Court upholds $1.3 billion Esformes nursing home fraud verdict, $44 million penalties
By
James M. Berklan
Jan 09, 2023
Convicted former nursing home chain operator Philip Esformes had his prison sentence commuted by then-President Trump in 2020, but a federal appeals court ruled Fridhe will still be liable for $44 million...
Updated: Philip Esformes reaches plea deal on remaining charges in $1.3B fraud case
By
Lois A. Bowers
Feb 02, 2024
Philip Esformes, the disgraced nursing home and assisted living community owner charged in a record $1.3 billion healthcare fraud case in 2016, has reached a plea deal with prosecutors on outstanding charges...
SNF owner led record $1 billion Medicare fraud ring, authorities say
By
James M. Berklan
Jul 25, 2016
The owner of more than 30 Miami-area nursing homes and assisted living facilities has been charged with leading a national record $1 billion-plus Medicare fraud scheme.
Supreme Court declines to hear appeal from former nursing home mogul Esformes
By
Josh Henreckson
Dec 12, 2023
The US Supreme court has rejected the appeal of Phillip Esformes, clearing the path for his continued prosecution on six counts related to a massive nursing home fraud scheme.
Medicare enhances readability and fraud protections with streamlined benefit statements
By
McKnight's Staff
Mar 08, 2012
Medicare recipients soon will be reaping the benefits of simplified benefit statements and will see added protections against Medicare fraud, the Centers for Medicare & Medicaid Services announced Wednesday.
Medicaid directors propose reforms for fraud-detection programs
By
McKnight's Staff
Jul 03, 2012
State Medicaid directors outlined several different strategies for streamlining collaboration between Medicare and Medicaid antifraud efforts in a June 29 letter to members of the Senate Finance Committee.
OIG: Cutting Medicare and Medicaid fraud still a top concern
Feb 03, 2012
Eliminating Medicare and Medicaid fraud should be a priority for the Department of Health and Human Services as it works to implement healthcare reform programs, according to a new report.
Lawmakers call for public disclosure of Medicare payments, ask for input on post-acute reforms
By
McKnight's Staff
Jun 20, 2013
The battle against Medicare waste, fraud and abuse heated up on Capitol Hill this week. Lawmakers introduced a bill to make Medicare claims and payments publicly available and asked for provider input...
Report: Nursing home therapy reimbursement under review as reform law toughens up
Mar 30, 2010
Healthcare analysts at the Department of Health and Human Services are re-evaluating Medicare’s “ultra-high” billing category for therapy services in skilled nursing facilities as a potential...
Providers to need NPI for Medicare, Medicaid enrollment and reimbursement
May 05, 2010
In an effort to crack down on healthcare fraud, the Centers for Medicare & Medicaid Services this summer will require all providers and suppliers who qualify for a National Provider Identifier (NPI) to...