On August 10, 2020, Dr. Richard Ferdinand Toussaint Jr., an anesthesiologist and cofounder of the upscale hospital, Forest Park Medical Center, received a 66-month federal prison sentence for his involvement in a $200 million fraud case. He was also ordered to pay restitution fees of more than $82.9 million.
In a separate March 2018 health care fraud conviction, Toussaint pleaded guilty to one count of conspiracy for paying health care bribes and kickbacks and one count of illegal remuneration, under the Travel Act. He is presently serving a 41-month federal prison sentence for that conviction, and the new 66-month sentence will be served simultaneously.
What Happened?
The alleged fraud took place from 2009 to 2013 and consisted of Toussaint and others, including Forest Park Medical Center cofounder, Dr. Wade Neal Barker, paying bribes or kickbacks to outside physicians to refer wealthy patients who had private, high-reimbursing health insurance plans to their medical facility. According to Federal agents, the offenders paid out around $40 million in bribes and concealed it as marketing money. Email correspondence provided evidence that Toussaint and Baker were informed of the amount surgeons were being paid for referrals. Court documents state that Forest Park managed to collect over $200 million from fraudulent claims.
Forest Park Medical Center did not join insurance networks and was able to set its own prices to receive reimbursements at a much higher rate than they would have received as an in-network provider. Forest Park waived the out-of-network co-payments and promised patients they would be billed in-network prices. They buried the discounts given to patients and wrote the funds off as bad debt.
Defense lawyers for Forest Park doctors argued that their clients’ activities were not illegal because the physicians only hoped the referrals would come, but there was no obligation attached to the money. They just wanted to provide the best possible care to patients at their state-of-the-art facilities. The attorneys also accused the prosecution of trying to turn the medical profession’s routine practice into an illegal offense.
Forest Park Medical Center had locations in Dallas, Fort Worth, Frisco, and San Antonio. One was planned for Austin but never opened. The company filed for bankruptcy in early 2016.
What It Means
Healthcare professionals can learn from this case and keep in mind that receiving compensation for patient referrals can mean a risk of criminal exposure. Because the most common federal healthcare fraud charges are centered on Medicare, Medicaid, or other government programs, medical providers may not realize that arrangements with private payers can also be scrutinized.
A Texas Defense Lawyer You Can Count On
The impact of a criminal conviction can be devastating. If you are facing a state or federal charge for alleged healthcare fraud or another white-collar crime, please reach out to Rosenthal Kalabus & Therrian immediately, so we can help you build a strong defense case. You can put your confidence in our experienced attorneys, who will make sure all of your legal rights are protected. Contact us today at (972) 369-0577 to schedule a confidential consultation. We will assess your situation and provide the peace of mind that you have someone fighting alongside you.