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Court upholds health exec's convictions, $44 million penalty over nursing home fraud

Philip Esformes
Rob Latour
/
Invision/AP
In this Aug. 7, 2015 file photo, Philip Esformes arrives at the 15th Annual Harold and Carole Pump Foundation Gala held at the Hyatt Regency Century Plaza, in Los Angeles. The Florida health care executive was sentenced to 20 years in prison and ordered to pay about $5.5 million in restitution and forfeit $38.7 million.

Philip Esformes was found guilty in 2019 in what federal prosecutors described at the time as the “largest health care fraud scheme charged by the U.S. Justice Department.”

A federal appeals court Friday upheld the convictions of a South Florida health care executive on charges of fraud, illegal kickbacks and money laundering.

A three-judge panel of the 11th U.S. Circuit Court of Appeals rejected arguments by Philip Esformes, who was found guilty in 2019 in what federal prosecutors described at the time as the “largest health care fraud scheme charged by the U.S. Justice Department.”

Esformes, whose businesses included nursing homes, was accused of defrauding the Medicare and Medicaid programs, according to Friday’s ruling. That included such things as bribing doctors to improperly refer patients to his facilities and billing for unnecessary and expensive medical services.

After being convicted, Esformes was sentenced to 20 years in prison and ordered to pay about $5.5 million in restitution and forfeit $38.7 million, according to the appeals court. Then-President Donald Trump commuted Esformes’ prison sentence but left intact the convictions and other parts of the sentence.

In the appeal, Esformes raised a series of issues, including that a district judge should have dismissed the indictment or disqualified prosecutors because of mishandling of legally privileged materials. But the appeals court rejected the arguments.

“Esformes has not even attempted to satisfy his burden of proving prejudice (related to prosecutorial misconduct),” Chief Judge William Pryor wrote in an opinion joined by Judges Jill Pryor and Britt Grant. “The district court applied the correct legal standard and found that the privilege violations did not prejudice Esformes because the privileged materials did not serve as either the basis for the charges against him or the evidence admitted at trial.”