The case involves American crooks, nursing homes, doctors, hospital workers, and over a billion in lost taxpayer dollars. Editor: One of my readers is urging me to write something about American frauds, crooks and criminals so I’ve picked this news about a case the federal government says is its largest bust (so far). (Incidentally, the charity fraud posts like the one I wrote about yesterday are about Americans too!)
Today’s story is about former ‘one-percenter’ Philip Esformes and his father Rabbi Morris Esformes and their nursing home empire.
From the Miami Heraldon Tuesday,
Once among the ‘1 percent,’ executive faces $1 billion Medicare fraud trial
Not long ago, Miami Beach executive Philip Esformes was living quite comfortably among America’s “1 percent,” raking in millions from his healthcare business, gobbling up pricey real estate and darting around the country in chartered jets. Philip Esformes has been held behind bars since his arrest in July 2016.
Then, in a flash, his luxurious lifestyle went poof: FBI agents arrested Esformes in July 2016 and he suddenly became the poster boy for the biggest Medicare fraud case in the country. He was charged with bilking $1 billion out of the federal healthcare program for the elderly and disabled, while his vast business assets and bank accounts were frozen. Worse, Esformes, 50, was ordered held without bail at the Federal Detention Center in Miami. Esformes was back in court Monday for one final hearing before he goes to trial by himself on Feb. 11. Once always tan and fit, he looked wan and frail as his defense team tried in vain to delay the start of trial. They sought more time to review the Justice Department’s long list of patients who prosecutors say received no services or medically unnecessary treatment at Esformes’ Miami-Dade chain of skilled-nursing and assisted-living facilities.
[….] Esformes is standing trial alone because all of his co-conspirators have already pleaded guilty, including a physician’s assistant, Arnaldo Carmouze, and a former Larkin Community Hospital outpatient director, Odette Barcha. In January, both admitted that they recycled Medicare patients through the hospital and Esformes’ network of nursing homes and ALFs in an elaborate bribery scheme that prosecutors say was orchestrated by the healthcare executive.
Carmouze, 59, pleaded guilty to conspiring to defraud Medicare by accepting bribes for making patient referrals to Larkin and Esformes’ healthcare facilities. Barcha, 52, pleaded guilty to conspiring to pay bribes to physicians to refer patients to Larkin and receiving kickbacks herself to move patients into Esformes’ facilities.
Read the story, the list of charges is stunning, including this one:
See a timeline of more than two decades of scams involving Philip and his father Rabbi Morris Esformes here: https://www.chicagotribune.com/news/watchdog/ct-esformes-timeline-met-20161002-story.html
Esformes is also accused of referring his own network of patients to convicted healthcare-fraud offenders, including Guillermo and Gabriel Delgado, who are serving prison time. The brothers admitted swindling Medicare for mental-health, prescription-drug, and home-healthcare services, and they ultimately helped federal investigators target the Miami Beach executive.
According to the indictment, the brothers paid some kickbacks for the patients by disguising them as payments for escort services for Esformes as well as related travel and hotel expenses. Esformes was also charged with obstructing justice because prosecutors say he plotted in 2015 with the Delgado brothers to help one of them leave Miami for Israel to avoid trial.
More here.
For those interested in more on the cheaters, see this local news storyfrom 2016 about divorce court proceedings where Philip’s ex-wife said he believed that “money is king.”
Accused wealthy fraudster’s alleged parenting style: ‘Money is king’
Are you keeping tabs of loved ones in nursing homes? Are they receiving treatment they don’t need while the facility bills Medicare? Or are they perhaps keeping a rehab patient longer than is necessary simply to milk the system, a system that is predictedto be insolvent by 2026?
Imagine “Medicare for all” that the Dems continue to clamor for!
This story should warm your heart—we are nabbing at least some of the cheaters!
This time it was by setting a trap for them with the creation of a fake university with all the trappings of a real college. The feds fake University of Farmington was located in this building says the Detroit News
Thanks to theDetroit News for another juicy story.
