inquired whether this was defense
    counsel’s last question on the topic. Counsel responded that
    all he wanted to do was to clarify the dates when Dr. Barros
    was terminated from Medicaid as opposed to Medicare be-
    cause he believed that the doctor had confused those dates
    during his direct testimony. The court then stated, “How
    about one last question, all it would establish is that as of
    2001 he could no longer submit whatever it is, Medicare to
    the state or Medicaid to the federal or whatever the right
    way to go and just tie up and then move on. Fair enough?” 25
    Defense counsel did not object to this proposed solution.
    Upon resuming his cross-examination, defense counsel clari-
    fied the correct dates of Dr. Barros’s termination and moved
    on to another line of questioning.
    24   R.153 at 29.
    25   
    Id. at 30.
    No. 14-1390                                                   17
    2.
    Mr. Kielar now contends that, by limiting his cross-
    examination of Dr. Barros, the district court violated both
    Federal Rule of Evidence Rule 608(b) as well as his right to
    confrontation guaranteed by the Sixth Amendment. He con-
    tends that the district court should not have prevented him
    from further inquiring about the doctor’s termination from
    Medicare and Medicaid. In his view, further inquiry into the
    circumstances of the doctor’s termination was necessary to
    show that Dr. Barros had a motive to “falsely testify[] that he
    did not prescribe Procrit,” so as to “maintain[] his medical
    license” and “regain[] eligibility for Medicaid.” 26
    Before proceeding to the merits of Mr. Kielar’s argument,
    we first must address the Government’s contention that
    Mr. Kielar waived, or at least forfeited, this objection by fail-
    ing to raise it before the district court. “Waiver is the inten-
    tional relinquishment of a known right, whereas forfeiture is
    the failure to timely assert a right.” 
    Rodriguez-Gomez, 608 F.3d at 972
    . “Forfeited errors may still be reviewed for plain
    error, while waived errors are extinguished and cannot be
    reviewed on appeal.” United States v. Berg, 
    714 F.3d 490
    , 494
    n.1 (7th Cir. 2013) (alterations omitted) (internal quotation
    marks omitted).
    Here, the Government first points out that, other than
    precluding the admission of extrinsic impeachment evidence
    against Dr. Barros (which Mr. Kielar does not challenge), the
    district court never restricted Mr. Kielar’s right to cross-
    examine Dr. Barros about his termination from Medicare or
    Medicaid, or any other issue for that matter. Thus, the only
    26   Appellant’s Br. 24.
    18                                                No. 14-1390
    reason why these questions were not asked, the Government
    submits, was because “defendant’s trial counsel made the
    strategic decision not to ask [them].” 27
    The Government’s assessment is correct. As the record
    clearly demonstrates, Mr. Kielar reached an agreement with
    the Government about how the parties would handle
    Dr. Barros’s termination from Medicare and Medicaid.
    When the Government objected that defense counsel’s cross-
    examination of Dr. Barros was treading beyond the scope of
    that agreement, the district court merely asked defense
    counsel whether this was his last question on the matter. In
    response, defense counsel stated that all he wanted to do
    was clarify the dates on which Dr. Barros was terminated
    from Medicaid as opposed to Medicare, because he believed
    that the witness had confused those dates during his direct
    examination. The court allowed defense counsel to clarify
    this issue, suggesting that he “tie it up” in “one last ques-
    tion” “and then move on.” 28 Notably, the court concluded its
    suggestion by asking the parties, “Fair enough?”, to which
    defense counsel expressed no objection. 29 In light of the par-
    ties’ earlier acknowledgement that they had “worked out a
    solution” in which Dr. Barros would “testify that he was
    terminated from Medicare and Medicaid in the early 2000–
    2001 time period” and “then that [would] be the end of the
    issue,” 30 defense counsel’s decision not to object to the
    court’s proposed solution, or to otherwise attempt to further
    27   Appellee’s Br. 41.
    28   R.153 at 30.
    29   
    Id. 30 R.151
    at 2.
    No. 14-1390                                                               19
    question Dr. Barros on this issue, was intentional. Accord-
    ingly, we conclude that Mr. Kielar has waived any objection
    concerning this issue. 31
    In any event, even if the district court had precluded
    Mr. Kielar from questioning Dr. Barros about his termination
    from Medicare and Medicaid, that decision would not have
    constituted reversible error under either Rule 608(b) or the
    Confrontation Clause. Rule 608(b) bars the admission of ex-
    trinsic evidence “to prove specific instances of a witness’s
    conduct in order to attack or support the witness’s character
    for truthfulness.” Fed. R. Evid. 608(b). Under this rule, how-
    ever, a district court may permit, in its discretion, a party to
    cross-examine a witness about such prior conduct so long as
    it is probative of the witness’s character for truthfulness. 
