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Articles Tagged with health care fraud

medicaid fraud case

Former Chicago Nursing Home Executive Has Sentence Commuted After Found Guilty of Largest U.S. Medicare Fraud Scheme

Philip Esformes, who used to be a well-known Chicago-area nursing home mogul, also known as the King of Medicaid Fraud, was released from prison after President Donald Trump commuted his sentence on December 22, 2020. The Presidential commutation disturbingly lessened the former executive’s criminal sentence, without vacating the conviction itself. Esformes, 51, was arrested in 2016 for various acts of criminal conduct tied to a $1.3 billion Medicare and Medicaid fraud scheme found through a complex web of bank accounts and systemic payment of bribes. Ultimately, he was caught continuously cycling as many as 14,000 nursing home and assisted living residents in Chicago and Miami while collecting millions from government programs designed to support services he never provided. In 2019, Federal prosecutors sentenced Esformes to 20 years in prison.

“Esformes exploited and victimized patients by providing inadequate medical care and poor conditions in his nursing homes. We will continue the fight against such parasites.” -Shimon Richmond, U.S. Department of Health and Human Services Office of Inspector Generals (Miami)

finalcial abuse of elderly
Financial Abuse and Scamming Nursing Home Residents of Their Money

Several research studies, including an analysis by the U.S. Consumer Financial Protection Bureau estimate that seniors in the U.S. are scammed out of anywhere from $3 billion to $37 billion a year. Those over age 70 lose an average of $10,000 to elder financial exploitation each year, and the losses are even higher when the scammer is a friend, trusted caregiver, or relative.

  • In 2018, the Office of Financial Protection for Older Americans received over 180,000 encounters of suspicious elder financial exploitation (EFE), involving a total of more than $6 billion since 2013.
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