The defendant convicted in connection of one of the most massive fraud schemes in U.S. healthcare history is free after his sentence was commuted.
I have written five previous articles on Philip Esformes, who was sentenced to 20 years in federal prison for a truly infamous scheme to defraud Medicare out of millions of dollars. He bribed doctors and other providers of care to send patients to his skilled nursing homes.
Esformes, the operator of a total of 16 skilled nursing and assisted living facilities in South Florida, was found guilty on 20 charges, including paying bribes and kickbacks to bring Medicare patients into his businesses. According to Assistant Attorney General Brian A. Benczkowski of the U.S. Justice Department’s Criminal Division, “Philip Esformes orchestrated one of the largest healthcare fraud schemes in U.S. history, defrauding Medicare and Medicaid to the tune of over a billion dollars.”
At his sentencing, Judge Robert Scola said Esformes’s illegal plotting to get Medicare patients was “unmatched in our community, if not our country.” The judge went on to say that Esformes “violated trust in epic proportions.”
Normally, a commutation of a federal prison term is granted out of compassion based on medical or family issues. It may also be the result of the recipient having “turned over a new leaf,” having gone on to provide a service to our society. Unfortunately, none of these appear to apply to Esformes, whose sentence was commuted by former President Donald Trump shortly before Christmas last year, after he had served fewer than five years of his 20-year term.
Yet the federal government is now trying Esformes on charges not related to the ones commuted. Concerned that a convicted healthcare mogul freed in such fashion might flee the country, Justice Department prosecutors urged a federal judge Tuesday to confine Esformes to his South Florida home with an electronic ankle monitor, and impose a $10.5 million bond to ensure his appearance for a new trial.
But their request was effectively rebuffed, at least for now. Judge Scola instead granted a request by Esformes’s defense team to postpone the government’s bond proposal until mid-August, when it will be taken up again.
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Recent guidance from the Centers for Medicare & Medicaid Services (CMS) on Medicaid State Directed Payments (SDPs) has been widely interpreted as a tightening of
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