Monday, July 25, 2016

An elderly man was held in a motel room for around four years so another man could steal his benefits, police say.

81-year old man held hostage for years in elder financial abuse case

An elderly man was held in a motel room for around four years so another man could steal his benefits, police say. 

A New York man held an 81-year-old veteran hostage for at least four years in order to collect his benefits, police said Thursday, weeks after the US House of Representatives passed legislation to call attention to financial elder abuse.
Perry Coniglio, 43, is accused of holding an elderly veteran with dementia at the U.S. Academy Motel in Highlands, New York, near West Point, in a room adjoining his own. The motel is located next to a police station, according to the Associated Press.
Mr. Coniglio was able to collect a "tremendous" amount of monthly funds through Social Security benefits, pension payments, and food stamps, police said, without specifying the amount.
Police were recently tipped off to the situation by concerned neighbors, one of whom had captured the former Marine being abused on video.
Coniglio is being held on $15,000 bail and is being charged with grand larceny and unlawful imprisonment, among other charges.
Elder abuse has become a particularly pressing issue as the population ages, as The Christian Science Monitor reported last month. In the vast majority of cases, the abuser is a family member.
A study from the British Geriatrics Society released in June found that more than a third of caregivers engage is potentially abusive behavior. Often, the abuse occurs when demands on carers become too much for them to be able to meet.
"Findings highlight the need for support and training for carers, so that they can care with confidence, have the skills to manage difficult caregiving situations and recognise when the pressures associated with caregiving may be harming the older person and know at which point they should seek help," the researchers wrote. "Community-based professionals such as public health nurses, GPs, social workers and home care staff need the skills to recognise behaviours that may act as early warnings."
The researchers said the data shows that family caregivers need more support to fulfill their duties.
One in 5 Americans will be in the "older" demographic by 2030, according to the US Census Bureau. Five million elderly adults are abused each year, according the National Center on Elder Abuse, 90 percent abused by family members.
Fighting elder abuse has become more of a priority on both the state and federal level in recent months.
The House of Representatives unanimously passed legislation that would protect financial advisers who try to fight the financial exploitation of the elderly, as Investment News reported.
The legislation gives financial advisers the ability to report abuse without fear of being prosecuted for violation of privacy laws. It also discusses training on how to identify financial abuse of the elderly.
"While Washington has been gridlocked for a long time, I'm very pleased that the House was able to pass this critical legislation, and I am hopeful the Senate will quickly follow suit," Dale Brown, the president and chief executive of the Financial Services Institute, said in a statement. "The Senior Safe Act is a big step forward in the prevention of elder financial abuse across the country."
The Senate could vote on a similar legislation this year.
One the state level, laws went into effect July 1 in Alabama, Indiana, and Vermont that require financial advisers to alert the state if they suspect elder financial abuse.
This report contains information from the Associated Press

Sunday, July 24, 2016

New Mexico: Life, Liberty and the Pursuit of….Death

Editor's note: Your ProbateShark feels Janet's concern that assisted suicide will lead to involuntary euthanasia is valid.  Alice R. Gore, a disabled 99 year old ward of the Probate Court of Cook County was completely dependent after a feeding tube was inserted unnecessarily into her abdomen in an Esformes nursing home.  Food and water were withheld from Alice and she was found dead in a dehydrated condition.  Conveniently, she died after most of her pillaged estate was depleted.  Lucius Verenus, Schoolmaster,  

