The failure to clearly instruct the grand jury as to the appropriate scope of a medical assistant’s practice also tainted the counts charging theft by deception, health care claims fraud, and conspiracy to commit health care claims fraud. The crux of the deception and the fraud was that Dr. Ferraro sought reimbursement for procedures and activities that Rodriguez performed, by falsely conveying Dr. Ferraro performed them instead. Menendez stated that only licensed health care professionals had identification numbers to bill insurers for services. Thus, any procedure or activities a medical assistant performed would have to be billed under the supervising physician’s number. It was essential for the grand jury to know what procedures or activities a medical assistant could lawfully undertake in order to fairly decide whether Rodriguez, Dr. Ferraro, or Galvan intended to deceive or defraud Horizon. There is a sense that the prosecution would only appeal the granting of a motion to dismiss an indictment if they wanted to send a message to the trial judge. It takes far less work to re-present a case to a grand jury than it does to brief and argue an appeal before the Appellate Division.