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Miami Man to Remain Jailed for Trial in Nation’s Largest Medicare Fraud Case

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

On December 3, 2018, a Florida judge ruled that a Miami businessman who has been jailed for more than two years on $1 billion health care fraud charges, must remain in custody through his trial next year. U.S. District Judge Robert N. Scola Jr. found no violation of his due process rights and denied Philip Esformes’ motion to dismiss several money laundering charges.

Trial Date is Set.

A February 11, 2019, trial date has been set for one of the nation’s biggest Medicare fraud cases that Esformes allegedly orchestrated through nursing homes and assisted living facilities he owned. […]

By The Health Law Firm|2024-03-14T10:00:17-04:00February 7, 2019|Nursing Law Blog|

Walgreens Agrees to Pay $269 Million to Settle Two FCA Suits

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

On January 22, 2019, Walgreens agreed to pay more than $269 million to settle allegations of False Claims Act (FCA) violations for overbilling of various drugs. The deals are some of the largest pay-outs ever by a retail pharmacy, according to the United States Department of Justice (DOJ).

The Two Settlements.

There were two separate complaints involving Walgreens to settle federal and state lawsuits that accused the pharmacy of overbilling federal healthcare programs. Both were unsealed by U.S. District Court judges in Manhattan, according to […]

By The Health Law Firm|2024-03-14T10:00:18-04:00January 29, 2019|Pharmacy Law Blog|

DOJ Announces $2.8 Billion Recovered Funds From Healthcare Cases in 2018

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

On December 21, 2018, the U.S. Department of Justice (DOJ) announced that it recovered more than $2.8 billion from False Claims Act (FCA) (also known as “qui tam” or “whistleblower cases”) cases in 2018. Of the $2.8 billion in settlements and judgments that the government obtained during the year through FCA cases, more than $2.5 billion involved health care fraud. These cases included drug and medical device manufacturers, managed care providers, hospitals, pharmacies, hospice organizations, laboratories, and physicians.

Health Care Fraud.

The DOJ’s largest recoveries involving the health care industry in 2018 came from the drug and medical […]

By The Health Law Firm|2024-03-14T10:00:19-04:00January 28, 2019|Health Facilities Law Blog|

DOJ Announces $2.8 Billion Recovered From Healthcare FCA Cases in 2018

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

On December 21, 2018, the U.S. Department of Justice (DOJ) announced that it recovered more than $2.8 billion from False Claims Act (FCA) (also known as “qui tam” or “whistleblower cases”) cases in 2018. Of the $2.8 billion in settlements and judgments that the government obtained during the year through FCA cases, more than $2.5 billion involved health care fraud. These cases included drug and medical device manufacturers, managed care providers, hospitals, pharmacies, hospice organizations, laboratories, and physicians.

Health Care Fraud.

The DOJ’s largest recoveries involving the health care industry in 2018 came from the drug and medical […]

By The Health Law Firm|2024-03-14T10:00:19-04:00January 14, 2019|Pharmacy Law Blog|

Miami Man to Remain Jailed for Trial in Nation’s Largest Medicare Fraud Case

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

On December 3, 2018, a Florida judge ruled that a Miami businessman who has been jailed for more than two years on $1 billion health care fraud charges, must remain in custody through his trial next year. U.S. District Judge Robert N. Scola Jr. found no violation of his due process rights. He also denied Philip Esformes’ motion to dismiss several money laundering charges.

Trial Date is Set.

A February 11, 2019, trial date has been set for one of the nation’s biggest Medicare fraud cases that Esformes allegedly orchestrated through nursing homes and assisted living facilities he […]

By The Health Law Firm|2024-03-14T10:00:20-04:00December 7, 2018|Health Facilities Law Blog|

Health Care Fraud Puts Miami Man in Jail

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

4.5 Year Sentence for Role in Fraud.

A Miami Man voluntarily returned to Miami from Cuba and was immediately met with a 4.5-year long prison sentence. Jose Gerardo Gonzalez, played a role in a scheme to defraud public schools and private health care insurers of $126 million.

Gonzalez allegedly created shell companies that submitted false health care claims. The private insurers were ultimately at lose for millions of dollars. Gonzalez fled to Cuba in 2015 after being charged with conspiracy and other charges. Upon voluntary return to Florida he is sentencing was reduced.
William Barzee, Gonzalez’s attorney, states […]

By The Health Law Firm|2024-03-14T10:01:26-04:00May 15, 2018|Mental Health Law Blog|

Jury Finds Four New Orleans Doctors and Others Guilty for Participation in $13.6 Million Medicare Fraud Scheme

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

On May 9, 2017, a federal jury found four New Orleans doctors and two others guilty for their participation in a Medicare fraud scheme. According to prosecutors the defendants netted more than $13.6 million in fraudulent Medicare reimbursements.

Details of the Scheme.

The six defendants worked for or with Abide Home Care Services (Abide) in New Orleans. Federal prosecutors said Abide routinely falsified diagnoses so Medicare reimbursements were inflated. Abide also falsified medical records that supported medically unnecessary home health services, prosecutors said. Abide was owned by Lisa Crinel, who pleaded guilty to her role in the scheme […]

By The Health Law Firm|2024-03-14T10:01:26-04:00May 15, 2018|Health Facilities Law Blog|

Health Care Fraud Puts Miami Man in Jail

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

4.5 Year Sentence for Role in Fraud.

A Miami Man voluntarily returned to Miami from Cuba and was immediately met with a 4.5-year long prison sentence. Jose Gerardo Gonzalez, played a role in a scheme to defraud public schools and private health care insurers of $126 million.

Gonzalez allegedly created shell companies that submitted false health care claims. The private insurers were ultimately at lose for millions of dollars. Gonzalez fled to Cuba in 2015 after being charged with conspiracy and other charges. Upon voluntary return to Florida he is sentencing was reduced.
William Barzee, […]

By The Health Law Firm|2024-03-14T10:01:27-04:00May 15, 2018|Health Facilities Law Blog|

Florida Government Officer Charged in Billion Dollar Medicare Fraud

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

Health Care Administrator Accepts Bribes.
An alleged $1 billion health care scheme has lead to the first known prosecution against a Florida Agency for Health Care Administration official. Bertha Blanco faces a wide range of charges including accepting bribes to tip off individuals when state wide investigations were to begin.

The Ring Alleged Ring Leader.

It is reported that Blanco oversaw inspections by the Florida Agency for Health Care Administration or “AHCA” of Florida nursing homes owned by Phillip Esformes. Blanco was allegedly taking bribes to tip off Esformes of violations reported to the state agency before the […]

By The Health Law Firm|2024-03-14T10:01:29-04:00May 15, 2018|Health Facilities Law Blog|

Florida Woman Lands Herself 6.5 Years in Prison, Owes $45 Million for Medicare Fraud Scheme

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

On November 22, 2017, a Florida woman who was accused of a $45 million Medicare fraud, received a six-and-a-half-year prison sentence, following a 2016 U.S. Supreme Court decision in her case holding that the government could not freeze untainted assets.

Sila Luis received an 80-month prison sentence in addition to being ordered to pay $45 million in restitution. This came after a 2016 guilty plea to a charge of conspiracy to commit health care fraud. Her case continued in 2017 following a 5-3 ruling by the Supreme Court holding that the government could not freeze assets […]

By The Health Law Firm|2024-03-14T10:01:31-04:00May 15, 2018|Health Facilities Law Blog|