Forest Park Medical Center anesthesiologist pleads guilty to $40M kickback scheme: 8 things to know

Dallas-based Forest Park Medical Center founder and anesthesiologist Richard F. Toussaint, MD, pled guilty to a count of conspiracy to pay healthcare bribes and kickbacks and a count of offering or paying illegal remuneration and aiding and abetting under the Travel Act on March 17, 2017, according to a press release from The United State's Attorney Office of the Northern District of Texas. The Travel Act prohibits the use of U.S. mail, interstate or foreign travel for criminal acts.

Dr. Toussaint faces up to five years in prison and a $250,000 fine for each count. The court will sentence him at a later date.

Co-defendants Andrea Kay Smith, Kelly Wade Loter and Israel Ortiz also pled guilty to their roles in the case. Seventeen other defendants will undergo a trial scheduled for July 10, 2017. Those pending trial will remain unnamed.

According to court documents,

1. Dr. Toussaint met with a co-defendant in 2003 and began providing anesthesia services for the man in 2005. Dr. Toussaint and the man decided to form the physician-owned hospital, Forest Park Medical Center, in 2008.

2. The center targeted bariatric and spinal surgeons for monetary reasons. The center stayed out-of-network to collect higher reimbursement rates.

3. Dr. Toussaint and FPMC's other founder as well as several co-defendants said they were aware of an arrangement where the center would pay surgeons "marketing checks" for performing procedures there. They paid approximately $40 million from 2009 to 2013.

4. A co-defendant allegedly kept tabs on the procedure amounts each surgeon brought to the center and used a metric to calculate surgeon payments on their anticipated case loads. Dr. Toussaint was copied on emails discussing how much the center paid certain surgeons.

5. Dr. Toussaint and FPMC waived coinsurance or reduced it to in-network levels to attract more patients. Dr. Toussaint misrepresented the practice to payers so they accepted the center's reimbursement claims. FPMC guaranteed patients they would either not pay, or pay only an in-network equivalent.

6. Dr. Toussaint and a co-defendant owned a commercial real estate company they used to funnel bribes and kickback payments through.

7. Dr. Toussaint and FPMC paid kickbacks to chiropractors to refer their patients to the clinic.

8. Dr. Toussaint and FPMC also offered surgeons stock options in the center to attract more referrals. According to court documents, "the more surgeries a surgeon could bring to FPMC, the more they were allowed to invest and profit from the hospital's billings." Dr. Toussaint helped decide how many shares a surgeon could invest. If a surgeon cutback on his cases, FPMC divested or cut his shares.

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