From Trillions magazine:
Medical Mafia Ring Busted – Again
July 24, 2016
Philip Esformes, son of Rabbi Morris I. Esformes, faces another indictment for his family’s career medical fraud.
Medicare and Medicaid fraud and other types of medical fraud can be extremely lucrative. In the latest case involving the Esformes family, it is estimated to amount to $1 billion from 2002 to 2016.
“This is the largest single criminal health care fraud case ever brought against individuals by the Department of Justice,” Leslie Caldwell, assistant attorney general of the department’s criminal division, said in a statement.
What Caldwell didn’t say that is that the fraud shouldn’t have been allowed to occur in the first place. The Esformes have long been known to authorities yet had been allowed to steal from taxpayers and abuse the people held in their care for far too long.
Rabbi Morris I. Esformes and his son Philip Esformes operated dozens of nursing homes in Illinois and Florida and used the people in their care to generate illicit payments from the government and get kick-backs from other medical service providers. The earliest complaints about their facilities goes back to the 1990s.
Philip Esformes is currently charged with colluding with doctors, hospitals and medical service providers to shuttle patients among their facilities for the purpose of filling their beds and maximizing Medicare reimbursements and engaging in fraudulent billings for treatments not needed.
While the Esformes family has long been on the radar of authorities, Rabbi Morris I. Esformes used his social and political connections to evade prosecution. In 2005, the esteemed Rabbi played the religion card when he was facing charges of abuse and neglect for abominable conditions in his Chicago nursing homes when he accused the authorities of being anti-mental health, racist and against jews. “Beside the fact that they’re anti-mental health and anti-black, they’re probably anti-jew because I’m an ordained rabbi,” he said.
An early co-conspirator with the Esformes, Chicago doctor Roland Borrasi, was recorded by federal agents saying, “Basically, I have a commodity; my commodity is nursing home patients.”
And those patients were treated as nothing more than commodities. Patients were given treatments that weren’t needed or even related to what conditions they might have had. The treaments damaged their health and shortened their lives. Taxpayers picked-up the tab.
To get the commodity, Borrasi claims to have essentially rented patients from the Esformes’ nursing homes. Lynn Madeja, Borrasi’s medical biller and mistress, told government agents that Borrasi had said: “I got to give Philip $1,000 or $10,000” to use Esformes’ patients.
Despite the evidence against them, the Ensformes were not indicted in the earlier cases and were allowed to continue to operate their racket unhindered. In a separate case in 2013, the Esformes agreed to pay the government $5 million to settle allegations that they took kickbacks related to the 2004 sale of a pharmacy company.
The Esformes family is just one of many operators in a criminal operation that permeats the medical industry. According to an article in the Economist in 2014, the RAND Corporation estimates that medical fraud in the United States amounts to $272 billion each year.
The medical industy remains the third leading cause of premature death. The three biggest killers are:
- Heart disease (clogged arteries)
- Medical mafia (doctors, nurses, hospitals, drug companies)
While prosecutions of medical fraud have increased in recent years, the problem remains massive and pervasive.
The next time you seek medical treatment you might want to reconsider who and what you might be dealing with and proceed with caution. Clearly, doctor does not always know best, or have good intentions.
Copyright: Trillions – North America Procurement Council, Inc. PBC
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