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Florida Health Care Admin Charged In $1B Medicare Fraud Case

Agency For Health Care Administration
Agency For Health Care Administration

A Florida health care administrator accepted bribes in exchange for helping a nursing home owner accused of orchestrating a $1 billion Medicare and Medicaid fraud scheme keep his license, federal prosecutors said.

Bertha Blanco, 66, faces federal criminal charges in a wide-ranging investigation that federal authorities are calling the nation's biggest health fraud case, The Miami Herald reported . She was charged earlier this month.

Blanco made about $31,300 a year overseeing inspections at nursing facilities owned by 48-year-old Philip Esformes, a wealthy businessman who owns dozens of Miami-Dade nursing facilities as well as homes in Miami, Los Angeles and Chicago, prosecutors said.

A criminal complaint filed against Blanco accused her of taking tens of thousands of dollars in cash in exchange for tipping Esformes off about violations so he could address them before state inspections.

Blanco's aid allowed Esformes to keep his license active and continue billing the federal government for questionable patient services, the complaint alleged.

Blanco, a 29-year veteran of the Florida Agency for Health Care Administration, is the first of its employees ever to be charged with taking bribes, the newspaper reported.

Blanco's attorney Robyn Blake told the newspaper she is reviewing the case and deciding whether to go to trial or bargain a plea deal. Blanco is out of custody on a $250,000 bond.

Federal authorities say Blanco took the bribes and provided patient and inspection records to intermediaries, who delivered the information to Esformes.

Esformes is being held in federal detention and is scheduled to go to trial in March. His attorneys have argued that the intermediaries to whom Blanco delivered the information acted without his knowledge.

Two of those intermediaries, brothers Gabriel and Guillermo Delgado, have made plea deals and are expected to testify against Esformes. The brothers helped investigators get to Esformes by videotaping a cash transaction that prosecutors said was meant to go for bribes.

Esformes is accused of using his 20 nursing facilities to file false Medicare and Medicaid claims for services that were not necessary for 14,000 patients.

Prosecutors said his health care network and other co-conspirators billed $1 billion for fraudulent services between 2009 and 2016.