One of the state’s wealthiest healthcare operators was arrested Friday at his Miami Beach waterfront estate on charges of orchestrating the nation’s biggest Medicare fraud scheme — $1 billion.
Philip Esformes, 47, charged with two other defendants, is accused of exploiting his network of about 20 Miami-Dade skilled-nursing and assisted-living facilities to fleece the taxpayer-funded Medicare by filing false claims for services that were not necessary or in some instances not provided over the past 14 years.
An unidentified local hospital referred some of the thousands of Medicare patients to his network through kickback payments to physicians and other medical professionals, according to an indictment. Esformes is charged with conspiring with Arnaldo Carmouze, 56, a Palmetto Bay physician’s assistant, and Odette Barcha, 49, a former longtime director of outreach programs at Larkin Community Hospital in South Miami. Authorities would not confirm whether that was the local hospital at the center of the alleged scheme...
Justice Department officials — along with South Florida’s U.S. attorney, the FBI and Health and Human Services agents — described the Esformes case as one for the record books in the nation’s long-standing battle against healthcare fraud. They noted that while his healthcare network billed $1 billion for fraudulent medical services, Medicare paid Esformes’ skilled-nursing and assisted-living facilities about $500 million since 2009.
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http://www.miamiherald.com/news/local/community/miami-dade/article91231277.html
Philip Esformes, 47, charged with two other defendants, is accused of exploiting his network of about 20 Miami-Dade skilled-nursing and assisted-living facilities to fleece the taxpayer-funded Medicare by filing false claims for services that were not necessary or in some instances not provided over the past 14 years.
An unidentified local hospital referred some of the thousands of Medicare patients to his network through kickback payments to physicians and other medical professionals, according to an indictment. Esformes is charged with conspiring with Arnaldo Carmouze, 56, a Palmetto Bay physician’s assistant, and Odette Barcha, 49, a former longtime director of outreach programs at Larkin Community Hospital in South Miami. Authorities would not confirm whether that was the local hospital at the center of the alleged scheme...
Justice Department officials — along with South Florida’s U.S. attorney, the FBI and Health and Human Services agents — described the Esformes case as one for the record books in the nation’s long-standing battle against healthcare fraud. They noted that while his healthcare network billed $1 billion for fraudulent medical services, Medicare paid Esformes’ skilled-nursing and assisted-living facilities about $500 million since 2009.
(Continued)
http://www.miamiherald.com/news/local/community/miami-dade/article91231277.html
