Prosecutors announced this week charges against Philip Esformes for an alleged $1 billion fraud scheme involving Medicare and Medicaid kickbacks.
The case was described as “the largest single criminal health care fraud case ever brought against individuals by the Department of Justice.”
Read the indictment here.
More from the Chicago Business Journal:
According to the Tribune, the new federal indictment alleges that Philip Esformes and a handful of Miami co-conspirators defrauded Medicaid and Medicare by running 14,000 patients through various Esformes Network facilities, where many were given unnecessary or even harmful treatments. The indictment further alleges that drug addicts were lured in with promises of narcotics and that some received OxyContin and fentanyl without a physician’s order so that they would stay in Esformes Network facilities.
To cover up the illegal admissions and treatment, prosecutors allege, Philip Esformes directed bribes and kickbacks to health care regulators and medical professionals.
Esformes, who was denied bond on Tuesday, has a long history of criminal transgressions. A brief summary, from the Chicago Tribune:
•1998: A Tribune investigation found that Morris Esformes had employed three people to scout shelters and hospitals for recruits to nursing facilities he and Philip Esformes controlled. Some of those homeless people caused violence in the homes and surrounding communities, the Tribune reported.
•2006: Without admitting wrongdoing, Philip and Morris Esformes joined a group of businessmen who paid $15.4 million to settle a U.S. Department of Justice Medicaid fraud civil lawsuit alleging they paid kickbacks to physicians in exchange for patient referrals to a Florida hospital they controlled.
•2009: The Tribune’s “Compromised Care” investigation found that violent felons had assaulted elderly and disabled residents in Esformes homes, including south suburban Burnham Healthcare. There, 63-year-old invalid Thomas Donovan died after beatings by fellow residents, the Tribune reported. No one was charged in Donovan’s death.
•2010: The Tribune used confidential FBI reports and interviews to show the Esformeses had been at the center of what prosecutors called a “horrific” patient-brokering scheme in which nursing home residents were shuttled to and from a Northern Illinois psychiatric hospital for unnecessary treatments. The Esformeses denied wrongdoing and were not among the medical professionals charged in that case. About two years later, the Esformeses sold their Illinois facilities and focused on their Florida operations.
•2013: Philip and Morris Esformes paid the U.S. government $5 million to settle a whistleblower’s court allegations that they took kickbacks to complete the sale of a nursing home pharmacy company. Again, the father and son did not admit wrongdoing.
