Florida trio charged in $1bn US healthcare scheme

The US Justice Department on Friday announced charges against three Florida residents in a $1 billion Medicare fraud and money laundering scheme said to be the largest US healthcare fraud case ever.

The scheme involved more than 30 Miami-area skilled nursing and assisted living facilities, where patients received unnecessary or incorrect treatment that was billed to Medicare — the federal health care program for the elderly and disabled — and Medicaid, the government program for low-income health coverage.

“This is the largest single criminal healthcare fraud case ever,” said Assistant Attorney General Leslie Caldwell of the Justice Department’s Criminal Division.

“Many individuals were drug addicts and some of the drug addicts were given opioids… greatly exacerbating their addiction,” Caldwell said at a news conference.

The suspects — Philip Esformes, 47; Odette Barcha, 49; and Arnaldo Carmouze, 56 — were arrested in Miami and face charges of conspiracy, obstruction of justice, money laundering and healthcare fraud.

Esformes owns a network of health care facilities. Barcha is a hospital administrator, and Carmouze is a medical assistant.

The three allegedly “wove together a network of corrupt doctors, hospitals, and other health care providers across South Florida in a sprawling conspiracy to cheat taxpayers out of millions of dollars,” said US Attorney Wifredo Ferrer of the southern district of Florida.

The conspirators allegedly “paid bribes and kickbacks to get patients admitted to facilities owned or controlled by Esformes,” Ferrer said.

He said the three suspects were “ruthlessly efficient” in bilking the government.

Since 2006, more than 2,000 people have faced healthcare fraud charges in South Florida — “ground zero” for these scams — totaling more than $6 billion, Ferrer said.