In largest healthcare fraud case, Florida executive sentenced to 20 years in prison

Gavel money handcuffs fraud
A Florida man was sentenced in the largest healthcare fraud case prosecuted by the Department of Justice. (Getty Images/alfexe)

A Florida healthcare executive was sentenced to 20 years in prison Thursday after he was convicted in what the U.S. Justice Department said was the largest healthcare fraud case it has ever prosecuted.

Philip Esformes, who was convicted in April for his role in a $1.3 billion scheme to defraud Medicare and Medicaid, was sentenced by U.S. District Judge Robert Scola.

Esformes, 50, a wealthy Miami businessman who operated a network of nursing homes and assisted living facilities in South Florida, wept in court as he delivered a 16-minute speech apologizing for his actions and asking for mercy, according to The Associated Press.

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Esformes has already spent more than three years in prison, and prosecutors are seeking forfeiture of $38.5 million in assets, which will be decided in a November hearing, the news agency said.

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After an eight-week trial, he was found guilty of submitting fraudulent claims for services that were not provided, not medically necessary or were procured through the payment of kickbacks. He was convicted of 20 charges including money laundering, receiving healthcare kickbacks, bribery conspiracy and obstruction of justice.

According to evidence presented at trial, Esformes bribed physicians to admit patients into his facilities, where those residents often failed to receive appropriate medical services that were then billed to Medicare and Medicaid.

To cover up inadequate care, he was charged with bribing an employee of a Florida state regulator to receive advance notice of surprise inspections at his facilities. He made extravagant purchases with his criminal proceeds, including luxury automobiles and a $360,000 watch, prosecutors said. He also bribed a basketball coach at the University of Pennsylvania to gain admission for his son into the university.

His trial revealed a link to the national college bribery scandal playing out in the courts. There was a series of text messages discussing SAT scores between Esformes and Rick Singer, the admissions consultant at the center of that college bribery case, who pleaded guilty in a Boston federal court, the AP said.