With trial just three months away, prosecutors have added another big name to their growing witness list in the alleged $200 million health care fraud involving Forest Park Medical Center — a hospital once hailed as a successful new industry model.

Alan Andrew Beauchamp, a Forest Park co-founder who managed the hospital, has agreed to plead guilty in the case. He says in the plea documents that he recruited high-volume specialty doctors and paid them millions of dollars in bribes and kickbacks to perform their surgeries at the now-defunct Dallas hospital.

Beauchamp is the sixth of 21 defendants to admit guilt in the alleged scheme, in which $40 million in bribes and kickbacks were paid to doctors, recruiters and others, according to prosecutors. His lawyer declined to comment. Beauchamp faces up to five years in prison.

Eight of the defendants are physicians, seven of whom have pleaded not guilty and plan to take their case to a jury. The hospital’s owners targeted bariatric and spinal surgeons because “their surgeries generated the most money,” prosecutors said.

The trial date is set for Oct. 22.

Patients of the hospital were a valuable commodity, according to court records in the case. The more surgeries doctors could bring to Forest Park Medical Center, the more money they could earn, prosecutors say. Some were aggressive about recommending surgeries, even when it meant their patients — who didn't know about the kickbacks — would have to travel to Dallas from across the state for the expensive procedures, court records in the case show.

Alan Beauchamp

Such cases have brought infamy to Dallas as one of the nation's biggest hotspots for health care fraud. Two ongoing cases involving local compounding pharmacies allege a combined fraud of over $180 million. In those cases, pharmacy owners and marketers paid kickbacks and bribes to doctors for writing bogus prescriptions for unneeded pain and scar creams.

Jeffrey Baird, an Amarillo attorney who handles health care fraud cases, said charging doctors makes a "big splash" that gets attention.

“Being able to indict a physician is the Holy Grail for the Department of Justice,” he said.

Also, doctors are the starting point for most health care costs and thus are the main targets of large fraud cases, he said. “The doctor triggers everything.”

Baird said he suspects indicted doctors had lawyers who approved their business arrangements. And those lawyers may also have been seduced by the lure of money, he said.

In December, another doctor-owned hospital in Dallas, Pine Creek Medical Center, agreed to pay the government $7.5 million to settle accusations that it violated the False Claims Act by paying physicians kickbacks in exchange for surgical referrals.

Dr. Richard F. Toussaint, who also was a Forest Park Medical Center co-founder, pleaded guilty last year. Toussaint, an anesthesiologist, is the first doctor to plead guilty in the case. Two chiropractors also have admitted to their roles in the case.

Beauchamp and Toussaint were leaders of the conspiracy who masterminded the scheme to hide bribes and kickbacks by disguising them as marketing payments and other forms of payment, prosecutors say. In their plea agreements, the men say the surgeons are equally to blame.

“Beauchamp would recruit doctors by pitching them on the opportunity to invest in FPMC,” his plea documents say. “Beauchamp recruited doctors with high volume, profitable practices who were willing to ‘buy into’ the idea of being paid for their surgeries in the form of marketing checks.”

Richard Toussaint

Several of the charged surgeons were investors in the now-defunct Forest Park Medical Center, the indictment says.

“FPMC based the number of shares that a doctor could purchase on their surgeries or patient referrals and divested investors who did not refer a sufficient number of patients to FPMC,” the Beauchamp plea documents say.

Also this week, a federal magistrate judge ordered two other Forest Park defendants to be held in custody until trial because they were arrested on unrelated charges of smuggling marijuana to Dallas from a California medical marijuana dispensary.

Andrew Hillman and Seymon Narosov are accused of using FedEx to ship the marijuana. They were on pretrial release in the Forest Park case at the time. Their attorneys said during a Tuesday detention hearing that their clients were not shipping marijuana but a legal oil derived from the plant.

Also, Beauchamp's plea documents link Forest Park Medical Center to another large Texas kickback case. Garry Craighead, an Austin chiropractor, was paid $175,000 in kickbacks by Forest Park for referring patients there, according to court records in both cases.

Craighead is serving 14 years in prison for using kickbacks to defraud the federal workers' compensation program out of $17 million. He was sentenced in June 2016 after pleading guilty in the case.

Doctor payments

Beauchamp filed documents Monday agreeing to plead guilty to conspiracy to pay and receive health care bribes and kickbacks, and commercial bribery. A judge has not yet accepted the plea.

The court documents detail how surgeries allegedly were tied to doctor payments.

