$1 billion Medicare fraud conspiracy alleged in Miami

The owner of more than 30 skillednursing and assisted-living facilities in the Miami area and two co-conspirators have been charged for their involvement in a $1 billion Medicare fraud and money laundering scheme, federal prosecutors said late last week.

The indictment marks the largest criminal healthcare fraud brought against individuals by the U.S. Justice Department, according to Assistant Attorney General Leslie Caldwell.

According to the indictment, Philip Esformes, 47, ran the massive scheme by billing Medicare and Medicaid for medically unnecessary services provided at his network of skilled-nursing and assisted-living facilities. Prosecutors alleged Esformes and two others named in the indictment—hospital administrator Odette Barcha, 49, and physician assistant Arnaldo Carmouze, 56—also received kickbacks for sending patients to community mental health centers, home health providers and other medical facilities that participated in the conspiracy.