New Mexico: Life, Liberty and the Pursuit of….Death

435345345345Bucking what is now a growing trend in the West for parliaments and legislatures to debate–and sometimes approve–assisted suicide laws, a court in New Mexico has issued a ruling that there is no constitutional right to aid in dying and that assisted suicide can and will lead to involuntary euthanasia.
The 5-0 ruling by the New Mexico Supreme Court overturned a lower  court decision that doctors in New Mexico could assist people in terminating their lives.
The New Mexico ruling highlights the controversy sparked by these laws. Several European countries now affirm the legality of assisted suicide and/or voluntary euthanasia, including Switzerland, Belgium, Netherlands and Luxembourg. Canada recently passed an assisted suicide law and five US states–Oregon, Washington, Vermont, California and Montana–have all approved assisted suicide.
The proponents of AS state that these laws are compassionate towards those who are in the end stages of life and that AS will provide relief from terrible suffering. According to Dr. Balfour Mount, who has been dubbed the “father of palliative care,” this ignores certain medical realities.
In a 2014 interview, Mount stated, “There’s no need [to legalize euthanasia] because of pain and symptom control. We’re able to control the suffering, and through palliative care with a skilled team able to minimize suffering that’s physical, psychological, social, spiritual, existential.”
In his opinion, New Mexico Supreme Court Justice Edward Chavez wrote:  “…end of life decisions are inherently fraught with the potential for abuse.” The court’s decision highlighted three specific areas of such potential abuse. First, according  to the opinion, “the State has legitimate interests in…protecting the integrity and ethics of the medical profession.”
In other words, giving physicians the license to prescribe life-ending substances is a departure from the impetus of the profession and its two thousand year old caveat: “First, do no harm.” Incidentally, following the passage of the California law, a non- practicing physician decided to re- enter his profession solely for the purpose of providing assisted suicide services to Californians.
Second, the New Mexico opinion asserts that the State has an interest in  “protecting vulnerable groups—including the poor, the elderly, and disabled persons—from the risk of subtle coercion and undue influence in end-of-life 
situations, including pressures associated with the substantial financial burden of end-of-life health care costs.”
According to the disability rights advocacy group, Not Dead Yet, “The disability experience is that people who are labeled “terminal,” predicted to die within six months, are – or will become – disabled. It is well documented that the six month prediction called for in the Oregon and Washington laws is unreliable.”
Not Dead Yet points out that disability, rather than physical  pain, appears to be the deciding factor in whether or not an individual chooses assisted suicide.
“Although intractable pain has been emphasized as the primary reason for enacting assisted suicide laws, the top five reasons Oregon doctors actually report for issuing lethal prescriptions are the “loss of autonomy” (89.9%), “less able to engage in activities” (87.4%), “loss of dignity” (83.8%), “loss of control of bodily functions” (58.7%) and “feelings of being a burden” (38.3%).” (Death With Dignity Act Annual Reports, PDF download )
The New Mexico ruling also  referenced  the “slippery slope”  that such physician- assisted suicide laws may subtly enable. The decision  asserted that the  State had an interest in “protecting against voluntary or involuntary euthanasia because if physician aid in dying is a constitutional right, it must be made 
available to everyone, even when a duly appointed surrogate makes the decision, and 
even when the patient is unable to self-administer the life-ending medication.”
Indeed,  assisted suicide is already being utilized by those merely afflicted with ennui. Recently, a retired English schoolteacher reportedly flew to Switzerland to end her life because she could not “adjust to the modern world.” An Italian woman was also reported as going to Switzerland to drink the kool aid because she was depressed about “losing her looks.”
And ratcheting up concerns about the slippery slope potential, a recent article in a bioethics journal bore the headline, “Should Happy Demented People be Euthanized? The article, published in the Journal of Medical Ethics, made a serious stab at considering the legal and ethical implications of whether someone who had signed a medical directive, asking to be euthanized should he end up with dementia, should have his wishes honored if the dementia had resulted in a state of happy forgetfulness of his prior wish.
In an ironic twist, the case before the New Mexico Supreme Court was initially filed in 2012 by a woman who was suffering from uterine cancer. Aja Riggs, who has since gone into remission, has vowed to continue the legal battle for the “right to die.”
As quoted in the Taos Journal, Riggs stated that: “I absolutely still believe it’s something that people should have a right to… Although I have managed to survive to see this decision, which was not necessarily expected, all of my time learning about this has only increased by feelings about how important it is for people who are terminally ill to have this option available, in addition to other options that are now legal and available.”
Suicide, however, is not illegal and some believe that the codification of a “right to die” will have unforeseen culture- changing ramifications. In a recent interview with Bioedge, author and attorney Wesley J. Smith stated, “I have observed in the 15 years since the first edition of Culture of Death, that throughout the developed world and the West we see a terrible and increasing disrespect for the intrinsic value of the most weak and vulnerable among us. Euthanasia has spread like a stain and grown increasingly toxic. For example, in Belgium medicalized killing is now coupled with organ harvesting—including of the mentally ill. Health care rationing, which is blatant and invidious medical discrimination, is a growing threat. Advocacy continues to discard the dead donor rule in organ transplant medicine, even proposals for the live-harvesting of patients with profound cognitive disabilities.” 
Not everyone agrees. The American Civil Liberties Union of New Mexico has called the decision “tragic news” for terminally ill New Mexicans and has stated it will now devote its efforts towards changing this law.
It should be noted that while the ACLU is apparently diligently serving those who wish to die, it remains curiously silent about those who wish to live. The ACLU has been repeatedly contacted concerning the involuntary euthanasias now regularly being executed against those under adult guardianships, also elderly or disabled. To date, the ACLU has declined to involve itself in a single case involving an individual who wished to escape from a guardianship.

