ALF owner in $1 billion fraud case now accused of bribery

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Before an owner of dozens of Miami-area assisted living and skilled nursing facilities was accused in a $1 billion healthcare fraud scheme in July, he allegedly tried to bribe a state regulator to find out what Florida officials knew about his operations, according to the Miami Herald.

In July, Philip Esformes was charged with conspiracy, obstruction, money laundering and healthcare fraud in what government officials called “the largest single criminal healthcare fraud case ever brought against individuals by the Department of Justice.”

The government alleges that when residents of Esformes' SNFs would near or arrive at the end of Medicare's 100-day post-hospital benefit period for skilled nursing, they would be moved to his ALFs, where Esformes would provide access to them by “any healthcare provider willing to pay a kickback,” even if providers did not deliver services or if the services were not medically necessary.

The residents allegedly would be readmitted to the hospital after the required 60-day waiting period between consecutive admissions to a SNF, and a new cycle would begin, according to the government.

In mid-2015, however, before the charges were announced, Esformes allegedly gave $5,000 to a friend to pass along to an employee of Florida's Agency for Health Care Administration. He hoped the money would provide him access to resident complaints and planned inspection dates for his facilities so he could address issues before inspectors visited, the media outlet reported, citing remarks that Justice Department attorneys made when they added a new federal grand jury indictment to the case earlier this month.

Esformes' transaction with friend Gabriel Delgado was videotaped, however; the friend and his brother, Guillermo, had agreed to help investigators because they were in trouble with the federal government for their roles in a Medicare fraud scheme, the Miami Herald said. The Delgados later cut plea deals on conspiracy charges.

Esformes' attorney, Michael Pasano, told the Miami Herald that “the newest version of the indictment repeats most of what has already been alleged against Mr. Esformes and is based directly on claims made by admitted criminals who in return for lesser sentences have pointed fingers at Mr. Esformes.”

Esformes has been in prison since July. His trial is set to begin Sept. 18. He faces possible life in prison and forfeiture of assets if found guilty, according to the newspaper.

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