Physicians, founders, executives and investors of physician-owned Forest Park Medical Center in Dallas have been charged in a federal indictment for their alleged involvement in a bribe and kickback scheme, according to the Department of Justice.
The scheme, which began in 2009 and ran through 2013, involved paying surgeons, lawyers and others for referring patients to FPMC, which was an out-of-network facility with payers.
"FPMC'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," according to the DOJ.
According to the indictment, FPMC's referral coordinator owned a shell entity called Unique Healthcare that was used to funnel kickback payments to surgeons in exchange for referrals to FPMC. Most of the referred patients had insurance plans that provided high reimbursement for out-of-network care.
Another FPMC employee sold Medicare and Medicaid referrals to a non-FPMC facility.
There were a total of 21 defendants charged in the scheme, including the hospital's founders and executives. Those involved paid and/or received about $40 million in bribes and kickbacks for referring patients. The fraud resulted in more than $500 million in patient charges and FPMC collecting more than $200 million.
Each of the defendants is charged with one count of conspiracy to pay and receive healthcare bribes and kickbacks. If convicted, they each face up to five years in federal prison and a $250,000 fine. More than half of the defendants face various other charges, including conspiracy to commit money laundering, violations of the federal Travel Act and offering or paying and soliciting or receiving illegal remuneration, according to the DOJ.
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