Austin, TX – U.S. District Judge Zack Zouhary recently sentenced the remaining defendants in the Forest Park Medical Center health care fraud bribery scam.
It’s the final chapter in what was a $40 million dollar fraud and bribery case that began in 2016 and involved 14 defendants. The defendants involved in the case were sentenced to a combined 74+ years in federal prison and ordered to pay $82.9 million in restitution.
In the scheme, surgeons, physicians, and hospital administrators steered patients, including many in the state workers’ compensation system, to Forest Park Medical Hospital. Surgeons got kickbacks, disguised as marketing or consulting fees for these referrals.
“Instead of basing decisions on patient needs, these health care providers sought to maximize their own income. Activities like this reflect a complete lack of patient care,” says DWC’s Deputy Commissioner of Compliance and Investigations, Debra Knight.
Eleven of the defendants participated in the Texas workers’ compensation system, including a nurse who recruited and preauthorized workers’ compensation requests, and the founder of a company that filled out preauthorization for workers’ compensation patients.
The DWC Fraud Unit identified Forest Park health care providers who billed within the state’s workers’ compensation system and provided data and investigation documents to the FBI for seven of the defendants. The Fraud Unit found that insurance carriers in the Texas workers’ compensation system alone were billed a little over $14 million and paid $2.6 million in this case.
“Fraudulent billing within the health care system drives up the costs of health care for everyone,” says Knight. “These significant sentences demonstrate that health care fraud will not be tolerated.”
The DWC Fraud Unit, a criminal justice organization, protects the public from economic harm by investigating allegations of fraud committed by workers’ compensation system participants. The team works with local, state, and federal investigators and prosecutors.
Source: TDI-DWC