|Larkin Community Hospital|
Miami Hospital Pays $15.4 Million to Resolve Fraud Casefor Kickbacks & Medically Unnecessary Treatments
WASHINGTON – Larkin Community Hospital in Miami and its current and former owners, Dr. Jack Michel, Dr. James Desnick, Morris Esformes and Philip Esformes, have paid $15.4 million to settle federal and Florida civil health care fraud claims against them, the Justice Department announced today. Additionally, 34 related companies owned by the Esformes that were used to operate nine assisted living facilities are part of the settlement along with Claudia Pace, an employee of one of the Esformes-owned companies; and Frank Palacios, a long-time employee of the hospital.
The settlement resolves the civil case entitled United States v. Jack Jacobo Michel, M.D., et al., which the government filed in 2004, alleging violations of the False Claims Act. The state of Florida joined the suit later that year.
The government alleged that in 1997, Larkin, then owned by Desnick, paid kickbacks to physicians in return for patient admissions. The United States contended that the primary recipient of the kickbacks was Jack Michel, who was paid for patient admissions to Larkin by himself and his brother, Dr. George Michel. Jack Michel purchased Larkin in 1998. In 2000, Desnick was a party to a $14 million settlement with the United States for a similar kickback scheme from 1992 to 2000 at another facility he owned, Doctors Hospital of Hyde Park in Chicago.
The United States also alleged in the Michel suit that from 1998 to 1999, Jack Michel, George Michel, Morris Esformes, Philip Esformes, Frank Palacios and Claudia Pace conspired to admit patients to Larkin for medically unnecessary treatment. The government asserted that some of these patients came from assisted living facilities owned and operated by Jack Michel, Morris Esformes and Philip Esformes.
“The Department of Justice is committed to vigorously litigating cases about conduct that undermines the integrity of the Medicare and Medicaid programs,” said Peter D. Keisler, Assistant Attorney General for the Department’s Civil Division. “We will not tolerate health care providers who pay kickbacks or perform medically unnecessary treatments on elderly beneficiaries in order to generate Medicare and Medicaid payments.”The case was investigated by the U.S. Department of Health and Human Services, Office of Inspector General; the Federal Bureau of Investigation; and the Florida Medicaid Fraud Control Unit. The case was handled by the Justice Department’s Civil Division, the U.S. Attorney’s Office for the Southern District of Florida in Miami and the Office of the Attorney General of the state of Florida.
Hector & Maria,The Mayor of South Miami has few duties & privileges distinct from the rest of the City Commission: convening meetings of the commission, running those meetings, delivering the State of the City Address, and awarding keys to the city.I see in the commission agenda for this Tuesday that someone has decided to have me award a key to the city to Larkin Hospital, but that same someone did not think to consult me on the matter. I found this a most unpleasant surprise.Six years ago, Larkin paid a $15.4 million fine to the feds for (1) paying kickbacks to physicians, (2) Medicare fraud, and (3) taking advantage of elderly people living in ALF's belonging to Larkin's owner. The DOJ investigation found that Larkin subjected ALF residents to repeated, unnecessary, and sometimes painful treatments so that Larkin could collect the medicare payments. The attached file summarizes DOJ's case and monetary settlement.Last month, the Miami Herald revealed that an independent survey of hospitals found Larkin ranked among the worst in South Florida (see attached file).Meanwhile, US News & World Report just rated South Miami Hospital the #1 best hospital in South Florida and 4th in the entire state.I recognize Larkin has given the city funds for city functions, but I'm not going to embarrass the city and insult SMH by giving a key to the city to confirmed fraudsters who appear to provide sub-par healthcare services.You need to tell Larkin not to show up for the key event. If you find it embarrassing, then I suggest you consult me in the future before making significant obligations on my behalf.-Philip
You have to ask yourself, what exactly is going on in South Miami? I'm beginning to think that what we uncovered through our Airways Auto Tag Agency story was just the tip of the iceberg, think about it, considering Larkin hospitals recent past, how could anyone with a modicum of common sense suggest that they should be commended let alone receive the key to the city especially as Mayor Stoddard says, when there's an award winning hospital worthy of such recognition just down the street?
There's something fishy going on down in South Miami, and like I said, we've only seemed to scratch at the surface...