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

 

 

 

Ex-revenue cycle director gets prison time for embezzling from Delaware hospital

https://www.beckershospitalreview.com/legal-regulatory-issues/ex-revenue-cycle-director-gets-prison-time-for-embezzling-from-delaware-hospital.html?origin=cfoe&utm_source=cfoe

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Hope Abram, a former revenue cycle director at Lewes, Del.-based Beebe Healthcare, has been sentenced to prison for embezzling more than $100,000 from Beebe Healthcare, according to the Salisbury Daily Times.

Ms. Abram was arrested earlier this year after Beebe Healthcare officials alerted police of a potential internal embezzlement. A standard audit of receivables and payments pointed to several irregularities tied to Ms. Abram. She recently pleaded guilty to theft of greater than $100,000 in connection with the incidents.

Between February and May of 2017, Ms. Abram requested refund checks for fictitious people. When the checks were returned, she deposited them into her personal account.

Ms. Abram was sentenced to 25 years in prison, but much of it was suspended. She will serve two years in federal prison followed by home confinement. In addition to the prison term, Ms. Abram was ordered to pay $201,451 in restitution, according to the report.

Fake owner pleads guilty in $4.2M home health fraud scheme

http://www.healthcaredive.com/news/fake-owner-pleads-guilty-in-42m-home-health-fraud-scheme/424577/

  • Ramon Collado Gonzalez of Miami, Florida pleaded guilty Monday to acting as the straw owner of Golden Home Health Care as part of a $4.2 million home healthcare fraud scheme, the U.S. Attorney’s Office for the Southern District of Florida announced Tuesday.
  • Gonzalez admitted he was recruited to cover for the real owners, Mildrey Gonzalez and Milka Alfaro, who were charged separately for their alleged roles.
  • Gonzalez signed documents for the submission of false Medicare claims in exchange for monthly payments and periodic bonuses, the press release states.