Physicians, execs at Forest Park Medical Center indicted for $40 million in bribes and kickbacks
FPMC billed patients' insurance plans and programs well over half a billion dollars and collected over $200 million in paid claims.
Forest Park Medical Center (Google Earth)
Founders and investors of the physician-owned Forest Park Medical Center in Dallas, as well as various executives, physicians, surgeons and others affiliated with the hospital, have been charged with numerous felony offenses stemming from their alleged ties to a $40 million bribes and kickbacks scheme.
The indictment was returned by a grand jury in Dallas in November and made public earlier this month.
FPMC was an out-of-network hospital. According to the indictment, the referred patients were primarily ones with high reimbursing out-of-network private insurance benefits, or benefits under certain federally-funded programs. FPMC's owners, managers, and employees also attempted to sell patients with lower reimbursing insurance coverage, namely unwitting Medicare and Medicaid beneficiaries, to other facilities in exchange for cash.
[Also: Texas home health agency owner convicted in $13 million Medicare fraud scheme]
As a result of the bribes, kickbacks and other inducements from 2009 to 2013, FPMC billed these patients' insurance plans and programs well over half of a billion dollars and collected over $200 million in paid claims.
Since FPMC was founded as an out-of-network hospital, it was free to set its own prices for services and was generally reimbursed at substantially higher rates than in-network providers. The hospital's strategy was to maximize profit for physician investors by refusing to join the networks of insurance plans for a period of time after its formation, allowing its owners and managers to enrich themselves through out-of-network billing and reimbursement.
[Also: Houston pharmacist admits to $5 million healthcare fraud, paid kickbacks for referrals]
Defendants charged in the indictment include: Alan Andrew Beauchamp, 64, of Dallas; Richard Ferdinand Toussaint, Jr., 58, of Dallas; Wade Neal Barker, 51, of Dallas; Wilton McPherson Burt, 61, of Costa Rica; Andrea Kay Smith, 37, of Rockwall, Texas; Carli Adele Hempel, 40, of Plano, Texas; Kelly Wade Loter, 48, of Dallas; Jackson Jacob, 53, of Murphy, Texas; Douglas Sung Won, 45, of Dallas Michael Bassem Rimlawi, 45, of Dallas; David Daesung Kim, 54, of Southlake, Texas; William Daniel Nicholson IV, 46, of Dallas; Shawn Mark Henry, 46, of Fort Worth, Texas; Mrugeshkumar Kumar Shah, 42, of Garland, Texas; Gerald Peter Foox, 69, of Tyler, Texas; Frank Gonzales Jr., 41, of Midland, Texas; Israel Ortiz, 49, of Dallas; Iris Kathleen Forrest, 56, of Dallas; Andrew Jonathan Hillman, 40, of Dallas; Semyon Narosov, 51, of Dallas; and Royce Vaughn Bicklein, 44, of San Antonio, Texas.
"Medical providers who enrich themselves through bribes and kickbacks are not only perverting our critical health care system, but they are committing a serious crime," said U.S. Attorney John Parker in a statement. "Massive, multi-faceted schemes such as this one, built on illegal financial relationships, drive up the cost of healthcare for everyone and must be stopped."
Twitter: @JELagasse