Janet C. Phelan, investigative journalist and human rights defender that has traveled pretty extensively over the Asian region, an author of a tell-all book EXILE, exclusively for the online magazine “New Eastern Outlook.

Google says it’s not deliberately filtering “Crooked Hillary” suggested search to favor Clinton

Editor's note: This Shark observes the Probate Court of Cook County "filtering" its active criminal activity with the law enforcement community.  It is impossible for a victim of "elder cleansing" to receive justice in this corrupt environment.  Repeated complaints to law enforcement have gone unheeded as exemplified by Alice R. Gore's 18 stolen annuity checks. Lucius Verenus, Schoolmaster,


Google says it’s not deliberately filtering “Crooked Hillary” suggested search to favor Clinton

Google offers an autocomplete suggestion of "Lying Ted" for "lying" but fails to do something similar for Clinton, raising questions.

google-search-new-logo1-ss-1920Type “lying” into Google, and it will suggest “Lying Ted,” the moniker US Republican presidential candidate Donald Trump placed on his onetime rival, Ted Cruz. But type “crooked” into Google, and it doesn’t bring up the “Crooked Hillary” label that Trump has attached to his Democratic rival Hillary Clinton. What’s going on?
It’s not because Google has done anything deliberate to favor Clinton, either through automated or manual means, the company told Search Engine Land. It sent this statement:
Autocomplete predictions are produced based on a number of factors including the popularity of search terms. Our systems are periodically updated to improve Search, and our users’ search activity varies, so the terms that appear in Autocomplete may change over time.
Additionally, our systems automatically filter a small set of offensive or inappropriate content from autocomplete predictions.
There is no difference between how our removal filters operate among candidates.
In short, if Google’s systems are filtering out the “Crooked Hillary” suggestion, it’s not because Google is trying to favor Hillary Clinton. Beyond that, the company isn’t going into more detail about why the change is happening.
The company notes that when searches are done for the full names of candidates, such as “Lying Ted Cruz” or “Crooked Hillary Clinton,” no suggestions at all appear — a sign of how both are being equally treated when their full and unambiguous names are involved.

Why is it happening?

So what is going on to cause this? That’s what I was trying to figure out when I first posted this story at 6:15 p.m. ET on June 3. At that time, Google had only provided an ambiguous statement without a denial that said:
Autocomplete predictions are produced based on a number of factors including the popularity of search terms. Our systems are periodically updated to improve Search, and our users’ search activity varies, so the terms that appear in Autocomplete may change over time.
With that effective non-answer, my original headline was “Google has no good explanation for why ‘Crooked Hillary’ isn’t a suggested search” and the original story dived into trying to figure out what was happening. That original exploration is below, my analysis of the weirdness in the situation.

