Esformes, Sentenced to 20 Years, Refused Offer of 4-Year Reduction in Exchange for Admission of Guilt and Plans Appeal

In 2016, then-U.S. Attorney Wifredo Ferrer announced a $1 billion Medicare fraud case against Miami Beach healthcare executive Philip Esformes and others at a news conference.

Miami healthcare exec Esformes sentenced to 20 years in biggest Medicare fraud case

Philip Esformes, who once reigned over a healthcare kingdom that made him a super-rich man, was sentenced to 20 years in prison Thursday for paying bribes and receiving kickbacks in a massive $1 billion Medicare fraud case touted by federal prosecutors as the biggest in the nation.

U.S. District Judge Robert Scola said Esformes’ scheme to generate thousands of Medicare patients for his chain of assisted-living and nursing-home facilities in Miami-Dade was “unmatched in our community, if not our country.”

The judge said the taxpayer-funded Medicare program for the elderly and indigent was built on an honor system, and that “Mr. Esformes violated that trust in epic proportions.”

Before Scola issued his punishment, the wealthy Miami Beach business executive sobbed as he apologized to the judge. “I lost everything I loved,” Esformes, 50, said, admitting he was a “broken” man who was “disgusted” by his criminal activity. “I destroyed my marriage. I scarred my three children. There is no one to blame but myself. I accept responsibility for what I have done and regret it.”

Convicted at trial in April of 20 healthcare-related bribery, kickback and money-laundering charges, Esformes gave an emotional 16-minute speech that generally acknowledged his criminal life but also aimed for mercy. He has been held in the Miami federal detention center since his arrest three years ago.

“Your honor, I don’t want this [crime] to be the only legacy I leave behind,” said Esformes, whose lawyers and supporters in the courtroom spoke of his personal and financial charity, especially in the Jewish, medical and academic communities.

Justice Department prosecutor Allan Medina said Esformes not only exploited patients to line his pockets at his chain of 16 assisted-living and skilled-nursing facilities, but “corrupted” the whole Medicare system in his zeal to fill patient beds without providing actual care.

“He corrupted the entire system — the Medicare and Medicaid system,” Medina said. “Philip Esformes had every opportunity. He had wealth, [making] $78 million in 2017. … He has no excuse for what he did. He has no respect for the law. He has no remorse whatsoever.

“He was the boss,” Medina said. “He bullied people to get what he wanted.”

Justice Department prosecutors Medina, Elizabeth Young and James Hayes argued that Esformes had billed $1 billion to the federal health insurance program for questionable services that patients largely didn’t need or even receive between 2006 and 2016. For his sentencing, they estimated the government’s loss at more than $550 million and urged the judge to give Esformes 30 years in prison.

However, one of Esformes’ defense attorneys, Howard Srebnick, argued that the government’s estimated loss to Medicare was grossly inflated. He said the loss was as low as $690,000 and argued for a 10-year sentence.

Scola then cut Esformes a break, saying the loss was between $4.9 million and $8.3 million, which helped reduce the defendant’s potential sentence significantly. Scola called his estimate “highly conservative.”

At a critical juncture before he imposed Esformes’ punishment, the judge seemed willing to lower his final sentence by four years if the defendant agreed to elaborate on his “acceptance of responsibility” in his original statement to Scola. The judge said he would only acknowledge Esformes’ acceptance if he specifically admitted he paid bribes and committed other crimes. But, after Srebnick consulted with counsels Roy Black and Jackie Perczek, Esformes’ legal team chose not to go that route because it would have precluded their appeal of his trial convictions.

“There’s not much more Mr. Esformes will say today about his feelings and remorse,” Srebnick told the judge, arguing he has suffered greatly in federal detention, endured unending shame, and is no longer the arrogant man he was before his arrest.

After the sentencing hearing, Srebnick said Esformes plans to raise critical pre-trial allegations on appeal that had attacked how federal authorities obtained documents and recordings that led to the defendant’s indictment.

“For three years, the government alleged a $1 billion fraud, but today the district judge rejected that grossly exaggerated characterization,” Srebnick told the Miami Herald. “We are optimistic that the [federal] court of appeals will reinstate the magistrate judge’s findings of deplorable prosecutorial misconduct and will vacate the convictions and sentence.”

