http://healthcare.dmagazine.com/2016/12/01/doj-indicts-21-alleges-forest-park-officials-paid-40-million-in-kickbacks-for-patient-referrals/?utm_source=hs_email&utm_medium=email&utm_content=38578013&_hsenc=p2ANqtz-9nq-_xFj_5ZsB5A4GXxtR4dmyVTHWn9cNkB_MTg2hapXhZT97fHccuUvHO0Xt0TZ00pj_4tk5lsYhA5hKfDHAVK1sDrw&_hsmi=38578013

A federal grand jury has returned indictments on 21 individuals allegedly involved in a massive kickback scheme through the defunct Forest Park Medical Center chain of luxury hospitals, which resulted in “well over half a billion dollars” in billed claims due to illegal bribes.

The 44-page indictment, unsealed Thursday, describes a vast, four-year conspiracy, fueled by $40 million in kickbacks funneled through a number of shell companies—consulting firms, commercial real estate firms, business services organizations—into the pockets of high-powered surgeons, some of whom have their faces on billboards throughout Dallas-Fort Worth.

The 21 suspects include two of the four physician founders of the hospital chain, including Dr. Richard Toussaint, the anesthesiologist who is awaiting sentencing on a separate fraud conviction; and Wade Barker, the bariatric surgeon who helped develop the idea for Forest Park. Other early adopters indicted in the scheme include Wilton ‘Mac’ Burt, a consultant who helped run the chain’s affiliated management company until he and his colleague, Alan Beauchamp, were bought out in 2015. Beauchamp was also indicted.

But the bribery scheme sailed far outside the doors of Forest Park’s grey and blue flagship at the corner of U.S. 75 and Interstate 635. Also indicted were prominent bariatric surgeons Drs. David Kim and William Nicholson as well as the minimally invasive spine surgeons Drs. Michael Rimlawi, Douglas Won, and Shawn Henry. Won, the DOJ alleges, was paid $7 million for his referrals. Rimlawi is accused of accepting $3.8 million. The feds argue that Kim and Nicholson, both of whom were investors in Forest Park, were paid $4.595 million and $3.8 million respectively. Reads the indictment: “The surgeons spent the vast majority of the bribe payments marketing their personal medical practices—which benefitted them financially—or on personal expenses such as cars, diamonds, and payments to family members.”

In all, the feds say Forest Park collected “in excess of two hundred million dollars in tainted and unlawful claims.” None of those named in the indictment have returned requests for comment. Sheryl Zapata, the chief development officer for the Texas Back Institute where Nicholson currently practices, said “TBI is not a part of this and we will not be commenting.”

“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,” read a statement from U.S. Attorney John Parker. “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.”

Forest Park Medical Center was a chain of luxury hospitals that sprouted in Dallas, Fort Worth, Southlake, Frisco, and San Antonio. One in Austin was built but never opened, kneecapped due to nearly two dozen construction liens.

The model collapsed in on itself due to its reliance on high out-of-network charges that it would bill to insurance companies. The payers eventually balked, and the patient volumes dried up. The hospitals died one by one, each eventually entering bankruptcy and sold off to a health system. Because they were physician owned, they were barred by the Affordable Care Act from billing any public health insurance plan, such as Medicare, for fear of conflicts of interest regarding referrals. And despite this, it twice had to settle claims with the DOJ for paying kickbacks for Tricare patients and Department of Labor employees. The indictment alleges that this is exactly what happened: Beauchamp, Barker, and Kim, among others, “also attempted to refer patients with lower-reimbursing insurance coverage, namely Medicare and Medicaid beneficiaries, to other facilities in exchange for cash.”