Feds used fake Michigan university in immigration sting
Federal agents used a fake university in Farmington Hills to lure alleged phony foreign students who were trying to stay in the United States illegally.
The University of Farmington had no staff, no instructors, no curriculum and no classes but was utilized by undercover Homeland Security agents to identify people involved in immigration fraud, according to federal grand jury indictments unsealed Wednesday.
Eight student recruiters were charged with participating in a conspiracy to help at least 600 foreign citizens stay in the U.S. illegally, according to the indictments, which describe a novel investigation that dates to 2015 but intensified one month into President Donald Trump’s tenure as part of a broader crackdown on illegal immigration. Simultaneously Wednesday, federal agents arrested dozens of University of Farmington students in a nationwide sweep. The students were arrested on immigration violations and face possible deportation, according to a spokesman for U.S. Immigration and Customs Enforcement. Most of the recruiters and students involved are originally from India, according to prosecutors.
“It’s creative and it’s not entrapment,” said Peter Henning, a Wayne State University law professor and former federal prosecutor. “The government can put out the bait, but it’s up to the defendants to fall for it.”
Those charged include:
• Bharath Kakireddy, 29, of Lake Mary, Florida.
• Aswanth Nune, 26, of Atlanta.
• Suresh Reddy Kandala, 31, of Culpeper, Virginia.
• Phanideep Karnati, 35, of Louisville, Kentucky.
• Prem Kumar Rampeesa, 26, of Charlotte, North Carolina.
• Santosh Reddy Sama, 28, of Fremont, California.
• Avinash Thakkallapally, 28, of Harrisburg, Pennsylvania.
• Naveen Prathipati, 29, of Dallas.
[….] “… the university was being used by foreign citizens as a ‘pay to stay’ schemewhich allowed these individuals to stay in the United States as a result of of foreign citizens falsely asserting that they were enrolled as full-time students in an approved educational program and that they were making normal progress toward completion of the course of study,” the indictment reads.
More here. Please go read it and send traffic to the story because the reporter, Robert Snell, has been doing great work on fraud cases.
Are you thinking about this? As we focus virtually all mainstream media coverage on the crisis at our southern border (yes, it is important), the national media is keeping us in the dark about some huge stories involving illegal immigrants (and legal ones !) who are ripping us off through fraud and other criminal activity that we must suffer and pay for.
The Westlake “man” (men) who is alleged to have ripped off US taxpayers for $2.7 million is a ‘new American’ from somewhere in the Middle East.
I hate to resort to photos like this one, but unfortunately it is rare to see a photo of the ‘new American’ fraudsters!
Of course none of the stories I’ve found mention the nationality (or immigration status) of the man and his son indicted by the US Justice Department yesterday in what may be the most egregious case of fraud I’ve seen in ten years of following these stories!
Rather than summarize the stunning news, here is the first half of the press releasefrom US Attorneys Office of the Northern District of Ohio. (Emphasis is mine)
A Westlake man with a history of food stamp fraud was indicted on charges that he continued to illegally accept food stamps at seven Cleveland-area gas stations, laundered the profits, illegally had firearms, operated an unregulated slaughterhouse and polluted a stream by dumping animal blood and other fluids into it. Amin M. Salem, 59, and Mohamed Salem, 32, were both indicted on one count each of conspiracy to launder money and one count of engaging in real estate transactions using laundered funds.
Papa Salem had previous convictions for food stamp fraud!
Amin Salem is additionally charged with one count of making unpermitted discharges into a waterway, one count of distribution of adulterated, misbranded or uninspected meat and one count of being a felon in possession of firearms. That charge stems from Amin Salem having an AR-15 rifle and a Savage 12-gauge shotgun, despite previous convictions for conspiracy to defraud the United States, food stamp fraud, mail fraud, and money laundering.
Mohamed Salem, also of Westlake and Amin’s son, is also charged with trafficking in counterfeit goods for his sale of counterfeit clothing and apparel.
