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Health care professionals sentenced in $40M scam in Texas


The Texas Department of Workers’ Compensation on Tuesday announced that all the defendants have been sentenced in a $40 million health care fraud bribery scam involving mostly those working with injured workers.

The case began in 2016 and involved 14 defendants, 11 of which worked with injured workers under the comp program. The defendants were sentenced to a combined 74-plus years in federal prison and ordered to pay $82.9 million in restitution, according to a statement.

In the scheme, surgeons, physicians and hospital administrators steered patients, including many in the state workers’ compensation system, to Forest Park Medical Hospital in Dallas. Surgeons got kickbacks, disguised as marketing or consulting fees for these referrals, according to the statement.

The defendants included 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 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.