State regulator took $100,000 in bribes to tip off nursing homes. Now, she's headed to prison - Insurance News | InsuranceNewsNet

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December 16, 2017 Newswires
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State regulator took $100,000 in bribes to tip off nursing homes. Now, she’s headed to prison

Miami Herald (FL)

Dec. 16--A Hialeah woman who accepted $100,000 in bribes from a wealthy businessman in exchange for tipping him off to state inspections and patient complaints at his healthcare facilities was sentenced to almost five years in prison on Friday.

Bertha Blanco, 66, who had worked for the state Agency for Healthcare Administration for nearly 30 years before getting fired in late 2016, admitted in her guilty plea this fall that she accepted the bribes from intermediaries who prosecutors say collaborated with Miami Beach executive Philip Esformes. Blanco made just over $30,000 a year as a healthcare inspection supervisor in Miami-Dade County.

Esformes, who once made more than $10 million in a single year from his network of Miami-Dade nursing and assisted living facilities, used the information to fix the complaints and problems before state workers could inspect his sites. As a result, Esformes avoided the revocation of his licenses and continued to bill Medicare for questionable patient services.

Earlier this year, the charge of bribing the state regulator added a layer of intrigue to a massive Medicare fraud case against Esformes in Miami federal court. He is being held without bond before trial in March on charges of conspiring with other healthcare operators to bilk $1 billion from the taxpayer-funded health insurance program for the elderly and disabled. It's touted by the Justice Department as the largest Medicare fraud case in the country.

Esformes, 48, is accused of exploiting his network of about 20 Miami-Dade skilled-nursing and assisted-living facilities to fleece the Medicare program by filing false claims for services that were not necessary or in some instances not provided to about 14,000 patients. Most of the patients came from Larkin Community Hospital in South Miami.

Esformes supplied tens of thousands of dollars in cash to Blanco but never knew her. Justice Department attorneys say the bribes were passed through four other people who have already pleaded guilty.

Esformes relied on two trusted business associates -- brothers Gabriel and Guillermo Delgado -- to obtain the valuable state information, by paying $200 cash for each patient complaint and $3,000 cash for each unannounced inspection schedule over the span of eight years. Gabriel Delgado then "personally provided these documents to Philip Esformes," according to a criminal affidavit.

Two people acted as intermediaries for the Delgados: Isabel Lopez, who also owned several assisted-living facilities, and her son, Gustavo Mustelier. They kept a cut of the cash bribes while delivering the rest to Blanco to obtain patient and inspection records.

Esformes' legal team, led by defense attorney Michael Pasano, asserts that the Delgado brothers, who have already struck plea deals on Medicare fraud offenses, acted on their own and that Esformes knew nothing about their bribery activity.

Jay Weaver: 305-376-3446, @jayhweaver

___

(c)2017 Miami Herald

Visit Miami Herald at www.miamiherald.com

Distributed by Tribune Content Agency, LLC.

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