    Id. Rule 608(b)
    operates subject to the limitations imposed by
    the Confrontation Clause of the Sixth Amendment, which
    protects the right of a criminal defendant “to be confronted
    with the witnesses against him.” U.S. Const. amend. VI.
    As a general matter, we review a district court’s limita-
    tion on the scope of cross-examination for abuse of discre-
    tion. United States v. Sasson, 
    62 F.3d 874
    , 882 (7th Cir. 1995).
    31 See United States v. Cooper, 
    243 F.3d 411
    , 418 (7th Cir. 2001) (holding
    “that a defendant’s attorney can waive his client’s Sixth Amendment
    confrontation right so long as the defendant does not dissent from his
    attorney’s decision, and so long as it can be said that the attorney’s deci-
    sion was a legitimate trial tactic or part of a prudent trial strategy” (in-
    ternal quotation marks omitted)); see also United States v. Donelli, 
    747 F.3d 936
    , 939, 941 (7th Cir. 2014) (concluding that a defendant waived any
    objection concerning the district court’s failure to consider adequately
    his mitigation arguments at sentencing by not raising that objection
    when the court asked the parties “whether they had any objection to the
    sentence or required ‘any further elaboration’ of the judge’s reasons”).
    20                                                  No. 14-1390
    Where, however, a limitation “directly implicates the core
    values of the Confrontation Clause,” our review is de novo.
    United States v. Recendiz, 
    557 F.3d 511
    , 530 (7th Cir. 2009) (in-
    ternal quotation marks omitted). In determining the appro-
    priate standard of review, it is important, therefore, to “dis-
    tinguish between the core values of the confrontation right
    and more peripheral concerns which remain within the am-
    bit of the trial judge’s discretion.” United States v. Degraffen-
    ried, 
    339 F.3d 576
    , 581 (7th Cir. 2003) (quoting United States v.
    Saunders, 
    973 F.2d 1354
    , 1358 (7th Cir. 1992)).
    It is well established that “[e]xposing witness bias lies
    within the protected core of the Confrontation Clause.” Unit-
    ed States v. Sanders, 
    708 F.3d 976
    , 990 (7th Cir. 2013) (internal
    quotation marks omitted). We also have recognized, howev-
    er, that the constitutional guarantee is limited to the oppor-
    tunity to expose the bias: “a limitation on cross-examination
    implicates the core of the Confrontation Clause when the de-
    fense is completely forbidden from exposing the witness’s
    bias.” 
    Id. (internal quotation
    marks omitted). “So long as the
    accused is given the opportunity to expose bias, further cross
    examination is at the discretion of the district court.” United
    States v. Smith, 
    308 F.3d 726
    , 738 (7th Cir. 2002); see also Re-
    
    cendiz, 557 F.3d at 530
    (“[O]nce a trial court permits a de-
    fendant to expose a witness’s motivation, it is of peripheral
    concern to the Sixth Amendment how much opportunity de-
    fense counsel gets to hammer that point home to the jury.”
    (internal quotation marks omitted)).
    In this case, the fact that Dr. Barros was terminated from
    participating in Medicare and Medicaid was exposed to the
    jury; both the Government and defense counsel questioned
    the doctor on this topic. Thus, because Mr. Kielar was “given
    No. 14-1390                                                          21
    the opportunity to expose [this potential ground for] bias,
    further cross examination [was] at the discretion of the dis-
    trict court.” 
    Smith, 308 F.3d at 738
    . A district court does not
    abuse its discretion in this context so long as “the jury had
    sufficient information to make a discriminating appraisal of
    the witness’s motives and biases.” Re
    cendiz, 557 F.3d at 530
    (internal quotation marks omitted). Here, the fact of
    Dr. Barros’s termination alone gave the jury enough infor-
    mation to appraise the witness’s motive to lie. Mr. Kielar’s
    counsel could well have argued forcibly to the jury that
    Dr. Barros’s removal from the government programs gave
    him a strong motive to deny writing the prescriptions in
    question because any such admission might have resulted in
    further problems with federal or state regulatory authorities.
    Indeed, an examination of the transcript at closing argument
    indicates that his counsel made some attempt to do so. 32 In
    any event, assuming for the sake of argument that this issue
    was not waived, it is clear that the cross-examination that
    did take place gave defense counsel enough opportunity to
    make his point.
    Therefore, assuming the district court had restricted
    Mr. Kielar’s cross-examination of Dr. Barros, that limitation
    would not have been an abuse of discretion. See 
    Sanders, 708 F.3d at 991
    (noting that just because “[t]he jury might not
    have possessed all the information [the defendant] wanted it
    to have” does not mean that the jury lacked “sufficient in-
    formation to evaluate [the witness’s] testimony”). Accord-
    32See R.154 at 148 (“And Dr. Barros. [The prosecutor] also asked what
    does Dr. Barros have to gain. Well, what Dr. Barros has to gain is he is
    not sitting right here.”).