Google autocomplete & the Trump insults

Vice’s Motherboard site has a good article on the situation, which was initially raised on a Reddit thread where many suspect a Google conspiracy.
As I told Motherboard, it was certainly weird to me. My initial thought was that perhaps because “Lying Ted” had been out there longer, it had more time to attract enough searches that, in turn, caused it to become a suggested search.
That’s how Google’s autocomplete suggestions work: it shows the most popular searches Google is seeing that are related to the words or characters you initially type in.
Here you can see it in action for a search on “lying,” which brings up “lying ted” as a suggestion:
Google lying tedBut for a search on “crooked,” you don’t get a similar situation for “crooked hillary,” as you can see:
Google crookedEven if you expand the search to “crooked h,” you don’t get “crooked hillary” as a suggestion but instead the strange “crooked hillary bernie” coming up:
Google crooked hillary

“Crooked Hillary” as search popular as “Lying Ted”

As it turns out, “Lying Ted” and “Crooked Hillary” are pretty much even in terms of search popularity, according to Google Trends, for this year within the United States. And while “Lying Ted” became popular earlier, at this point, “Crooked Hillary” has been out there long enough that you’d think it would be a suggested term also:
lying ted versus crooked hillaryOf course, if “Lying Ted” is more popular among all the various lying-related searches than “Crooked Hillary” is among the various crooked-related searches, that might explain the absence of “Crooked Hillary.” But once again, Google Trends debunks this possible explanation:
crookedFor over a month, “Crooked Hillary” has been more popular than “crooked smile” in the US, yet “crooked smile” appears as the top suggested search, while “crooked hillary” does not. Crooked Hillary is even more popular than “Crooked Hillary Bernie,” yet only the latter shows if you do a “crooked h…” search.

Why Google filters autocomplete

Again, it’s weird. There’s no good explanation for it. Personally, I doubt Google would actually proactively filter this particular search. But it’s neither confirmed nor denied that, so the guessing, speculation and assumptions will continue.
Google does use various methods that it doesn’t discuss much to filter out some suggestions. What suggestions and for what reasons, it doesn’t specify. I asked again about this, twice today, and got no answer.
When I last wrote about autocomplete in detail about five years ago, Google had told me the reasons below might cause a suggestion to be censored either through an automated or human review process:
  • Hate or violence-related suggestions
  • Personally identifiable information in suggestions
  • Porn and adult content-related suggestions
  • Legally mandated removals
  • Piracy-related suggestions
Since then, Google still hasn’t posted any of these reasons to its site. Its help page on autocomplete simply says that some terms might get filtered for “policy reasons,” as I’ve bolded below, without any further detail:
If no predictions appear for a particular word or topic, it could be that:
  • The search term isn’t popular.
  • The search term is too new. You might need to wait a few days or weeks to see predictions.
  • The search term was mistaken for a policy violation.

Then again… Chicken Trump

Shortly after I wrote this story, Tom Bruning noted on Twitter that “Chicken Trump” isn’t a suggestion when you type in “chicken” on Google — a label attached to Trump by many on Twitter, after Trump recently declined to debate the other Democratic candidate, Bernie Sanders.
This is true — and all the same weirdness about why “Crooked Hillary” doesn’t appear also applies to “Chicken Trump,” which works against the anti-Trump conspiracy argument.
Google Trends shows that “Chicken Trump” has been more popular than “Crooked Hillary” on average in the US for the past 90 days:
chicken trump crooked hillaryDespite this, typing in “chicken” doesn’t suggest “Chicken Trump,” as you can see:
chicken searches on GoogleGoogle Trends also shows that “Chicken Trump” has been about as popular as the top suggestion of “Chicken George” and certainly more than “chicken maison,” as shown below:
chicken chicken eggWhat’s going on? Chances are, “Chicken George” — a character in “Roots” — has shot to the top of the list based on a very recent spike in popularity as the “Roots” remake has been airing. That’s despite the fact that “chicken recipes” and “chicken pox,” which are two and three on the list, easily beat “Chicken George” in search popularity. Meanwhile, “chicken maison” is likely showing up for me because of my geographic location near a restaurant of the same name.
As you can see, Google’s suggestions aren’t simply down to everyone seeing the same list or the most popular thing always being first. It would be so much better if Google were transparent about how it works. But in lieu of that, those who want to believe that Chicken Trump has been filtered out as part of a pro-Trump conspiracy are free to do so.

