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April 05, 2019 09:39 AM

Fla. healthcare executive found guilty in $1B Medicare fraud case

Modern Healthcare
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    AP

    Florida healthcare executive Philip Esformes was found guilty Friday of paying and receiving kickbacks and other charges as part of the biggest Medicare fraud case in U.S. history.

    During the seven-week trial in federal court in Miami, prosecutors called Esformes a trickster and mastermind of a scheme paying bribes and kickbacks to doctors to refer patients to his nursing home network from 2009 to 2016. The fraud also included paying off a regulator to learn when inspectors would make surprise visits to his facilities, or if patients had made complaints.

    Esformes owns dozens of Miami-Dade nursing facilities as well as homes in Miami, Los Angeles and Chicago.

    Although Esformes' attorney told jurors the executive never paid kickbacks, they ultimately convicted him for the kickbacks, money laundering, bribery and obstruction of justice. Jurors were undecided on six additional counts, but prosecutors accepted the verdict rather than send them back for further deliberations.

    The jury could not decide whether Esformes was guilty of Medicare fraud conspiracy after four days of deliberations. They found him guilty of money laundering and of bribing a Florida health regulator to warn him when inspectors planned surprise visits to his facilities and when patients made complaints.

    During the seven-week trial, a former University of Pennsylvania basketball coach also testified that he accepted bribes from Esformes to have his son admitted into the business college. Another coach implicated was recently suspended from Auburn University.

    "Philip Esformes can't help himself. That's part of his tragedy," Justice Department attorney James Hayes said during closing arguments.

    Esformes' defense team plans to appeal the decision.

    Attorney Roy Black said the government attorneys could not prove the main count in their case against Esformes — the conspiracy to commit healthcare fraud charge. He also suggested prosecutors inflated the amount of money involved.

    "They have hyped this into astronomical terms since the beginning. It came back to bite them," Black said.

    Esformes has been jailed since his 2016 arrest. The charges he was convicted of add up to more than 250 years in prison, but he is likely to get far less than that under federal sentencing guidelines.

    A hospital administrator and a physician's assistant and other co-conspirators pleaded guilty previously for their roles in the scheme. Some of them testified against Esformes during the seven-week trial.

    The Associated Press contributed to this report.

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