Phillip Esformes' Fraud Case in Healthcare Services for Elderly

Legal Aspects of Healthcare: Phillip Esformes Case
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Legal Aspects of Healthcare: Phillip Esformes Case Introduction Fraud is arguably the most prevalent crime in banking, insurance, real estate, cryptocurrency, and federal and state government tenders and contracts. Health care is also affected by cases of fraud, where companies submit claims for services and care that were not rendered in the first place. The billing of services not provided is proliferated by medical practitioners and caregivers who charge patients for services not offered (Whistleblower Attorneys, 2016). As a result, the Phillip Esformes case presents an actual fraud case in providing healthcare services for the elderly. Charges and Penalties In 2019, Phillip Enformes, an assisted living and skilled nursing facility mogul in Miami, Florida, was charged with more than 20 counts of bribery, money laundering, fraud, and obstruction of justice in a 1.3-billion-dollar case. The fraud involved claims for services provided in his elderly care nursing and assisted living homes from Medicare and Medicaid (Hiltzik, 2020). Esformes used to bribe doctors and physicians to admit patients into his facilities in Miami. As a result, the patients were subjected to poor services and received unrequired medical services that were compelled on them to attract higher billing charges (Hiltzik, 2020). The fraudulent claims led to an outstanding bill of 800 million dollars, which was historic and the largest recorded by the Department of Justice. The scheme has been in operation for more than 18 years until the regulators and the media flagged it in 2016. Furthermore, he bribed the health care regulators to provide him with a watchful eye and inform him of surprise inspections at his facilities to avoid being caught. Regarding obstruction of justice, Phillip aided his associates and directors into fleeing the country before they could testify against him in court, who had agreed to cooperate with the government (Hiltzik, 2020). In addition, he also attempted to persuade one of his associates to commit suicide rather than face the trial in court. Finally, the case came to light when he amassed over $80 million, luxury cars, a lavish lifestyle, and costly and high-end jewelry. Such sudden changes flagged his sources of wealth. Punishment Due to the numerous charges against him, the court sentenced Phillip Esformes to 20 years in jail on the 20-felony charged against him. The prosecution noted that the fines were equivalent to a combined sentence of 255 years but asked for 30 years and to pay over 207 million dollars in restitution (Hale, 2019). In addition, he was found guilty of fraud, bribery, and obstruction of justice, with the crimes amounting to more than 1.3 billion dollars for the years he was involved in the fraud in his nursing home facilities. The Outcome of the Case Despite the sentencing by the court, Phillip Esformes's case was commuted by former President Donald Trump...