Dallas healthcare executive sentenced for role in $450M billing fraud scheme

A Dallas healthcare executive was recently sentenced to 5.5 years in prison for his role in two healthcare fraud schemes, according to the Department of Justice.

Andrew Hillman, owner of Nexthealth, was sentenced Dec. 19 after pleading guilty in 2018 to conspiracy to commit money laundering and conspiracy to pay and receive healthcare bribes and kickbacks.

As part of the plea agreements, Mr. Hillman admitted that he conspired to launder the proceeds of various healthcare schemes related to Nexthealth's pharmacies, resulting in $450 million in fraudulent claims submitted to payers. The company's pharmacies paid illegal kickbacks to physicians to generate prescriptions, misbranded drugs, and self-funded patient copays to dupe auditors, according to the Justice Department.

Mr. Hillman also admitted that he and his business partner were paid $190,000 by Dallas-based Forest Park Medical Center in exchange for referring patients to the hospital or surgeons with privileges there. Mr. Hillman is one of 18 defendants that have been convicted in connection with the Forest Park Medical Center scheme, which allegedly involved hospital officials making $40 million in illegal payouts to surgeons.

In addition to the prison term, Mr. Hillman was ordered to pay $3 million in restitution.

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