Nursing Home Owner Scammed Medicare Out Of $1 Billion

A Florida owner of 30 assisted living facilities has been brought to justice for defrauding the U.S. government's health care system of over $1 billion.

In what has amounted to the largest healthcare fraud case in the history of the U.S. Department of Justice, nursing home tycoon Philip Esformes has been charged for defrauding Medicare and Medicaid of more than $1 billion throughout the past 14 years. Esformes owns more than 30 elderly care homes in Florida. 

Esformes, along with two others, allegedly placed 14,000 elderly people in his facilities who were unqualified to live in such places and did not fit the criteria to receive certain medical services. These services were then billed to Medicare and Medicaid, adding up to over $1 billion in fraudulent costs.

elderly care

The DOJ found that in some cases Esformes and his two wingmen forced prescription addictions onto the elderly patients in order to lengthen the period of their stay in the nursing homes.

These addictions would also continue the dependency on federal dollars, for which Esformes and other top-level staff members would receive kickbacks disguised as charitable donations. They were often paid in cash to avoid creating a paper trail, although the money laundering eventually caught up with the white-collar criminals.  

While Esformes’ attorney says that his client “strongly asserts his innocence,” it is worth noting that the assisted-living facilities owner has a history of similar cases of healthcare fraud. The DOJ has recommended that Esformes be held without bail. The abuse of the elderly is certainly condemnable, and even more so considering that Esformers and his employees used the money for personal spending.

The Obama administration has played a major role in the recent crackdown on healthcare fraud. The DOJ is reported to have recovered an estimated $16.5 billion since January 2009.



Banner/thumbnail photo credit: Flickr, Images Money

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