Federal investigators on Friday unveiled a whopping $1-billion Medicare fraud case against a Miami nursing home owner – the largest in U.S. Justice Department history.
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The indictment, unsealed Friday says Philip Esformes, 47, Odette Barcha, 49, and Arnaldo Carmouze, 56, all of Miami-Dade County were part of a scheme that would send patients for unnecessary treatments then bill Medicare and Medicaid.
To put this Medicare scheme in context, the healthcare network’s billing activity equaled the amount of money that convicted Fort Lauderdale Ponzi schemer Scott Rothstein churned while he ripped off wealthy investors from Florida to NY.
Two of the accused are well known to Health and Human Services’ fraud squads: Esformes and Barcha were involved in an earlier healthcare fraud case involving similar activities in 2006, where Esformes paid $15.4 million in a settlement, the DOJ statement notes.
The three allegedly received kickbacks to steer clients to other healthcare providers, including mental-health centers and home healthcare providers.
Federal prosecutors said it was the biggest Medicare fraud scheme in the nation’s history, costing the US government program for the elderly and disabled hundreds of millions of dollars in fraudulent payments. After the 2014 arrest of co-conspirators Guillermo and Gabriel Delgado, Esformes allegedly attempted to help Guillermo Delgado’s attempt to avoid trial in Miami by helping pay for his departure from the United States.
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The indictment also alleges the group used sophisticated money laundering techniques in order to hide the scheme and Esformes’ identify from investigators.