Meanwhile, over at Bing

To further complicate matters, let’s bring in Google’s chief rival, Bing. It also shows suggested searches. There, “Crooked Hillary” is suggested, while “Chicken Trump” is not:
Bing crooked hillarybing chicken trumpThe Clinton suggestion at Bing can be taken as a further sign that Google is somehow working to prevent the same thing from happening. After all, both search engines offer search suggestions largely based on popularity. Then again, the lack of a Trump suggestion could indicate that Bing is somehow favoring Trump. Or… both are a reminder that Bing is an entirely different search engine, so you can’t expect it to behave exactly like Google.

The bigger issue: no favoritism for Clinton in search results

While it’s easy to get concerned with Google over this — and it does deserve some criticism, especially when it effectively responded in silence — the bigger issue is whether Google is perhaps slanting search results themselves to favor Clinton. That certainly does not seem to be the case.
Someone who starts to type in “crooked” in hopes of finding information about “Crooked Hillary” is almost certainly going to continue that search whether or not Google automatically fills in the rest. It’s such an unusual term that they’re most likely deliberately seeking that out. And the results they get back aren’t positive to Clinton:
crooked_hillary_-_Google_SearchAs with the flap over Facebook Trending Topics, concerns over suggestions are real, but far more important is what people get in the stuff they actually see the most. Are Facebook News Feed content or Google search results being skewed for some political agenda?
This doesn’t appear to be happening with Google (nor did it seem the case with Facebook). Still, a weird situation with the suggestions isn’t going to help Google’s credibility.
NOTE: As explained within the story, this has been updated with a new top to reflect Google’s effective denial of intervention with suggested searches to favor Hillary Clinton or any candidate.

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Yesterday the Justice Department announced that it charged Esformes

Yesterday the Justice Department announced that it charged Esformes with a One Billion dollar Fraud Medicare FRaud Scheme.    Take a look at the Chicago Tribune and the Chicago Sun-Times for today.

The Esformes nursing homes have been infamous here in Chicago and the relationship between them and the elder cleansing scandal notorious.   Alice Gore was one of the notable alleged victims and blogs and public access television has fought the news blackout with valor.   How often does anyone steal a billion dollars?  Even the Clinton's with their $250,000 speeches, foundation conduit, etc are no so bold or so callous.   But - the Saturday newspapers of Chicago have barely a mention! 

The past few months have demonstrated that the 'great unwashed' are restless and want HONEST and responsive government, public institutions, and judiciary.    The crafty  from whom Justice can be purchased is no longer admired.   The double speak and double dealing political miscreant who promises the world and delivers a cesspool no longer has the large following that is mesmerized by the words ******* and *******.    People no longer look to the mainstream media for their filtered news and even the New York Times has financial problems.   Here in Chicago is not conceivable that we are to become a town with no daily newspaper (such as the Suntimes/Tribune)    

It is a shame!    But with the political and judicial elite being a able to cover-up their amoral and criminal conduct because the mainstream media desires to control thought by discriminating journalism (i.e. protecting the elite from bad publicity).   The fact is that any mention of bad conduct by the political and judicial elite that  fortuitously occurs - i.e. they get caught - is suppressed.

The most recent example is found in the JoAnne Denison disciplinary case.    Forget about the fact that everything she did was appropriate and as a good citizen she had an obligation to do.   Forget about the fact that blatantly openly and notoriously her appropriate conduct was derogatorily labeled.  (yelling fire in a crowded theater equated to exposing judicial corruption).    Forget about the fact that the actions of the Attorney Registration and Disciplinary commission not only told lies about her, subordinated perjury, abdicated its official duties, and lied to Supreme Court as to the holdings of the SCOTUS, and the facts.
Forget about the fact that the American Bar Association, the Illinois Bar Association, ***** all were good little Nazis and sat silent.   Forget all about that!

