Ex-Florida hospital director admits role in $1B fraud scheme

The former director of outreach programs at Larkin Community Hospital in South Miami, Fla., faces up to five years in prison after pleading guilty in Florida federal court Jan. 23 to her role in a $1 billion fraud scheme.

Four things to know:

1. Odette Barcha, who pleaded guilty to conspiring to defraud the federal government and paying and receiving healthcare kickbacks, was one of three defendants charged in an indictment unsealed in July 2016.

2. According to the indictment, Philip Esformes operated a network of more than 30 skilled nursing homes and assisted living facilities in Florida. Prosecutors alleged he and his co-conspirators admitted many 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.

3. Ms. Barcha allegedly had physicians at Larkin Community Hospital discharge patients to facilities owned by Mr. Esformes, who paid kickbacks for those admissions, according to McKnight's Long-Term Care News.

4. Mr. Esformes is in prison awaiting trial, which is slated to begin Feb. 11. Arnaldo Carmouze, who was charged in the fraud case with Mr. Esformes and Ms. Barcha, pleaded guilty to one count of conspiracy to commit healthcare fraud in early January. He faces up to 10 years in prison.

More articles on legal and regulatory issues:

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Ex-pharmacy owner gets 3 years in prison for healthcare fraud
38 hospitals sue HHS over site-neutral payment policy

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