A Texas anesthesiologist convicted in a $200 million healthcare fraud scheme has been sentenced to five and a half years in prison, the U.S. Justice Department said August 10.
Richard Ferdinand Toussaint Jr., MD, also was ordered to pay more than $82.9 million in restitution. He pleaded guilty to the scheme in March 2018.
According to the plea agreement, Dr. Toussaint teamed up with co-defendant and bariatric surgeon, Wade Neal Baker, MD, to create Forest Park Medical Center in Dallas for bariatric and spinal surgery patients.
According to the suit, Dr. Toussaint, Dr. Barker and their colleagues conspired to steer patients, particularly those with high-reimbursing or out-of-network insurance, to the hospital by paying physicians and surgeons for referrals.
Forest Park Medical Center paid physicians and surgeons more than $40 million for the lucrative patient referrals with most of the kickbacks disguised as consulting fees or "marketing money," according to the Justice Department.
Instead of billing patients for out-of-network copays, the Forest Park hospital allegedly waived copays and assured patients they would pay in-network prices. Because insurers don't allow hospitals to provide these discounts, those involved in the scheme allegedly concealed the patient discounts and wrote off the difference as bad debt.
Dr. Toussaint was one of 18 people convicted in the scheme.
Dr. Toussaint already is serving more than three years in prison for a separate healthcare fraud conviction. The new five and a half year sentence will be served concurrent to the more than three-plus year sentence.
Read the full news release here.