Fraud

Justice Department Charges Three in $1 Billion Medicare Fraud Scheme in Florida

The Justice Department on Friday unsealed charges in its largest-ever criminal health-care-fraud case, charging three individuals with using a network of doctors, hospitals and health-care providers across South Florida to improperly bill more than $1 billion to Medicare and Medicaid.

Philip Esformes, the owner of more than 30 Miami-area skilled-nursing and assisted-living facilities, was the project’s mastermind, the indictment alleged. He and two co-defendants, along with other co-conspirators, allegedly paid and received bribes and kickbacks to get thousands of patients admitted to facilities Mr. Esformes controlled.

In those facilities, they were often given medically unnecessary and sometimes harmful treatments, which were then billed to Medicare and Medicaid, according to court papers.