Zahran al-Qadan, 55, of Cleveland, was indicted on one count of conspiracy to launder money.
Prosecutors are seeking to forfeit properties at 43588 Stang Road and 7250 West Ridge Road in Elyria owned by the Salems.
According to the six-count indictment: Amin Salem secretly owned several area gas stations: Henry’s Marathon at 3106 Fulton Road; Gas Way at 10606 Bellaire Road; Turney Sunoco at 6009 Turney Road in Garfield Heights; Harvard Gas USA at 7020 Harvard Ave.; Bellaire Gas USA at 3934 West 117th Street; Rapid Stop at 1712 East 55th Street and Memphis Shell at 7210 Memphis Ave. Mohamed Salem managed the gas station’s finances of behalf of his father. The gas stations had terminals to accept and process Electronic Benefits Transaction (EBT) cards as part of the Supplemental Nutrition Assistance Program (SNAP), formerly known as food stamps.
Papa Salem was not permitted to own stores due to previous convictions, so Mohamed was running them!
The gas stations and the EBT terminals inside were in the names of Mohamed Salem or another person, since Amin Salem was prohibited from owning stores that processed EBT transactions because of previous convictions for food stamp fraud and related crimes. The gas station terminals were used by the Salems to process more than $2.7 million in fraudulent SNAP transactions between 2010 and 2016.
The words halal slaughter are absent, but you know what this was all about!
Blood and bodily fluids went in to Ohio’s Black River
Amin Salem slaughtered lambs and goats at his propertyon Stang Road in 2015 and 2016. He sold the meat, which was not inspected by the U.S. Department of Agriculture. He also caused, without a permit, the discharge of blood and other bodily fluids from the slaughtered animals into Engle Ditch, which flows into the Black River and eventually Lake Erie.
There is actually much more in the US Attorney’s press release (click here). Joe Cimperman of Global Cleveland https://globalcleveland.org/about/staff/ One of yours Joe?
My first thought was to wonder where the ‘Welcoming Cleveland’ propagandists are about this ‘new American’ entrepreneur in their midst! (Westlake is a suburb of Cleveland). Hereis what Global Clevelandwants you to know:
“Immigrants strengthen our community in so many ways, and one of them is by opening businesses,” said Joe Cimperman, president of Global Cleveland, in a written statement. “These businesses do more than create jobs. They add vitality to our neighborhoods and become part of the cultural tapestry that makes Cleveland so special. They reflect our deepest DNA and remind us of the best of ourselves.”
What can you do? If you live in the Cleveland area send the DOJ press release to Global Clevelandand to everyone you know! If you live elsewhere, this story must get out to social media because the national big media never reports these stories!!!
That is just the money recovered in successful health care fraud cases. Imagine how much more goes undetected! Here is the news of the Department of Justice’s annual report for 2018 for legal judgements under the federal False Claims Act. (Fascinating! the Act has been around since the Civil War.)
I know this might sound pretty boring, but you need to know about it especially as some of the successes come from “whistleblowers” who are able to make some serious money while unearthing fraud in primarily (in this case) the health care sector.
So, if you work for a doctor or hospital and notice some strange financial transactions, or see something suspicious on your Medicare statements, keep this in mind!
From a report by the law firmHolland & Knight:
In December 2018, the U.S. Department of Justice (DOJ) released its annual statistics for its civil False Claims Act (FCA) and fraud cases from the fiscal year ending Sept. 30, 2018 (fiscal year 2018). The DOJ reports it recovered $2.8 billion in settlements and judgments for Fiscal Year 2018. Of the $2.8 billion recovered in fiscal year 2018, $2.5 billion involved the healthcare industry—the ninth consecutive year that the DOJ’s civil health care fraud settlements and judgments have exceeded $2 billion.
[….]