One surgeon defendant, Douglas Won, was not able to keep up the pace at one point, the documents say.

“Beauchamp told Won, ‘Here’s your check, but if you don’t increase your surgeries - don’t expect anymore,’” the plea documents say.

Another surgeon defendant, David Kim, was a “player” who performed many bariatric surgeries, according to the documents.

Beauchamp told Kim he could pay him $100,000 a month to perform 20 out-of-network surgeries a month, the documents say.

Another defendant, Shawn Henry, a Fort Worth spine surgeon, wanted to invest in Forest Park Medical Center but didn’t have the necessary money, the plea documents say.

Beauchamp and Toussaint came up with some ideas to boost Henry’s salary so he could obtain a loan to invest, the court documents say.

One idea: Could Henry supervise Forest Park’s emergency room?

“Dr. Henry informed the FPMC executives that he was not willing to perform any work at all,” the plea documents say.

Toussaint and Wilton Burt, another Forest Park executive, then decided to pay Henry a $30,000 monthly kickback for real estate consulting through a company Toussaint owned with another defendant, the documents say. Henry, however, didn’t do any real estate consulting, according to the plea documents.

Instead, he had to perform 25 to 30 surgeries a month at Forest Park Medical Center, the records say.

“We believe there’s evidence that’s contrary to that,” Burt’s lawyer, Edwin Tomko, said Wednesday. He said he would share it with the jury.

Wade Barker, another surgeon defendant, often asked Beauchamp for more money due to his increasing surgeries at Forest Park Medical Center, the plea documents said.

So the hospital paid the salary of “a woman whose job was to market Barker’s personal medical practice,” the documents say.

Texas is the site of two federal fraud Strike Force operations. (HHS OIG)

“Dr. Barker founded Forest Park Medical Center with the best of intentions,” said his attorney, Mark Werbner. “He hopes this matter will go to trial this fall so that he can clear the cloud that he has been under for the past few years.”

Hillman and Narosov got paid by recruiting doctors to bring their surgeries to Forest Park Medical Center, according to prosecutors.

Their company, Hospital Business Concepts, “acted like a broker by finding surgeons who would agree to do a surgery at FPMC,” according to the new plea documents.

Attorneys for Henry could not be reached. Attorneys for Won and Kim declined to comment.

'More bodies on the table'

Beauchamp has been quoted in court documents in the case as saying about surgeries at Forest Park Medical Center: "We need more bodies on the table."

As a result of that demand, the alleged fraud reached across Texas, from the Midland-Odessa area in West Texas to Austin and to East Texas, according to court documents in the case.

Craighead, the Austin chiropractor in prison, wrote to an associate in 2011 that Forest Park Medical Center was expecting an “informal list of cases we realistically feel we can get over there the next 30 days, 60 days and on out,” according to court documents in Craighead’s case.

Craighead also wrote that he was “working closely with Forest Park to keep the numbers increasing each week,” the documents say.

But Beauchamp was not pleased.

“It appears that your projection of cases have fallen ... short. You said 20 in November and 40 in December. I want to ... find out why my $150K investment has not produced Jack,” Beauchamp said in an email to Craighead in 2011.

The following year, Craighead was more upbeat, writing to an associate, “We have the patient flow to make serious $$$,” according to the Craighead court records.

Earlier this month, Frank Gonzales Jr., a West Texas chiropractor, agreed to plead guilty in the Forest Park case. He said in court documents that Henry was "aggressive" in recommending surgeries at the hospital.

Gonzales said in his plea documents that his patients had to travel from Midland to Dallas, a five-hour drive, because Henry referred them to Forest Park Medical Center. But the patients didn’t know Henry was being paid by the hospital’s owners for referring them there, according to prosecutors.

Kim, 55, of Southlake once sent an email in 2012 to Beauchamp and Toussaint “lamenting” a drop in his monthly payments for referrals, court documents in the case say.

In it, Kim said he sends his Fort Worth patients to Forest Park Medical Center for various conditions like fevers, pain control and dehydration, according to the documents.

Kim, a bariatric surgeon and Forest Park Medical Center investor, said “we as surgeons pass up to six hospitals on our way to FP [Forest Park] for medical conditions that could be treated locally,” according to the indictment.

Baird, the Amarillo lawyer, said many doctors have 12 years of college but don’t earn as much money as some other professionals due to limited government insurance reimbursements. So they look for other ways to supplement their income — and sometimes ignore their instincts, he said.

“They don’t start out thinking, I will commit fraud and make a lot of money,” he said. “It’s a slippery slope.”