Chicago Sun-Times (Sunday)

TRUMP’S PARDONS INCLUDED EXECS BEHIND MASSIVE MEDICARE FRAUDS

- BY FRED SCHULTE

At the last minute, former President Donald Trump granted pardons to several individual­s convicted in huge Medicare swindles that prosecutor­s said often harmed or endangered elderly and infirm patients while fleecing taxpayers.

“These aren’t just technical financial crimes. These were major, major crimes,” said Louis Saccoccio, chief executive officer of the National Health Care Anti-Fraud Associatio­n, an advocacy group.

The list of about 200 Trump pardons or commutatio­ns, most issued as he vacated the White House, included at least seven doctors or health care entreprene­urs who ran discredite­d health care enterprise­s, from nursing homes to pain clinics.

One is a former doctor and California hospital owner embroiled in a massive workers’ compensati­on kickback scheme that prosecutor­s said prompted more than 14,000 dubious spinal surgeries.

Another was in prison after prosecutor­s accused the former owner of nursing homes in Illinois and Florida of ripping off more than $1 billion from Medicare and Medicaid through nursing homes and other senior care facilities — among the largest frauds in U.S. history.

“All of us are shaking our heads with these insurance fraud criminals just walking free,” said Matthew Smith, executive director of the Coalition Against Insurance Fraud.

The Trump White House said that all deserved a second chance. One man was said to have devoted himself to prayer. Another planned to resume charity work or other community service. Others won clemency at the request of prominent Republican former attorneys general or others who argued their crimes were victimless or said critical errors by prosecutor­s had led to improper conviction­s.

Trump commuted the sentence of former nursing home magnate Philip Esformes, a part-time Chicago resident, in late December. He was serving a 20-year sentence for bilking $1 billion from Medicare and Medicaid.

An FBI agent called him “a man driven by almost unbounded greed.” Prosecutor­s said Esformes used proceeds from his crimes to make a series of “extravagan­t purchases, including luxury automobile­s and a $360,000 watch.”

Esformes also bribed the basketball coach at the University of Pennsylvan­ia “in exchange for his assistance in gaining admission for his son into the university,” according to prosecutor­s.

Fraud investigat­ors had cheered the conviction. In 2019, the National Health Care Anti-Fraud Associatio­n gave its annual award to the team responsibl­e for making the case.

Saccoccio said that such cases are complex and that investigat­ors sometimes spend years and put their “heart and soul” into them. “They get a conviction, and then they see this happen,” he said. “It has to be somewhat demoralizi­ng.”

Tim McCormack, a Maine lawyer who represente­d a whistleblo­wer in a 2007 kickback case involving Esformes, said these cases “are not just about stealing money.”

“This is about betraying their duty to their patients,” McCormack said. “This is about using their vulnerable, sick and trusting patients as an ATM to line their already rich pockets. These pardons send the message that, if you are rich and connected and powerful enough, then you are above the law.”

The Trump White House saw things much differentl­y.

“While in prison, Mr. Esformes, who is 52, has been devoted to prayer and repentance and is in declining health,” the Trump White House’s pardon statement said.

The White House said the action was backed by former Attorneys General Edwin Meese and Michael Mukasey, while Ken Starr, one of Trump’s lawyers in his first impeachmen­t trial, filed briefs in support of his appeal claiming prosecutor­ial misconduct related to violating attorney-client privilege.

Trump also commuted the sentence of Dr. Salomon Melgen, a Florida eye doctor who had served four years in federal prison for fraud. That case also ensnared U.S. Sen. Robert Menendez, D-New Jersey, who was acquitted in the case and helped seek the action for his friend, according to the Trump White House.

Prosecutor­s had accused Melgen of endangerin­g patients with needless injections

to treat macular degenerati­on and other unnecessar­y medical care, describing his actions as “truly horrific” and “barbaric and inhumane,” according to a court filing.

Melgen “not only defrauded the Medicare program of tens of millions of dollars, but he abused his patients — who were elderly, infirm, and often disabled — in the process,” prosecutor­s wrote. These treatments “involved sticking needles in their eyes, burning their retinas with a laser and injecting dyes into their bloodstrea­m.”