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College Scandal Tied to Massive Medicare Fraud Case and the Key Worldwide Foundation – Esformes and Singer

William “Rick” Singer

FBI found clues to college admissions scandal years earlier in massive Medicare fraud case

Federal authorities were combing through the finances and phone records of a Miami businessman suspected of Medicare fraud when they came across a curious name: Rick Singer.

Philip Esformes, who was accused of farming out patients from his nursing homes to steal millions in bogus insurance claims, had sent hundreds of thousands of dollars to a foundation Singer controlled. And in text messages discovered on Esformes’ phone, the men discussed how one of Esformes’ sons had performed on his college entrance exams.

Only years later would authorities learn what Esformes had paid Singer to do: Slip his daughter into USC as a fake soccer player and fix his youngest son’s college entrance exam, according to statements a prosecutor made in court and sources familiar with the case.

Singer has said he struck similar deals with dozens more parents, an admission that has roiled higher education and implicated elites from Hollywood, Silicon Valley and the Newport coast.

But in 2016, when agents seized the iPhone Esformes used to text Singer and obtained their messages, Singer was a peripheral, if curious, player in an enormous healthcare fraud investigation. The Esformes case marks the first time Singer is known to have crossed the radar of law enforcement.

Singer would run his admissions scam undisturbed until another team of investigators, working in Boston on an altogether different case, caught a second glimpse of his operation in 2018 and unraveled it.

Andrew Lelling, the U.S. Attorney in Massachusetts, unveiled that investigation in March. Fifty people were charged, including dozens of parents and coaches at such elite schools as Yale, Stanford, Georgetown and USC, who were accused of selling spots that their schools reserved for recruited athletes.

Esformes has not been charged in the college admissions case. Convicted in April of paying and receiving kickbacks in connection with a federal healthcare program and other crimes, he faces decades in prison when a judge sentences him in September. His attorneys declined to comment.

Spokespeople for federal prosecutors in Boston and Miami declined to comment.

It is unclear how much federal authorities uncovered of Esformes’ dealings with Singer while investigating his case. But at his trial in March, a fraud expert used by the government to make sense of his finances testified that Esformes had made $400,000 in payments over several years to Singer’s foundation. At least some of the money was traced to Medicaid and Medicare funds, the expert testified.

Singer has since admitted that his Key Worldwide Foundation was little more than a sham used to launder money from clients and parcel out bribes to coaches, test proctors and bagmen.

Esformes check to The Key.jpg

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Esformes Must Forfeit Interests in Long-Term Care Companies, if Only Others Would Follow

Esformes must forfeit interest in long-term care operating companies, judge rules

Philip Esformes, the Florida assisted living and skilled nursing facility owner found guilty in April of more than 20 charges in a case that the federal government described as “the largest single criminal healthcare fraud case ever brought against individuals by the Department of Justice,” must forfeit his interest in seven operating companies related to his facilities, a federal court has ruled.

The decision, issued July 1 in the U.S. District Court for the Southern District of Florida, was a denial of Esformes’ motion asking the court to acquit a jury’s verdict that the assets were forfeitable. The judge’s order applies to Esformes’ interest in the operating companies for the following assisted living or skilled nursing properties: Eden Gardens in Miami, Fair Havens Center in Miami Springs, Flamingo Park Manor in Hialeah, Harmony Health Center in Kendall, North Dade Nursing and Rehabilitation Center in North Miami, Nursing Center at Mercy in Miami and the now-closed Oceanside Extended Care Center in Miami Beach.

“Esformes’s operating companies gave his business a facade of legitimacy as he used them to hold bank accounts and operate the various SNFs and ALFs engaged in the elaborate money laundering and kickback scheme,” U.S. District Judge Robert N. Scola Hr, wrote. “Accordingly, the Court finds that there is sufficient evidence to ‘permit a reasonable jury to conclude that the Government has proven, by a preponderance of the evidence, that the property is subject to forfeiture.’ ”

Scola also denied Esformes’ motions seeking acquittal and a new trial.

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