$1 billion alleged Medicare fraud, money laundering scheme leads to Florida arrests

[babylonsister]

$1 billion alleged Medicare fraud, money laundering scheme leads to Florida arrests
Dan Mangan | @_DanMangan
11 Hours Ago
CNBC.com


Three Florida residents have been charged in the "largest single criminal health-care fraud case ever brought against individuals" by the U.S. Justice Department — an alleged Medicare fraud and money laundering scheme that netted participants a whopping $1 billion since 2009, prosecutors revealed Friday.

The owner of more than 30 Miami-area skilled nursing and assisted living facilities, as well as a hospital administrator and a physician's assistant were charged in an indictment with conspiracy, money laundering and health-care fraud, the U.S. Attorney's office in Miami said.

An explosive indictment and other court documents filed Friday claim that the massive alleged scam helped wealthy health-care operator Philip Esformes, 47, fund a lifestyle that included private jets, a $600,000 watch, meetings with escorts in hotel rooms, and a private basketball coach for his son.

The indictment claims that Esformes, 47, with his co-conspirators, cycled thousands of Medicare and Medicaid beneficiaries through his Esformes Network facilities despite the fact they didn't qualify for such care.

At those facilities, prosecutors said, they also "received medically unnecessary services that were billed to Medicare and Medicaid," the huge government-run health programs that cover primarily senior citizens and the poor, respectively.

more...

http://www.cnbc.com/2016/07/22/1-billion-alleged-medicare-fraud-money-laundering-scheme-leads-to-florida-arrests.html?__source=msn%7Cmoney%7Cheadline%7Cstory%7C&par=msn

[spanone]

1. Following the lead of their florida governor.....rick scott

ricky scott:

On March 19, 1997, investigators from the FBI, the Internal Revenue Service and the Department of Health and Human Services served search warrants at Columbia/HCA facilities in El Paso and on dozens of doctors with suspected ties to the company.[31] Eight days after the initial raid, Scott signed his last SEC report as a hospital executive.[32] Four months later the board of directors pressured Scott to resign as Chairman and CEO.[33] He was paid $9.88 million in a settlement, and left owning 10 million shares of stock worth over $350 million.[34][35][36] The directors had been warned in the company's annual public reports to stockholders that incentives Columbia/HCA offered doctors could run afoul of a federal anti-kickback law passed in order to limit or eliminate instances of conflicts of interest in Medicare and Medicaid.[32]

In settlements reached in 2000 and 2002, Columbia/HCA pleaded guilty to 14 felonies and agreed to a $600+ million fine in the largest fraud settlement in U.S. history. Columbia/HCA admitted systematically overcharging the government by claiming marketing costs as reimbursable, by striking illegal deals with home care agencies, and by filing false data about use of hospital space. They also admitted fraudulently billing Medicare and other health programs by inflating the seriousness of diagnoses and to giving doctors partnerships in company hospitals as a kickback for the doctors referring patients to HCA. They filed false cost reports, fraudulently billing Medicare for home health care workers, and paid kickbacks in the sale of home health agencies and to doctors to refer patients. In addition, they gave doctors "loans" never intending to be repaid, free rent, free office furniture, and free drugs from hospital pharmacies.[3][4][5][6][7]

In late 2002, HCA agreed to pay the U.S. government $631 million, plus interest, and pay $17.5 million to state Medicaid agencies, in addition to $250 million paid up to that point to resolve outstanding Medicare expense claims.[37] In all, civil lawsuits cost HCA more than $2 billion to settle; at the time this was the largest fraud settlement in U.S. history.[38][39]

https://en.wikipedia.org/wiki/Rick_Scott

[babylonsister]

2. I was hoping Scott

was somehow involved; that would make sense to me as he has his hand in so many cookie jars.

[progressoid]

3. "meetings with escorts"

Meetings?

I'm guessing it was more than a meeting.

[Scuba]

4. Spin Alert! "Three Florida *** residents *** were actually three Florida corporate con men.

"Residents" of course are people who live in apartments, or maybe small houses, and of course nursing homes.