The Miami Herald’s Jay Weaver reported the cliche story of greed and loathing in Miami represented by the disgusting Philip Esformes. “FBI agents arrested Esformes in July 2016 and he suddenly became the poster boy for the biggest Medicare fraud case in the country. He was charged with bilking $1 billion out of the federal healthcare program for the elderly and disabled, while his vast business assets and bank accounts were frozen.”
According to the Justice Department’s indictment, Esformes is accused of exploiting his network of about 20 Miami-Dade skilled-nursing and ALFs to fleece the taxpayer-funded Medicare program by filing false claims for services that were not necessary or not provided over the decade leading up to his arrest. Esformes is also accused of referring his own network of patients to convicted healthcare-fraud offenders, including Guillermo and Gabriel Delgado, who are serving prison time. The brothers admitted swindling Medicare for mental-health, prescription-drug, and home-healthcare services, and they ultimately helped federal investigators target the Miami Beach executive.
Esformes was also charged with obstructing justice because prosecutors say he plotted in 2015 with the Delgado brothers to help one of them leave Miami for Israel to avoid trial. Unbeknown to Esformes, the co-conspirators, who had already been charged with sharing Medicare patients with him in the alleged kickback scheme, recorded a two-hour conversation with him before Esformes was indicted the following year. The secret recording was carried out as part of the brothers’ cooperation deal with the feds to plead guilty.
Esformes was back in court for one final hearing asking for another delay before he goes to trial by himself on Feb. 11., two and half years after Esformes’ arrest. Esformes is standing trial alone because all of his co-conspirators have already pleaded guilty, including a physician’s assistant, Arnaldo Carmouze, and a former Larkin Community Hospital outpatient director, Odette Barcha. In January, both admitted that they recycled Medicare patients through the hospital and Esformes’ network of nursing homes and ALFs in an elaborate bribery scheme that prosecutors say was orchestrated by the healthcare executive.
His father, Morris Esformes, a Chicago rabbi who made a fortune in the healthcare business, is footing the son’s legal bills. Father and son were once partners in a similar chain of skilled-nursing and assisted-living facilities in Chicago before expanding to Miami.
Justice Department officials — along with South Florida’s U.S. attorney, the FBI, and Health and Human Services agents — described the Esformes prosecution as the nation’s biggest Medicare fraud case.
Prosecutors said his healthcare network as well as other co-conspirators billed $1 billion for fraudulent medical services since 2009. In turn, Medicare paid Esformes’ skilled-nursing and assisted-living facilities and the Delgado brothers’ healthcare operations about $500 million.