$1 billion fraud investigation leads to five-year prison sentence for former Florida state employee

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$1 billion fraud investigation leads to five-year prison sentence for former Florida state employee
$1 billion fraud investigation leads to five-year prison sentence for former Florida state employee

A 30-year employee of the agency that oversees the licensure of assisted living and skilled nursing facilities in Florida was sentenced to almost five years in prison Friday for accepting bribes in exchange for providing confidential information to operators.

Bertha Blanco, who worked for Florida's Agency for Health Care Administration, was sentenced to 57 months in prison after pleading guilty Oct. 13 to one count of bribery concerning a program receiving federal funds. The facilities allegedly involved in the scheme accepted payments from Medicare and Medicaid. AHCA also administers Florida's Medicaid program.

Blanco additionally was ordered to pay $441,000 in restitution and will forfeit $100,000, an amount that represents the gross proceeds traced to the crimes.

According to the Department of Justice, one of the people to whom she provided information is Philip Esformes, the ALF/SNF owner who was charged in July 2016 with conspiracy, obstruction, money laundering and healthcare fraud in connection with a $1 billion scheme that the department said was “the largest single criminal healthcare fraud case” it ever has brought against an individual.

Blanco's actions, in fact, were uncovered as part of the investigation into Esformes. She was arrested and charged July 11, as McKnight's Senior Living previously reported.

According to court documents obtained by McKnight's Senior Living, Blanco asked for and received cash bribes for providing ALF and SNF owners with confidential resident complaints made to AHCA as well as the dates for unannounced inspections scheduled by the agency's surveyors. The owners reportedly used the information to falsify medical paperwork and remedy deficiencies in advance of visits so that AHCA would not revoke their facility licenses. The owners then submitted false claims to Medicare and Medicaid for residents named in the complaints and inspection reports, the Justice Department said.

As part of her guilty plea, Blanco admitted that she solicited and received thousands of dollars in cash bribes from Miami-area owners of ALFs, SNFs and home health agencies, as well as intermediaries working with them, from at least 2007 through June 2015.

In addition to Esformes, who is scheduled for a March trial, other purchasers of information provided by Blanco, according to the Justice Department, include Sila Luis, Isabel Lopez, Gustavo Mustelier, and Gabriel Delgado and Guillermo Delgado.

Luis pleaded guilty in June to conspiracy to commit healthcare fraud and was sentenced to 80 months in prison.

Lopez and Mustelier pleaded guilty in May to conspiracy to defraud the United States and are awaiting sentencing.

Gabriel Delgado pleaded guilty in 2015 to money laundering and was sentenced to 55 months in prison. Guillermo Delgado pleaded guilty in 2015 to conspiracy to distribute a controlled substance and was sentenced to 110 months in prison.

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