 The involvement of Carmouze in the grand scheme was to prescribe unnecessary prescription drug to patients who may or may not have needed the medications.He also facilitated community physicians to visit the patient in the assisted living facilities owned by Esformes in order for the physician to bill Medicare and Medicaid and Esformes received kickbacks.Carmouze also assisted in falsifying medical documentation to represent proof of medical necessity for many of the medications, procedures, visits, and equipment charged to the government.