….the FCA is used by the U.S. government to combat healthcare fraud and also serves as the primary civil remedy for redressing false claims involving federal government contracts, grants, and federally-funded programs. FCA cases can originate in one of two ways: (1) actions brought by the DOJ, or (2) actions brought by whistleblowers, known as relators, who are entitled to a portion of any proceeds recovered through settlement or judgment. In the latter actions, called qui tam actions, the case is filed under seal and the DOJ is given a period of time to evaluate the allegations and decide whether to intervene (i.e. take over the case). If DOJ declines to intervene, the relator may proceed with the action and potentially receive a greater cut of the recovery.
[….]
…in the healthcare industry newly brought qui tam cases are down while non-qui tam cases are slightly up.
[….]
The increase in government-initiated healthcare cases may be attributable to enforcement initiatives such as the nationwide Medicare Strike Force Teams. These teams, which are scattered throughout the United States, focus on criminal and civil health care fraud.
Feds are increasing the number of US Attorneys in key hot spots!
The trend line for government-initiated FCA actions should increase over the next few years. DOJ recently added a cadre of new affirmative civil enforcement attorneys, whose role will include initiating cases under the FCA. The new Assistant United States Attorneys (AUSAs) are being placed throughout the country—and offices where there is a hotbed of government contracting and healthcareare receiving more than one new AUSA. While most U.S. Attorney’s Offices will receive one additional AUSA for affirmative civil enforcement, DOJ announced that offices such as Colorado, Middle District of Florida, Southern District of Florida, Massachusetts, New Jersey, Eastern District of New York, Southern District of New York, and Eastern District of Virginia, would receive two.
This got me thinking. Have you seen any funny money business going on with the US Refugee Admissions Program and the Dept. of Health and Human Services contractors?
If so, think about this avenue to bring attention to possible fraud! You might actually make a few bucks in the process!
Afterthought: I need to be sure to let new readers know why I write this blog, here is my “welcome” post from January first.
This is an update of the story I posted two weeks ago, here. Dr. Rajendra Bothra
Dr. Rajendra Bothra had not been granted bail at the time because of a fear that he would flee to his native India. But, reporter Robert Snell at theDetroit News, who has been following the case closely, says Bothra was granted bail on Tuesday—believed to be a new record high.
You know we keep talking about migrants bringing drugs across our southern border when in fact “new American” doctors are allegedly dispensing them like Pez candy!
(And, likely ripping off US taxpayers to boot!)
Judge frees doctor on record-setting bond in opioid case
Detroit — The accused architect of a nearly $500 million health care fraud could leave jail within days after being freed on a record-setting $7 million bond Tuesday.
U.S. District Judge Stephen Murphy granted the bond for Dr. Rajendra Bothra, 77, of Bloomfield Hills, despite the government’s concern the doctor has hidden money that could bankroll an escape to his native India.
The amount shattered the previous record-high bond of $4.5 million granted two years ago to Dr. Jumana Nagarwala, who is charged in the nation’s first case involving female genital mutilation.
Bothra, the lead defendant in one of the largest health care fraud cases in U.S. history, must liquidate an $8.5 million retirement account to cover the bond, a process that could take three days. Bothra will be released on home confinement and tracked by a GPS tether and must identify all assets under penalty of perjury.
His wife and daughter, who attended the hearing Tuesday, will surrender their passports to alleviate concerns that the family might flee while Bothra awaits trial in July.
[….] Prosecutors have been unable to pinpoint Bothra’s net worth, which could be as high as $35 million.Assistant U.S. Attorney Brandy McMillion noted that Bothra owns a real-estate company that owns 22 properties across Metro Detroit, including $2.8 million worth of condominiums and commercial buildings in downtown Royal Oak.
Continue here. There is much more including photos of the real estate holdings Bothra may have purchased with funds from his alleged fraud scheme.
Are you keeping tabs of loved ones in nursing homes? Are they receiving treatment they don’t need while the facility bills Medicare? Or are they perhaps keeping a rehab patient longer than is necessary simply to milk the system, a system that is predicted to be insolvent by 2026?
What can you do? If you live in the Cleveland area send the DOJ press release to 