    22                                                No. 14-1390
    ingly, waiver aside, Mr. Kielar’s evidentiary challenge fails
    on its merits.
    C.
    Finally, Mr. Kielar contends that the district court erred
    by preventing him from calling Fernando Perez as a defense
    witness. We review the district court’s evidentiary rulings
    for abuse of discretion. United States v. Khan, 
    771 F.3d 367
    ,
    377 (7th Cir. 2014).
    1.
    Prior to trial, the Government listed Fernando Perez as a
    potential witness. Perez, a former patient of Dr. Barros and a
    customer at the Cartagena Pharmacy, was slated to testify
    that Dr. Barros never had prescribed Procrit for him. When
    the Government later elected not to call Perez, defense coun-
    sel informed the Government of his intent to call the witness.
    In response, the Government moved to preclude Mr. Kielar
    from calling Perez. When asked by the district court why he
    intended to call Perez, defense counsel explained that he in-
    tended to impeach the witness’s credibility. In particular, de-
    fense counsel stated that, when called, Perez would “deny
    that he was ever prescribed Procrit, [or] that he ever got any
    Procrit,” and that defense counsel would then impeach the
    witness by asking whether he had stolen his cousin’s identi-
    ty and whether he was an illegal alien (both of which de-
    fense counsel believed were true). 33
    33   R.153 at 126.
    No. 14-1390                                                    23
    The Government objected to this proffer, asserting that
    defense counsel was “calling [Perez] solely for the purpose
    of impeaching him.” 34 In response, the court asked defense
    counsel whether “that[ was] all there [was] to it,” to which
    defense counsel responded, “That’s all there is to it,
    Judge.” 35
    When asked whether he intended to ask Perez any other
    questions, defense counsel responded that he also might ask
    the following: “The government told you that they were go-
    ing to call you as a witness and then sometime during the
    trial you were—on a certain date you were interviewed and
    the government told you that they were not going to call you
    as a witness.” 36
    The next day, the court granted the Government’s oral
    motion in limine. Relying on our decision in United States v.
    Giles, 
    246 F.3d 966
    (7th Cir. 2001), the district court ruled that
    Mr. Kielar’s counsel could not call Perez as a defense witness
    because his only reason for doing so was to impeach him.
    2.
    It is well established that “a party may not call a witness
    for the sole purpose of impeaching him.” 
    Id. at 974.
    In Giles,
    as here, a defendant sought to call as a witness an individual
    who was slated to testify for the Government but whom the
    Government chose not to call at trial. 
    Id. We affirmed
    the dis-
    34   
    Id. 35 Id.
    at 127.
    36   
    Id. 24 No.
    14-1390
    trict court’s decision to preclude the defendant from calling
    this individual, concluding that the defendant’s “true de-
    fense reason…for wanting to put [this witness] on the stand
    was to expose his warts to the jury and float the inference
    that the [Government] should not play footsie with a sleaze-
    ball.” 
    Id. Mr. Kielar
    attempts to avoid Giles’s clear holding by as-
    serting that impeachment was not the “only reason” that he
    wanted to call Perez as a witness. 37 In particular, he contends
    that although “trial counsel believed Mr. Perez would likely
    testify that he was never prescribed Procrit by
    Dr. Barros…[,] trial counsel was willing to make the tactical
    decision that under oath Mr. Perez may testify that he was
    prescribed Procrit.” 38
    Mr. Kielar never communicated to the district court this
    reason for permitting Perez’s testimony. We therefore refuse
    to consider this theory of admissibility for the first time on
    appeal. See United States v. Biesiadecki, 
    933 F.2d 539
    , 544 n.1
    (7th Cir. 1991); United States v. Marrera, 
    768 F.2d 201
    , 209 (7th
    Cir. 1985); see also Stephens v. Miller, 
    13 F.3d 998
    , 1008 n.5 (7th
    Cir. 1994) (en banc) (Rovner, J., concurring) (“A defendant
    cannot advance one reason for admitting evidence during
    trial and then advance a wholly separate basis for admis-
    sion…on appeal. An evidentiary rationale not raised before
    the trial judge at the time of ruling is waived.”). Because
    Mr. Kielar’s only proffered reason for calling Perez as a de-
    fense witness was to impeach him, we conclude that the dis-
    37   Appellant’s Br. 26 (emphasis in original).
    38   
    Id. at 26–27
    (emphasis in original).
    No. 14-1390                                                25
    trict court’s decision to grant the Government’s motion in
    limine was proper.
    Conclusion
    The judgment of the district court is affirmed.
    AFFIRMED