It used to be if a man bit a dog it was news, and the New York Times printed it under the heading of all the news meant to be printed.

Fast forward to 2016.   The Illinois legislature determined that to protect the public and preserve some integrity in the legal process Court reporters have to be licensed.    (The legislature wanting to make certain that Reports of Proceedings were no edited so as to change testimony - see the testimony of Judge Stuart and the editing out of her admission to lying under oath during direct testimony).    The IARDC has been formed to protect the public from dishonest lawyers whether practicing law or on the bench.    (Ask Mr. Larkin and his cronies as to what their mission is!)

It appears in documents that the IARDC filed before the Supreme Court of Illinois in ex-parte proceedings that should never have been ex-parte, that unlicensed court reporters were engaged by the IARDC.    Yes, the IARDC admits that they hired unlicensed court reporters.   Their excuse - we need time to think of an excuse, or how to cover up the violation of law!
The story that is suppressed!   Jerome Larkin, that bastion of the morality of the 2nd oldest profession, dipped into public funds to make illegal payments.   Jerome Larkin, like the GAL who supervised the prospecting for gold in the mouth of Alice Gore, teaches legal ethics in the official Illinois Continuing Legal Education program.

No - you cannot make this stuff up!    Even the cover-up of one hell of story of Illinois corruption cannot kill the outrage that Larkin's theft of public funds is causing or the fact that local law enforcement is disinterested.   

We are citizens are creating a hue and cry.  If you read the Chicago Tribune and the Chicago Sun-Times it appears that we are accepting his outrage in the very same manner as we accept the South and West sides of our City of Chicago being turned into war zones.    Or maybe NOT!
We shall see *******.       

Ken Ditkowsky

From: kenneth ditkowsky <>
To: Donald J. Trump <>
Cc: JoAnne M. Denison <>; Janet Phelan <>;
Sent: Friday, July 22, 2016 8:34 PM
Subject: Re: Thank you Attorney General Lynch

from the Wall Street Journal 0

Justice Department Charges Three in $1 Billion Medicare Fraud Scheme in Florida

Prosecutors outline details of its largest-ever single criminal health-care fraud case

