Convicted long-term care businessman Philip Esformes has been ordered to pay a total of $44.2 million for his role in a $1.3 billion healthcare fraud scheme that ran through his network of nursing homes. 

Judge Robert N. Scola Jr. ordered Esformes to forfeit $38.7 million and pay $5.5 million in restitution during a hearing Thursday in the U.S. Southern District of Florida. 

The forfeiture judgement of $38.7 million — the amount Esformes personally pocketed from the scheme — was in line with prosecutors’ initial requests.

Prosecutors also had requested that he pay $207 million in restitution to Medicare and Medicaid prior to his sentencing in September. Scola, however, questioned the prosecution’s high calculations and ultimately found the program’s loss between $4.9 million and $8.3 million. 

Earlier this year, a jury found Esformes, who owned a chain of skilled nursing and assisted-living facilities, guilty on 20 charges for bribery, money laundering and paying and receiving kickbacks in connection to the $1.3 billion scheme that occurred between 1998 and 2016. He was sentenced to 20 years in prison for the fraud scheme in September. After his arrest in 2016, prosecutors called his Medicare fraud case the largest in the nation’s history. 

Esformes must also pay an additional $617,000 for the cost of his incarceration, the Miami Herald reported.