Issue link: https://beckershealthcare.uberflip.com/i/1198635
44 HEALTHCARE NEWS Ex-Missouri hospital CEO faces criminal charges in $114M billing fraud case By Ayla Ellison D avid Byrns, the former CEO of Put- nam County Memorial Hospital in Unionville, Mo., has been charged in a billing fraud scheme that came to light in 2017, according to e Kansas City Star. Mr. Byrns was charged Sept. 27 with conspir- acy to commit healthcare fraud in the feder- al 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 hospi- tal 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 Au- ditor Nicole Galloway's office raised concerns about a billing arrangement Hospital Part- ners set up with Putnam County 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 e Kansas City Star, Mr. Byrns and others al- legedly 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. e hos- pital 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. "is all began with our audit of a small county-owned hospital," Ms. Galloway said in a statement to e Kansas City Star. "Our work helped expose a nationwide conspiracy that led to these federal criminal charges." Mr. Byrns has agreed to plead guilty to par- ticipating in the scheme. e case will be transferred to a federal court in Florida for Mr. Byrns' plea and sentencing. n Cambia, BCBS of North Carolina call off affiliation for now By Morgan Haefner C ambia Health Solutions and Blue Cross and Blue Shield of North Carolina have called off their affilia- tion agreement for now after the recent arrest and resignation of BCBSNC's CEO. The organizations had paused their merger after reve- lations surfaced about an allegedly alcohol-related car crash involving BCBSNC CEO Patrick Conway, MD, and his two daughters. In June, Dr. Conway was charged with driving while impaired and misdemeanor child abuse af- ter the car crash. In an online statement published Sept. 27, Cambia said: "In accordance with the previously announced pause in the Strategic Affiliation process, Cambia Health Solutions and Blue Cross Blue Shield of North Carolina have mutually agreed to withdraw their respective Form A applications for regulatory approval." The statement doesn't necessarily mean the deal is off the table, but the companies would need refile if they want to combine in the future. Dr. Conway resigned Sept. 26 at the request of the insurer's board of trustees. He was set to lead the combined entity. n Indiana system mistakenly gives 16 students insulin shots By Mackenzie Bean C linicians at Indianapolis-based Community Health Network mistakenly administered insulin shots to 16 students at a nearby school, reports Fox59. The students were supposed to receive a tuberculo- sis skin test at Indianapolis-based McKenzie Center for Innovation and Technology. Instead, employees gave them small doses of insulin. The students were sent to local hospitals for observation. "As soon as the error was discovered, immediate action was taken to care for these students," Community Health Network said in a Sept. 30 statement posted on its Face- book page. "The safety of the students in our care is top priority." The health system said it is working closely with school district officials to determine how the mistake happened and update processes, as necessary. "We have full confidence that the events of today are iso- lated in nature and will be addressed swiftly by the Com- munity Health Network," Metropolitan School District of Lawrence Township said in a statement cited by Fox39. n