Some 21 doctors, executives, investors and others have been accused of a massive conspiracy to direct patients to the Forest Park Medical Center in Dallas in exchange for money.

The group dished out nearly $40 million in bribes and kickbacks which influenced doctors to refer higher-paying patients to the medical center, according to the U.S. Department of Justice.

The group was charged in a sealed indictment last month following an FBI investigation. The indictments were unsealed Thursday.

FPMC was an out-of-network hospital in Dallas, prosecutors said. This meant it could usually set its own prices and receive greater reimbursements from some patients.

It also meant patients whom doctors and surgeons referred to FPMC usually had high-reimbursing out-of-network private insurance benefits, according to the indictment.

According to the indictment, two surgeons were paid over $3 million to refer their patients to FPMC. Another surgeon allegedly received $7 million in exchange for a referral. Many of the doctors and surgeons involved were also FPMC investors.

“The surgeons spent the vast majority of the bribe payments marketing their personal medical practices, which benefitted them financially, or on personal expenses, such as cars, diamonds, and payments to family members,” the Justice Department said.

From 2009 to 2013, the medical center allegedly collected over $500 million from patient insurance plans and over $200 million in paid claims.

“Medical providers who enrich themselves through bribes and kickbacks are not only perverting our critical health care system, but they are committing a serious crime,” U.S. Attorney John Parker said in a statement.

The long list of doctors, surgeons, investors and executives who are under investigation could receive up to 20 years in federal prison and a $250,000 fine.

It could also force the defendants to forfeit “any property, real or personal, which constitutes or is derived from proceeds traceable to the offenses," prosecutors said.

Here is a list of 21 people indicted:

Alan Andrew Beauchamp, 64, of Dallas

Richard Ferdinand Toussaint, Jr., 58, of Dallas

Wade Neal Barker, 51, of Dallas

Wilton McPherson Burt, 61, of Costa Rica

Andrea Kay Smith, 37, of Rockwall, Texas

Carli Adele Hempel, 40, of Plano, Texas

Kelly Wade Loter, 48, of Dallas

Jackson Jacob, 53, of Murphy, Texas

Douglas Sung Won, 45, of Dallas

Michael Bassem Rimlawi, 45, of Dallas

David Daesung Kim, 54, of Southlake, Texas

William Daniel Nicholson IV, 46, of Dallas

Shawn Mark Henry, 46, of Fort Worth, Texas

Mrugeshkumar Kumar Shah, 42, of Garland, Texas

Gerald Peter Foox, 69, of Tyler, Texas

Frank Gonzales Jr., 41, of Midland, Texas

Israel Ortiz, 49, of Dallas

Iris Kathleen Forrest, 56, of Dallas

Andrew Jonathan Hillman, 40, of Dallas

Semyon Narosov, 51, of Dallas

Royce Vaughn Bicklein, 44, of San Antonio, Texas