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FBI and HHS bust 3 in $1 billion fraud scheme

Philip Esformes, a Miami-based healthcare provider, has been charged in a $1bn Medicare fraud case. Esformes allegedly admitted patients to his skilled nursing homes and assisted living facilities who did not qualify for care, and then provided them with medically unnecessary services that he billed to Medicare and Medicaid. Esformes and his co-conspirators are also accused of receiving kickbacks for referring patients to other healthcare providers who also performed unnecessary treatments. Esformes had previously settled civil federal healthcare fraud claims in 2006.

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