Morning Briefing
Summaries of health policy coverage from major news organizations
$1B Fraud Case Shines Light On Lucrative Medicare Black Market
The New York Times: U.S. Says Florida Network Defrauded Medicare And Medicaid Of Over $1 Billion
In the biggest health care fraud case the Justice Department has ever brought, prosecutors charged on Friday that the owner of a network of Florida nursing facilities orchestrated an elaborate scheme to defraud Medicare and Medicaid of more than $1 billion over the last 14 years. The case, featuring allegations of bribes to Miami doctors, hush money to witnesses, and laundering of huge profits through shell companies, shone a light on a lucrative Medicare black market that has surfaced in the last decade. (Lichtblau, 7/22)
The Associated Press: Authorities: $1B Medicare Fraud Nursing Home Scam, 3 Charged
"This is the largest single criminal health care fraud case ever brought against individuals by the Department of Justice," Assistant Attorney General of the Justice Department's Criminal Division Leslie Caldwell announced in a statement. Authorities said Philip Esformes, who ran 30 nursing homes and assisted living facilities, joined with two conspirators and a complex network of corrupt doctors and hospitals to refer thousands of patients to their facilities even though the patients did not qualify for the services. Some of the treatments were harmful, they added. (Kennedy, 7/22)
The Wall Street Journal: Justice Department Charges Three In $1 Billion Medicare Fraud Scheme In Florida
The case was brought as part of an interagency Medicare Fraud Strike Force, which operates in nine locations across the country, officials said. Since its creation in March 2007, the task force has charged nearly 2,900 defendants who have collectively billed the Medicare program for more than $10 billion, they said. Fraud continues to plague the roughly $600 billion Medicare program, though new criminal cases have slowed in recent years. (O'Keeffe, 7/22)
Bloomberg: U.S. Charges 3 In $1 Billion Miami-Based Medicare Fraud Case
The Justice Department charged three Florida health care executives for allegedly carrying out a $1 billion Medicare scam involving numerous Miami-based medical providers. ... Philip Esformes, owner of a chain of more than 30 Miami-area skilled nursing and assisted living facilities, allegedly conspired with two other people to defraud Medicare by providing medically unnecessary services to people, according to a 34-page indictment released Friday. (Strohm and Harris, 7/22)
