- A federal court has set a fall 2017 trial date (Sept. 18) for alleged Medicare fraudster Philip Esformes, who was accused of illegally referring thousands of patients to his chain of nursing home facilities.
- Esformes, who has maintained his innocence, had motioned for the delay.
- This is the largest healthcare fraud case in U.S. history, according to the U.S. Department of Justice.
The trial had been scheduled to begin Feb. 6, but the court put an end to any hopes of a speedy trial. “The Court finds that the continuance is necessary given the nature of the prosecution and the complexity of the case and the reasonable time needed for counsel to effectively prepare with all due diligence,” the order states.
Esformes used a network of corrupt physicians and hospitals to direct patients to 30 Florida nursing homes and assisted living facilities operated by Chicago-based Esformes Network, according to the DOJ. The illicit referrals occurred over a 14-year period.
Esformes — who has been in the Miami Federal Detention Center since his July 22 arrest — was denied bond for his alleged activities. He could receive life in prison if convicted on the fraud and conspiracy charges.
A hospital administrator and a physician’s assistant also were charged in the scam.
The case underscores DOJ’s hard line on fraud. The Federal Bureau of Investigation and HHS’ Office of Inspector General used advanced data analysis and forensic accounting to shine light on the full extent of the scheme. The case was investigated by a Medicare Fraud Strike Force team.
Venson Wallin, consulting managing director at accounting firm BDO, told Healthcare Dive earlier this year that administrators need to properly monitor health system data to ferret out fraud. “You need to know what’s going on in your shop from a data perspective,” he said.