Philip Esformes arrives at a gala in Los Angeles on Aug. 7, 2015. Mr. Esformes, the owner of more than 30 Miami-area skilled nursing and assisted-living facilities, was the scheme’s mastermind, the indictment alleged.
Philip Esformes arrives at a gala in Los Angeles on Aug. 7, 2015. Mr. Esformes, the owner of more than 30 Miami-area skilled nursing and assisted-living facilities, was the scheme’s mastermind, the indictment alleged. PHOTO: ROB LATOUR/INVISION/AP
Updated July 22, 2016 8:13 p.m. ET
The Justice Department on Friday unsealed charges in its largest-ever criminal health-care-fraud case, charging three individuals with using a network of doctors, hospitals and health-care providers across South Florida to improperly bill more than $1 billion to Medicare and Medicaid.
Philip Esformes, the owner of more than 30 Miami-area skilled-nursing and assisted-living facilities, was the project’s mastermind, the indictment alleged. He and two co-defendants, along with other co-conspirators, allegedly paid and received bribes and kickbacks to get thousands of patients admitted to facilities Mr. Esformes controlled.
In those facilities, they were often given medically unnecessary and sometimes harmful treatments, which were then billed to Medicare and Medicaid, according to court papers.
Esformes attorneys Marissel Descalzo and Michael Pasano of Carlton Fields said their client “adamantly denies these allegations and will fight hard to clear his name.”
The case was brought as part of an interagency Medicare Fraud Strike Force, which operates in nine locations across the country, officials said. Since its creation in March 2007, the task force has charged nearly 2,900 defendants who have collectively billed the Medicare program for more than $10 billion, they said.
Fraud continues to plague the roughly $600 billion Medicare program, though new criminal cases have slowed in recent years. Fraud enforcers have brought fewer cases since 2013, but convictions and settlements since the start of the decade have netted Medicare between $1 billion and $2.5 billion annually, according to a report from the Department of Health and Human Services’ Office of the Inspector General.
Last year, Medicare took in $1.6 billion from fraud-enforcement efforts and Medicaid scored another $135.9 million, according to the report. The figures don’t include what states won in Medicaid-fraud cases. Medicaid, which helps pay for health care for the needy, aged, blind and disabled, and for low-income families with children, is partially financed by states.
“The conspirators were ruthlessly efficient” as they used the scheme to line their pockets with tens of millions of dollars, said Assistant Attorney General Leslie R. Caldwell at a news conference in Miami regarding the latest case.
She was joined by officials from the Federal Bureau of Investigation and the inspector general, or in-house watchdog, of the Department of Health and Human Services, which investigated the case.
Ms. Caldwell detailed how conspirators in the latest case allegedly arranged from 2009 to 2016 to have patients moved between facilities after they had reached Medicare-imposed limits on their length of stay. In some cases, patients who were drug addicts were prescribed opioids—including OxyContin and Fentanyl—to entice them to stay in the facilities, she said.
As part of the plan, Mr. Esformes also received bribes and kickbacks from other health providers to refer patients to them, prosecutors said. These bribes were disguised as payments to unnamed escorts flown into Orlando and transported to a hotel by limousine, payments to a basketball coach for Mr. Esformes’s son and as charitable donations, the court documents allege.
Mr. Esformes, along with hospital administrator Odette Barcha and physician assistantArnaldo Carmouze, were charged with money laundering and conspiracy to defraud the U.S. and pay and receive health-care kickbacks, among other charges. The identities of attorneys representing Ms. Barcha and Mr. Carmouze weren’t immediately known.
Assistant Attorney General Leslie R. Caldwell, shown in May 2015, called the defendants in Friday’s indictment ‘ruthlessly efficient.’
Assistant Attorney General Leslie R. Caldwell, shown in May 2015, called the defendants in Friday’s indictment ‘ruthlessly efficient.’ PHOTO:CLIFF OWEN/ASSOCIATED PRESS

Saturday, July 23, 2016

Three Individuals Charged in $1 Billion Medicare Fraud and Money Laundering Scheme

Editor's note: The Esformes family owned the nursing home where Alice R. Gore was warehoused until her death.  This Shark observed the drug induced zombie-like demeanor of Alice and her fellow residents at all times except when the various health departments were making scheduled inspections. Lucius Verenus, Schoolmaster,
Department of Justice
Office of Public Affairs

Friday, July 22, 2016

Three Individuals Charged in $1 Billion Medicare Fraud and Money Laundering Scheme

