Ex-Missouri hospital CEO faces criminal charges in $114M billing fraud case

David Byrns, the former CEO of Putnam County Memorial Hospital in Unionville, Mo., has been charged in a billing fraud scheme that came to light in 2017, according to The Kansas City Star.

Mr. Byrns was charged Sept. 27 with conspiracy to commit healthcare fraud in the federal district court for the Western District of Missouri. He was allegedly part of a scheme to submit fraudulent claims for laboratory services to insurers for patients who never visited Putnam County Memorial Hospital. 

Mr. Byrns took control of the 15-bed hospital in 2016 under a management agreement with Hospital Partners, a company he ran with Jorge Perez, according to the Kansas City Business Journal. In 2017, Missouri Auditor Nicole Galloway's office raised concerns about a billing arrangement Hospital Partners set up with Putnam County Memorial Hospital. Ms. Galloway released a report alleging the hospital received $90 million in questionable insurance payments in less than a year.

According to court documents cited by The Kansas City Star, Mr. Byrns and others allegedly submitted false claims for blood and urine tests to private insurers and an affiliate of Missouri's Medicaid program between October 2016 and February 2018. The hospital was paid $114 million for the allegedly fraudulent claims, $63 million of which was transferred to a lab operator in Florida under contract with the hospital.

"This all began with our audit of a small county-owned hospital," Ms. Galloway said in a statement to The Kansas City Star. "Our work helped expose a nationwide conspiracy that led to these federal criminal charges."

Mr. Byrns has reportedly agreed to plead guilty to participating in the scheme. The case will be transferred to a federal court in Florida for Mr. Byrns' plea and sentencing. 

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