Friday, December 15, 2017

Former Florida State Health Care Administration Official Sentenced to More Than Four Years in Prison for Accepting Bribes



A former employee of Florida’s Agency for Health Care Administration (AHCA) was sentenced today to 57 months in prison for accepting bribes in exchange for providing confidential information about health care facilities that received Medicare and Medicaid funds.

Acting Assistant Attorney General John P. Cronan of the Justice Department’s Criminal Division, Acting U.S. Attorney Benjamin G. Greenberg 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’s (HHS-OIG) Miami Regional Office made the announcement.

Bertha Blanco, 66, of Miami, Florida, was sentenced by U.S. District Judge Ursula Ungaro of the Southern District of Florida.  Judge Ungaro also ordered Blanco to pay $441,000 in restitution and to forfeit $100,000, which represents the gross proceeds traced to Blanco’s commission of the offense.  Blanco pleaded guilty on Oct. 13 to one count of bribery concerning a program receiving federal funds.

AHCA’s Division of Health Quality Assurance is responsible for the licensure and regulation of health care facilities in Florida that receive Medicare and Medicaid funds, including skilled nursing facilities (SNFs), assisted living facilities (ALFs) and home health agencies (HHAs).  As part of her guilty plea, Blanco, who was employed by AHCA for approximately 30 years, admitted that, from at least 2007 through June 2015, she solicited and received thousands of dollars of cash bribes from Miami-area owners of SNFs, ALFs and HHAs, and intermediaries working with them, in exchange for providing the purchasers with sensitive, nonpublic AHCA reports and information related to their facilities.  The information included the schedules of future unannounced inspections by AHCA surveyors and previously undisclosed patient complaints filed with AHCA.  Blanco knew that the information she provided in exchange for bribes could ultimately be used to fabricate and falsify medical paperwork and to temporarily remedy deficiencies so that AHCA would not discover lapses in patient care and revoke the licenses of the facilities that had received the information.

The purchasers of information provided by Blanco included Philip Esformes, Isabel Lopez, Gustavo Mustelier, Gabriel Delgado, Guillermo Delgado, and Sila Luis.  Esformes is awaiting trial, presently scheduled for March 2018, on numerous charges related to health care fraud, wire fraud, kickbacks, money laundering, bribery, and obstruction of justice.  Lopez and Mustelier pleaded guilty in May 2017 to conspiracy to defraud the United States and are awaiting sentencing.  Gabriel Delgado pleaded guilty in 2015 to money laundering and was sentenced to 55 months in prison.  Guillermo Delgado pleaded guilty in 2015 to conspiracy to distribute a controlled substance and was sentenced to 110 months in prison.  Luis pleaded guilty in June 2017 to conspiracy to commit health care fraud and was sentenced to 80 months in prison.

The FBI and HHS-OIG investigated this case.  Trial Attorneys David Snider, Elizabeth Young and Drew Bradylyons of the Criminal Division’s Fraud Section are prosecuting the case.

An indictment is merely an allegation and all defendants are presumed innocent until proven guilty beyond a reasonable doubt in a court of law.

The Fraud Section leads the Medicare Fraud Strike Force, which is part of a joint initiative between the Department of Justice and HHS to focus their efforts to prevent and deter fraud and enforce current anti-fraud laws around the country.  The Medicare Fraud Strike Force operates in nine locations nationwide.  Since its inception in March 2007, the Medicare Fraud Strike Force has charged over 3,500 defendants who collectively have falsely billed the Medicare program for over $12.5 billion.

No comments: