Largest healthcare fraud exposed through nursing home mogul
CHICAGO: The largest ever healthcare fraud has been exposed via a court cross examination of a nursing home impresario.
A 12-person jury deliberated for four days before finding Philip Esformes, a 50-year-old entrepreneur and owner of a network of 16 nursing homes and assisted living facilities in Florida, guilty on 20 out of 26 charges related to healthcare fraud. This is believed to be the largest fraud scheme ever charged by the U.S. Justice Department and a reflection of the business owner’s greed through receiving kickbacks, money laundering and conspiracy to commit federal program bribery totaling $37 million. In an April 5th, 2019 public statement, prosecutors called him a “despicable,” “vampire” who was fueled by “unbounded greed.”
According to the Department of Justice, Esformes led an “extensive” healthcare fraud conspiracy through his network of poorly kept, for profit Miami-Dade nursing homes by bribing doctors to admit patients, making families believe loved ones should reside and bill Medicare and Medicaid for unnecessary services, or in some cases, no care at all. He also bribed an employee of a Florida state regulator to give him advance notice of facility inspections. All the while, Esformes was collecting on over $1.3 billion in fraudulent claims to purchase luxury items for himself including automobiles, a $360,000 watch, and allegedly using the money to bribe the basketball coach at the University of Pennsylvania for help getting his son admitted to the Ivy League university. Two others have pled guilty as co-conspirators to the fraudulent acts and identified as physician’s assistant Arnaldo Carmouze and former hospital administrator Odette Barcha.
