Medicare fraudster Philip Esformes pleaded guilty on Thursday to health care fraud, laying to rest a longstanding effort to prosecute him after his 20-year sentence was commuted by former President Donald Trump.

Esformes, previously convicted of one of the biggest Medicare frauds in 2019 for his involvement in a billion-dollar Medicare fraud scheme, pleaded guilty to one count of conspiracy to commit health care fraud, according to filings in federal court in Miami, Florida, NBC News reported. The Department of Justice agreed to drop five other counts against him.

This news comes after Esformes reached a plea deal agreement at the start of February.

While Trump commuted the nursing home mogul’s prison sentence in December 2020, he left the conviction on 20 criminal counts and financial penalties intact.

Now however, Esformes will face no further restrictions, fines or additional time in jail as part of his plea agreement. He served over four years behind bars from his July 2016 arrest through late 2020, when his original sentence was commuted.

In 2019, Esformes was required to forfeit $38.7 million and pay $5.53 million in restitution after being found guilty on counts related to kickbacks, money laundering, obstruction of justice and conspiracy, according to court documents.

Esformes co-owned a slew of skilled nursing facilities (SNFs) and assisted living facilities (ALFs) spread out over Illinois, Missouri and Florida. His assets also included a Miami-area hospital, which was used to approve the hospital stay requirement.

Esformes is said to have bribed doctors to put patients into his nursing homes, where they frequently received inadequate care or were given unnecessary services that were then billed to Medicare and Medicaid.