The Cost of Medicare Fraud: The Case of Adrian Galette
March 25, 2026
About Adrian Galette
Adrian Galette is a 78-year-old man who was living in Golden Glades Nursing and Rehabilitation home in Miami. He has cognitive disabilities that prevent him from communicating and uses a wheelchair to get around. In 2017, his leg began to swell. After a few days, when the pain became unbearable, nurses at the center finally sent Galette to Aventura Hospital.
What they found surprised them.
According to the law firm representing Galette, his leg was “broken with such force that fragments of the bone were visible throughout the entire X-ray field.” Yet this severe injury had never been reported by Golden Glades, and the lack of treatment meant that Galette now faced life-threatening injuries.
Your tax dollars had already been paying for Galette’s care through Medicare, which provides a vital safety net for millions of senior citizens, particularly those who rely on the program for essential health services. Yet he had not received even the most basic treatment during his stay at Golden Glades. But you—the US taxpayer—were billed as though he received the care he deserved. This is the very definition of Medicare fraud, as his lawyers allege.
The Largest Medicare Fraud in History
What happened to Galette would have been bad enough, but this neglect was part of a broader pattern. In what the US Department of Justice has called the largest Medicare fraud case in history, fraudsters stole $1.3 billion from American taxpayers over the course of almost two decades.
The man at the center of the scheme is Philip Esformes, the former owner of Golden Glades as well as over 30 Miami-area skilled nursing and assisted living facilities. Esformes and his two co-conspirators ran an elaborate scheme to defraud Medicare and Medicaid. According to the FBI, the fraudsters worked to admit “unqualified beneficiaries to Esformes’ network of nursing homes and assisted living facilities, where they then billed the federal health insurance programs for medically unnecessary services.” Esformes and his co-conspirators also allegedly received kickbacks and bribed physicians to admit patients to his facilities, even as those patients faced unsanitary conditions and medical neglect.
The US Department of Justice fought to get justice for the victims and for the US taxpayer. According to the filings, Galette was one of 14,000 victims of this fraud. In 2019, Esformes was found guilty and sentenced to 20 years in prison, what the Department of Justice called the largest medical fraud in history. To compensate his long list of victims, the court ordered Esformes to pay “$5.5 million in restitution to the Centers for Medicare & Medicare Services and pledge at least $14 million in assets toward his outstanding forfeiture penalty of $38.7 million, the amount of money he received from the Medicare program through fraudulent billing between 2010 and 2016.”
What Trump’s Pardon Cost Us
Do the crime, pay the time, right? Not under President Trump.
According to Mother Jones, Esformes’ family donated $65,000 to the Aleph Institute, a Chabad-Lubavitch criminal justice non-profit with ties to Jared Kushner, President Trump’s son-in-law. The organization advocated on Esformes’ behalf to Trump in what the New York Times described as a “case study in special access.”
The result? Donald Trump granted clemency to Esformes shortly before leaving office in 2020, which erased his prison sentence and wiped away the repayments to the victims of his crime.
After such a stunning reversal of justice, you would think that Esformes must have learned his lesson, right? Guess again. He is the seventh person previously granted clemency by the president to be retried for new crimes. In Esformes’ case, he now faces domestic violence charges.
What’s especially galling about this case is that President Trump had the nerve to announce a new Task Force to Eliminate Fraud just a few days ago, in spite of his multiple pardons of fraudsters who have swindled billions from taxpayers. If we were gamblers, we’d suggest that this will be about as successful as DOGE at saving money. Instead of recovering stolen money and catching criminals, the task force will likely be a platform to smear the programs that provide services to our neighbors and families.
It’s easy to get lost in the details of how much money was stolen and how the Trump administration has worked to unravel yearslong fraud investigations in this case and others. But to wrap up this first edition of our Costs of Corruption series, we would like to end with the staggering scale of victims affected by this crime and its subsequent pardon.
- Tens of thousands of seniors, people with disabilities, and their families who needed help and were supposed to get paid for damages
- Honest businesses that could have received these patients and treated them with care
- All of the other recipients of Medicare who had their benefits cut last year under the guise of eliminating waste, fraud, and abuse, all while President Trump willfully ignored the facts of actual fraud and abuse
- Everyone who wants to trust that we are equal before the law and that the justice system works
- You, the US taxpayer, who didn’t get what you paid for
We can—and must—do better.
The American Kleptocracy Clearinghouse will continue to track the costs of corruptions to everyday people in this country. Accountability does not disappear simply because those in power find it inconvenient.