On Sept. 12, a historic Miami nursing home fraud case concluded. Philip Esformes was sentenced to 20 years in prison for using his Miami nursing home to commit, as Law360 described it, “the largest health care fraud case” the U.S. Department of Justice had ever prosecuted.
Philip Esformes was the owner and profiting party in the Miami nursing home fraud case. Esformes allegedly “placed more emphasis on filling the beds than on filling the needs of his patients and protecting his patients.” and defrauded the Medicare and Medicaid systems millions of dollars.
Following his April 5 conviction of 20 counts paying and receiving kickbacks, money laundering, bribery and obstruction of justice, the perpetrator of the largest Miami nursing home fraud was described by Judge Robert N. Scola Jr. as “unmatched in our community or country.”
For his part in the Miami nursing home fraud, Esformes was sentenced to 20 years in prison and will be required to forfeit all his business interests in nursing homes and other facilities to pay for a $38.7 million forfeiture. Though the prosecution sought a minimum of 30 years, Judge Scola stated that the penalty should be within the recommended guidelines of 19 – 24.5 years. Judge Scola made this decision based on the evidence that the losses suffered by Medicare and Medicaid were $4.9 to $8.3 million as opposed to the $1.1 billion claimed by the prosecution. These numbers are not known to be perfectly accurate because the decade-long fraud scheme did not have data available for several years.
Although the 50-year-old businessman was not convicted of all charges, most notably the DOJ prosecutors failed to convict on counts of health care fraud and a related conspiracy charge, Esformes was found to have made a significant number of kickbacks to vendors for access to his facilities’ patients, and bribes he paid doctors, state health officials and former University of Pennsylvania men’s basketball coach Jerome Allen to allegedly get his son a spot on the school’s basketball team and admission into its prestigious Wharton School of Business.
For more information about financial abuse, visit the National Association of Nursing Home Attorneys’ Financial Abuse Page.