Philip Esformes had an expensive Thursday. That’s because the senior living operator was ordered to pay $44.2 million for his role in a $1.3 billion healthcare fraud scheme.

Judge Robert N. Scola Jr. ordered Esformes to forfeit $38.7 million and pay $5.5 million in restitution during a hearing in Miami federal court.

Earlier this year, he was found guilty of several bribery, kickback and money-laundering charges. He was sentenced to 20 years in prison in September. After his arrest in 2016, government officials called his Medicare fraud case the largest in the nation’s history.

Department prosecutor Allan Medina said that thousands of elderly residents were denied services as a result of his money-skimming schemes.

“He has no excuse for what he did,” Medina said. “He has no respect for the law. He has no remorse whatsoever.”