Florida man Philip Esformes, a 50-year-old Miami Beach resident, was convicted on Friday “of running an 18-year, $1.3 billion health-care fraud”1that prosecutors called the largest scheme ever prosecuted by the U.S. Justice Department.
Esformes is accused of using a network of nursing homes and assisted-living facilities in South Florida “to defraud government health-care programs.”1 However, according to prosecutors, he didn’t even do it well. The facilities were said to be inadequate and often the care was unnecessary (because that’s where the money is!). The total value of fraudulent claims that his companies submitted to Medicare and Medicaid exceeded $1.3 billion.
“Esformes made off with at least $37 million for himself from 1998 to 2016, according to prosecutors, using the money to finance a lavish lifestyle of fancy cars and a $360,000 watch. Esformes also used some of the proceeds from the fraud to bribe the University of Pennsylvania basketball coach to help get his son into the school, prosecutors said. The coach pleaded guilty to money laundering last year in connection with the case.”1
Prosecutors said Esformes bribes doctors to admit patients to the facilities he operated and also bribed a Florida state regulator so he could be apprised of surprise inspections ahead of time.
“A jury found Esformes guilty on 20 counts in U.S. district court in the Southern District of Florida. Charges included conspiracy to defraud the United States, receiving kickbacks, money laundering and conspiracy to commit bribery. Two co-conspirators pleaded guilty. Sentencing hasn’t been scheduled.”1
Since 2007, more than 4,000 Medicare fraud cases have been charged.
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