Ex-Florida hospital director gets prison time for role in $1B fraud scheme

https://www.beckershospitalreview.com/legal-regulatory-issues/ex-florida-hospital-director-gets-prison-time-for-role-in-1b-fraud-scheme.html

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The former director of outreach programs at Larkin Community Hospital in South Miami, Fla., was sentenced to 15 months in prison April 3 for her role in a $1 billion healthcare fraud scheme.

Four things to know:

1. The judge handed down the sentence just over two months after Odette Barcha pleaded guilty to conspiring to defraud the federal government and paying and receiving healthcare kickbacks.

2. Ms. Barcha was one of three defendants charged in an indictment unsealed in July 2016. She allegedly had physicians at Larkin Community Hospital discharge patients to skilled nursing homes and other facilities owned by Philip Esformes, who allegedly paid kickbacks for those admissions.

3. Prosecutors allege Mr. Esformes, who operated a network of more than 30 skilled nursing homes and assisted living facilities in Florida, admitted Medicare and Medicaid beneficiaries to the facilities even if they did not qualify for skilled nursing home care or for placement in an assisted living facility. Once admitted, the patients received medically unnecessary care that was billed to Medicare and Medicaid.

4. The seven-week trial of Mr. Esformes wrapped up March 29, according to the Miami Herald. On April 5, a federal jury found Mr. Esformes guilty of various counts, including paying and receiving kickbacks, bribery, money laundering and obstruction of justice, according to Law360

 

 

 

Lawyer sentenced to prison for stealing $1.2M in patient payments from St. Luke’s

http://www.beckershospitalreview.com/legal-regulatory-issues/lawyer-sentenced-to-prison-for-stealing-1-2m-in-patient-payments-from-st-luke-s.html

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Alan B. Gallas, 65, was sentenced Friday to one year and one day in federal prison for stealing more than $1.2 million from Kansas City, Mo.-based St. Luke’s Health System between 2009 and July 2015, according to the Department of Justice.

Mr. Gallas’ firm, Gallas & Schultz, collected past-due payments from patients for the hospital network. Money collected by the firm on behalf of St. Luke’s was supposed to go into a trust account. However, Mr. Gallas admitted in April that he had employees put holds on more than $1.2 million in St. Luke’s collections and then transfer the funds to the law firm’s operating account.

Mr. Gallas’ law partner Mark J. Schultz, 57, pleaded guilty Friday to participating in the fraud conspiracy. He admitted to transferring funds from the trust account to the law firm’s operating account. The total amount of funds diverted by Mr. Schultz will be determined by the court at his sentencing hearing, according to the DOJ. He faces up to five years in federal prison for his role in the scheme.

In addition to his prison term, Mr. Gallas was ordered to pay more than $1.2 million in restitution.