UNITED STATES COURT OF APPEALS FOR THE SIXTH CIRCUIT

┐ UNITED STATES OF AMERICA, │ Plaintiff-Appellee, │ > No. 24-1452 │ v. │ │ SARDAR ASHRAFKHAN, aka Dr. Khan, │ Defendant-Appellant. │ ┘

Appeal from the United States District Court for the Eastern District of Michigan at Detroit. No. 2:11-cr-20551-12—Laurie J. Michelson, District Judge.

Decided and Filed: March 3, 2025

Before: COLE, WHITE, and MATHIS, Circuit Judges. _________________

COUNSEL ON BRIEF: Benton C. Martin, FEDERAL COMMUNITY DEFENDER OFFICE, Detroit, Michigan, for Appellant. Wayne F. Pratt, UNITED STATES ATTORNEY’S OFFICE, Detroit, Michigan, for Appellee. _________________

OPINION _________________

COLE, Circuit Judge. A district court sentenced Sardar Ashrafkhan for conspiring to distribute and possess with intent to distribute a controlled substance, conspiring to commit health care fraud, and money laundering. After a retroactive amendment to the United States Sentencing Guidelines, Ashrafkhan moved for a sentence reduction under 18 U.S.C. § 3582(c)(2). To be eligible for the reduction, a defendant must meet ten criteria, including showing that “the defendant did not receive an [aggravating role adjustment] and was not No. 24-1452 United States v. Ashrafkhan Page 2

engaged in a continuing criminal enterprise[].” USSG Amend. 821, Pt. B; § 4C1.1(a)(10). Since Ashrafkhan received an aggravating role adjustment, the district court determined he was ineligible and denied his motion. Ashrafkhan appeals, arguing he meets the criteria despite the aggravating role adjustment because he did not engage in a continuing criminal enterprise. We affirm.

I.

Sardar Ashrafkhan owned and operated a sham medical practice where doctors wrote and billed Medicare for fraudulent prescriptions. Associates would visit specific pharmacies to fill the false prescriptions, and those pharmacies would pay Ashrafkhan kickbacks. The scheme resulted in the collection of millions of dollars from fake Medicare claims and the sale of hundreds of thousands of opioid-based drugs on the illegal street market.

Ashrafkhan was indicted in 2013 with dozens of coconspirators and tried in 2015 alongside two doctors he employed. At trial, the government presented evidence that Ashrafkhan masterminded the scheme. The jury convicted Ashrafkhan of drug conspiracy, health care fraud conspiracy, and money laundering.

At sentencing, Ashrafkhan’s total offense level was 43. He received an adjustment for being an “organizer or leader of a criminal activity that involved five or more participants or was otherwise extensive” under USSG § 3B1.1(a). Ashrafkhan had no criminal history points, so his criminal history category was I. Since those calculations would result in a guidelines range exceeding the total maximum term of imprisonment that could be imposed under the statute, Ashrafkhan’s applicable guidelines range was set at the statutory maximum of 600 months. Varying downwards, the district court sentenced him to 27