Former GA Insurance Commissioner John Oxendine indicted for conspiracy to commit health care fraud The scheme allegedly involved fraudulent insurance claims against major health insurers.
ATLANTA — Former Georgia Insurance Commissioner John Oxendine has been charged by a federal grand jury with health care fraud.
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Channel 2 investigative reporter Mark Winn It was learned he appeared in court earlier today. The scheme allegedly involved fraudulent insurance claims against major insurers such as Aetna, Blue Cross/Blue Shield and UnitedHealthcare.
The claims allegedly involve medically unnecessary pharmacogenetics, molecular genetics and toxicology testing. One of the allegations is that in September 2015, a doctor held a meeting at the Ritz-Carlton Hotel in Buckhead, where Oxendine gave a speech in which he told doctors they needed to order such a procedure for their patients. detection.
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He was also charged with conspiracy to launder money.
“The indictment alleges that Oxendine conspired to obtain kickbacks for unnecessary genetic and toxicology laboratory tests and used his insurance business to hide those kickbacks,” said U.S. Attorney Ryan K. Buchanan. “Patients go to their healthcare provider for treatment expecting their treatment or testing to be necessary and not a fraudulent scam.”
According to the indictment, doctors at the Jeffrey Gallup ENT clinic were forced to order unnecessary tests at the Texas lab. The laboratory company agreed to pay Oxendine and Gallups a rebate of 50% of the net profit of specimens submitted by Gallup Clinic to the laboratory.
In total, the lab company filed claims for more than $2,500,000 in lab tests ordered by Gallup Clinic, according to the indictment. As a result of these claims, the insurance company paid the lab company more than $600,000. The lab company then paid $260,000 in rebates through Oxendine’s insurance services business. Oxendine used a portion of the kickback funds to repay debts on Gallup’s behalf, paying $150,000 in charitable donations and $70,000 in attorney’s fees.
Oxendine and others involved in the program “were motivated more by personal greed than their responsibility to provide appropriate and necessary care to patients,” said Special Agent in Charge of the FBI in Atlanta, Cri Farley.
Oxendine’s attorney, Drew Findling, sent Winne a statement saying:
“As the son of a respected judge, a former public servant dedicated to Georgia and a longtime Bar Association member, John Oxendine understands the importance of pursuing justice. We thank him for the trust he has placed in our office “We will bring justice to him through active investigation and analysis of the allegations to prove his innocence. John Oxendine is a husband, a father, a stepfather and a grandfather. At the same time, he maintains a successful legal practice and Passionately representing clients across the country. Because of his name and majesty, he has been the target of this investigation, but to be clear, he did not violate any laws and is not subject to this prosecution.”
Oxendine was last elected as insurance commissioner for the state of Georgia in 2006. He ran for governor in 2010 but lost to Nathan Deal.
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