The owner of a network of South Florida assisted living and skilled nursing facilities was sentenced Thursday to 20 years in prison after being found guilty in what the U.S. Justice Department described as the largest health care fraud scheme charged by the DOJ.
The decades-long scheme of 50 year old Miami Beach resident Philip Esformes involved kickbacks and money laundering in connection with fraudulent claims to Medicare and Medicaid for services deemed medically unnecessary.
According to the DOJ Office of Public Affairs press release, Esformes bribed an employee of a Florida state regulator thereby concealing the sub-par living conditions of patients.
According to the evidence presented at trial, between January 1998 and July 2016, Esformes led an extensive health care fraud conspiracy involving a network of assisted living facilities and skilled nursing facilities he owned. Esformes bribed physicians to admit patients into his facilities. Then, he cycled the patients through his facilities where they often failed to receive appropriate medical services or received medically unnecessary services billed to Medicare and Medicaid. Several witnesses testified to the poor conditions in the facilities and the inadequate care patients receive.
Esformes concealed the poor conditions and scheme from authorities by bribing an employee of a Florida state regulator for advance notice of surprise inspections scheduled to take place at his facilities. The evidence further showed Esformes used his criminal proceeds to make a series of extravagant purchases, including luxury automobiles and a $360,000 watch.
Esformes also used criminal proceeds to bribe the basketball coach at the University of Pennsylvania in exchange for his assistance in gaining admission for his son into the university.Read the rest here.