Prosecutor­s said the scheme raked in “a staggering amount of money.” Between 2008 and 2013, Medicare paid the solo practition­er about $100 million. He took in an additional $10 million from Medicaid, the government health care program for low-income people, $62 million from private insurance and about $3 million in patients’ payments, prosecutor­s said.

In commuting Melgen’s sentence, Trump cited support from Menendez and U.S. Rep. Mario Diaz-Balart, R-Florida. “Numerous patients and friends testify to his generosity in treating all patients, especially those unable to pay or unable to afford health care insurance,” the statement said.

In a written statement, Melgen, 66, thanked Trump and said his decision ended “a serious miscarriag­e of justice.”

“Throughout this ordeal, I have come to realize the very deep flaws in our justice system and how people are at the complete mercy of prosecutor­s and judges,” Melgen said. “As of today, I am committed to fighting for unjustly incarcerat­ed people.”

He denied having harmed any patients. Faustino Bernadett, a former California anesthesio­logist and hospital owner, received a full pardon. He had been sentenced to 15 months in prison in connection with a scheme that paid kickbacks to doctors for admitting patients to Pacific Hospital of Long Beach for spinal surgery and other treatments.

“As a physician himself, defendant knew that exchanging thousands of dollars in kickbacks in return for spinal surgery services was illegal and unethical,” prosecutor­s wrote.

Many of the spinal surgery patients “were injured workers covered by workers’ compensati­on insurance. Those patient-victims were often blue collar workers who were especially vulnerable as a result of their injuries,” according to prosecutor­s.

The Trump White House said the conviction “was the only major blemish” on the doctor’s record. While Bernadett failed to report the kickback scheme, its pardon statement said, “He was not part of the underlying scheme itself.”

It also said Bernadett was involved in numerous charitable activities, including “helping protect his community from COVID-19.”

“President Trump determined that it is in the interests of justice and Dr. Bernadett’s community that he may continue his volunteer and charitable work,” the White House statement said.

Others who received pardons or commutatio­ns included former New York businessma­n Sholam Weiss, who was said to have been issued the longest sentence ever for a white-collar crime — 835 years.

“Mr. Weiss was convicted of racketeeri­ng, wire fraud, money laundering and obstructio­n of justice, for which he has already served over 18 years and paid substantia­l restitutio­n. He is 66 years old and suffers from chronic health conditions,” according to the White House.

John Davis, the former chief executive officer of Comprehens­ive Pain Specialist­s, a Tennessee-based chain of pain-management clinics, had spent four months in prison. Federal prosecutor­s charged Davis with accepting more than $750,000 in illegal bribes and kickbacks in a scheme that billed Medicare $4.6 million for durable medical equipment.

Trump’s pardon statement cited support from country singer Luke Bryan, said to be a friend of Davis.

“Notably, no one suffered financiall­y as a result of his crime and he has no other criminal record,” the statement said. “Prior to his conviction, Mr. Davis was well known in his community as an active supporter of local charities. He is described as hardworkin­g and deeply committed to his family and country. Mr. Davis and his wife have been married for 15 years, and he is the father of three young children.”

CPS was the subject of a November 2017 investigat­ion by KHN that scrutinize­d its Medicare billings for urine drug testing. Medicare paid the company at least $11 million for urine screenings and related tests in 2014, when five of CPS’ medical profession­als were among the nation’s top such Medicare billers.

 ?? AP FILE ?? Philip Esformes, seen at a fund-raising gala in Los Angeles in 2015, was sentenced to 20 years in prison for orchestrat­ing what prosecutor­s described as a $1 billion Medicare fraud scheme.
AP FILE Philip Esformes, seen at a fund-raising gala in Los Angeles in 2015, was sentenced to 20 years in prison for orchestrat­ing what prosecutor­s described as a $1 billion Medicare fraud scheme.
 ??  ?? Former President Donald Trump
Former President Donald Trump
 ?? AP FILE ?? Dr. Salomon Melgen, a Florida eye doctor, did four years in federal prison for fraud. Prosecutor­s said he endangered patients with unnecessar­y medical care they described as “truly horrific.”
AP FILE Dr. Salomon Melgen, a Florida eye doctor, did four years in federal prison for fraud. Prosecutor­s said he endangered patients with unnecessar­y medical care they described as “truly horrific.”

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