Articles Tagged with health care fraud

nursing home operator on way to prison

Virginia Nursing Home Operator Found Guilty of Health Care Fraud

In Norfolk, Virginia, the operator of Turning Points Residential Care has been sentenced to two years in prison for defrauding Medicaid. According to July 2, 2021 court documents, 47-year-old Lopez Scott submitted more than $188,000 in false claims for a residential nursing facility his business was authorized to use to provide residential support services and skilled nursing services to recipients of Medicaid.

“For three years, the defendant used his position as a nursing home operator to obtain over $188,000 from the Virginia Medicaid program fraudulently,” said Raj Parekh, Acting U.S. Attorney for the Eastern District of Virginia. “Health care fraud takes funding and critical services away from those who truly need it. We will continue to hold accountable those who exploit these essential health care programs at the expense of vulnerable members of our communities.”

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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