A former executive of a northern Missouri hospital pleaded guilty in federal court in Florida Wednesday to a $114 million pass-through billing scheme.

The Justice Department in Washington says former Putnam County Memorial Hospital chief executive officer David Lane Byrns pleaded guilty to a one-count information charging him with conspiracy to commit health care fraud. Byrns pleaded guilty before U.S. Magistrate Judge James Klindt, of the Middle District of Florida.

The criminal count was originally filed in Missouri and was transferred to Florida, where Byrns now lives. The complex case was investigated by the FBI in Kansas City, Jefferson City and in Jacksonville, Florida. The Justice Department in Washington has been involved, as has the U.S. Department of Labor and the offices of two Missouri statewide officials.

The Justice Department says Byrns used the Unionville hospital to submit fraudulent claims for blood testing and toxicology, causing the Missouri Medicaid program and multiple insurance companies to pay more than $100 million in claims.

The Medicaid program is health care for low-income residents. Unionville is in far north-central Missouri, just south of the Iowa border.

Federal prosecutors in Missouri and Florida say billing companies and labs were also involved in the scheme, describing them as “co-conspirators.”

Missouri Auditor Nicole Galloway’s (D) scathing 2017 audit of Putnam County Memorial Hospital uncovered $90 million in inappropriate lab billings, and prompted calls for the federal investigation.

The Justice Department is acknowledging Galloway’s office for assistance, along with Missouri Attorney General Eric Schmitt’s (R) Medicaid Fraud Control Unit.

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