Dive Brief:
- The U.S. attorney's office alleges that Dallas anesthesiologist Dr. Richard Ferdinand Toussaint Jr. submitted $5 million in false claims in 2009 and 2010 to Blue Cross Blue Shield of Texas, United Healthcare and the Federal Employees Health Benefits Program.
- Toussaint will plead not guilty to the 17 counts of healthcare fraud. He co-founded Forest Park Medical Center, founded Ascendant Anesthesia and had practiced at Doctors Hospital at White Rock Lake in Dallas.
- Touissant could face 170 years in federal prison—10 for each count of fraud—as well as a $250,000 fine and an order to pay restitution.
Dive Insight:
The case is among the latest to come under scrutiny in the crackdown on healthcare fraud.
It alleges that Toussaint submitted claims for procedures for which he could not have been present; that he overstated the length of time he spent performing procedures; that he pre-signed medical records before patients underwent procedures; and that he instructed others to do so as well.
Toussaint's attorney released a statement saying he was "disappointed the government moved to formal charges," and highlighted Toussaint's philanthropic and religious efforts that included multiple medical missions to Haiti and Honduras.
Meanwhile, Ascendant Anesthesia distanced itself from Toussaint with a statement that he had previously retired from the firm and had no ongoing role.