The owner of more than 30 Miami-area skilled nursing and assisted living facilities, a hospital administrator and a physician’s assistant were charged with conspiracy, obstruction, money laundering and health care fraud in connection with a $1 billion scheme involving numerous Miami-based health care providers. 
Assistant Attorney General Leslie R. Caldwell of the Justice Department’s Criminal Division, U.S. Attorney Wifredo A. Ferrer of the Southern District of Florida, Special Agent in Charge George L. Piro of the FBI’s Miami Field Office and Special Agent in Charge Shimon R. Richmond of the U.S. Department of Health and Human Services-Office of Inspector General (HHS-OIG) Miami Regional Office made the announcement.
“This is the largest single criminal health care fraud case ever brought against individuals by the Department of Justice, and this is further evidence of how successful data-driven law enforcement has been as a tool in the ongoing fight against health care fraud,” said Assistant Attorney General Caldwell. 
“Medicare fraud has infected every facet of our health care system,” said U.S. Attorney Ferrer.  “As a result of our unrelenting efforts to combat these pernicious schemes, the Criminal Division, the U.S. Attorney’s Office and our law enforcement partners continue to identify and prosecute the criminals who, driven by greed, steal from a program meant for our aged and infirmed to increase their personal wealth.”
“Esformes is alleged to have been at the top of a complex and profitable health care fraud scheme that resulted in staggering losses – in excess of $1 billion,” said Special Agent in Charge Piro.  “The investigators who unraveled this intricate scam are to be commended for their diligence and commitment to root out fraud within our health care system.”
“Health care executives who exploit patients through medically unnecessary services and conspire to obstruct justice in order to boost their own profits – as alleged in this case – have no place in our health care system,” said Special Agent in Charge Richmond.  “Such actions only strengthen our resolve to protect patients and the U.S. taxpayers.”
Philip Esformes, 47, Odette Barcha, 49, and Arnaldo Carmouze, 56, all of Miami-Dade County, Florida, were each charged in an indictment unsealed today.  According to the indictment, Esformes operated a network of over 30 skilled nursing homes and assisted living facilities (the Esformes Network), which gave him access to thousands of Medicare and Medicaid beneficiaries.  Many of these beneficiaries did not qualify for skilled nursing home care or for placement in an assisted living facility; however, Esformes and his co-conspirators nevertheless admitted them to Esformes Network facilities where the beneficiaries received medically unnecessary services that were billed to Medicare and Medicaid.  Esformes and his co-conspirators are also alleged to have further enriched themselves by receiving kickbacks in order to steer these beneficiaries to other health care providers – including community mental health centers and home health care providers – who also performed medically unnecessary treatments that were billed to Medicare and Medicaid.  In order to hide the kickbacks from law enforcement, these kickbacks were often paid in cash, or were disguised as payments to charitable donations, payments for services and sham lease payments, court documents allege.
Esformes and Barcha were also charged with obstructing justice.  According to the indictment, following the 2014 arrest of co-conspirators Guillermo and Gabriel Delgado, Esformes attempted to fund Guillermo Delgado’s flight from the United States to avoid trial in Miami.  The indictment further alleges that Barcha created sham medical director contracts following receipt of a grand jury subpoena in June 20, 2016, in order to conceal and disguise the payment of kickbacks she made in exchange for patient referrals for admission to Esformes Network facilities and another Miami-area hospital.
According to court documents, in 2006, Esformes paid $15.4 million to resolve civil federal health care fraud claims for essentially identical conduct, namely unnecessarily admitting patients from his assisted living facilities into a Miami-area hospital.  However, Esformes and his co-conspirators allegedly continued this criminal activity-adapting their scheme to prevent detection and continue their fraud after the civil settlement.  The indictment alleges that the co-conspirators accomplished this by employing sophisticated money laundering techniques in order to hide the scheme and Esformes’ identify from investigators.  The FBI and HHS-OIG ultimately employed advanced data analysis and forensic accounting techniques and were able to identify the full scope of the fraud scheme.
The charges and allegations contained in an indictment are merely accusations.  The defendants are presumed innocent unless and until proven guilty beyond a reasonable doubt in a court of law. 
The FBI and HHS-OIG investigated the case, which was brought as part of the Medicare Fraud Strike Force, supervised by the Criminal Division’s Fraud Section and the U.S. Attorney's Office for the Southern District of Florida.  Deputy Chief Joseph Beemsterboer, Assistant Chief Allan J. Medina and Trial Attorney Elizabeth Young of the Criminal Division’s Fraud Section, and Assistant U.S. Attorneys Alison Lehr, Daren Grove and Susan Torres of the Southern District of Florida are prosecuting the case. 
Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in nine locations across the country, has charged nearly 2,900 defendants who have collectively billed the Medicare program for more than $10 billion.  In addition, the HHS Centers for Medicare and Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.
To learn more about the Health Care Fraud Prevention and Enforcement Action Team (HEAT), go  
Healthcare Fraud
Updated July 22, 2016