Florida healthcare executive gets 20 years in $1.3B Medicare fraud case

Philip Esformes, who operated a chain of skilled nursing homes and assisted living facilities in Florida, was sentenced Sept. 12 to 20 years in prison, according to the Miami Herald.

The sentencing came roughly five months after a 12-person jury found Mr. Esformes guilty of 20 charges, including paying and receiving kickbacks, money laundering and bribery. He was convicted after an eight-week trial for his role in a $1.3 billion Medicare and Medicaid fraud case, which was one of the largest healthcare fraud schemes ever charged by the Justice Department.

According to evidence presented at trial, Mr. Esformes bribed physicians to admit patients into his facilities. Once admitted, some patients received medically unnecessary care that was billed to Medicare and Medicaid, according to prosecutors.

Mr. Esformes was one of three defendants charged in an indictment unsealed in July 2016 for their alleged involvement in the fraud scheme that began in January 1998. He allegedly received more than $37 million from the scam.

Mr. Esformes is also accused of paying bribes to Jerome Allen, a former University of Pennsylvania head basketball coach, to get his son into the university. Mr. Allen, now an assistant with the Boston Celtics, testified that Mr. Esformes paid him about $300,000 to put his son on a priority list as a "recruited basketball player" to help ensure he would be accepted to the university and its Wharton School of Business, according to the report.

Mr. Allen pleaded guilty to a bribery-related money-laundering charge and was sentenced to probation in exchange for testifying against Mr. Esformes. Mr. Allen was also fined more than $200,000.

Access the full Miami Herald article here.

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