Georgia Insurance Commissioner John Oxendine speaks about the launch of Green Insurance during a Firefighters Fund Insurance press conference at EcoManor in Atlanta, Georgia, September 30, 2008. (Photo by Rick Diamond/Wire Image/Getty Images)
atlanta – Georgia's former health commissioner has pleaded guilty to federal charges related to a scheme to defraud major health care providers with unnecessary medical tests.
In federal court on Friday, John W. Oxedine pleaded guilty to conspiracy to commit health care fraud.
According to the indictment, while working as a private attorney, Oxendine submitted fraudulent insurance claims to Aetna, Blue Cross Blue Shield, United Healthcare and other health care providers for medically unnecessary tests. colluded with.
More information: Ethics Commission settles campaign finance lawsuit against John Oxendine
The indictment alleges that doctors in Dr. Jeffrey Gallups' ear, nose, and throat practice ordered medically unnecessary pharmacogenetic, molecular genetic, and toxicology tests from a Texas laboratory called Next Health. He claims that he was pressured to do so.
FILE – John Oxendine, former Georgia gubernatorial candidate and former insurance secretary.
Federal prosecutors allege that as part of the scheme, Next Health, Oxendine and Gallups agreed that doctors would receive a 50% kickback of the net profits of eligible specimens submitted by their clinics for testing. He said he tied it. Next Health was paid about $700,000 by the insurance company, officials said. Some patients have been charged for testing, and authorities say the bill could be as high as $18,000.
To hide the kickbacks, officials say payments were made from Next Health to Oxendine's insurance consulting business. Oxendine then reportedly kept some of the kickback money and used some of it to pay off the debt to Gallups.
“As a former statewide insurance commissioner, John Oxendine recognized the importance of honest dealings between physicians and insurance companies,” said U.S. Attorney Ryan K. Buchanan. “But for personal gain, he knowingly conspired with doctors to order hundreds of unnecessary laboratory tests that cost hundreds of thousands of dollars. They will be held responsible for infringing on the
As a result of his guilty plea, Oxendine is scheduled to be sentenced by a federal judge on July 12.
John Oxendine indicted by federal grand jury
A federal grand jury in Atlanta returned an indictment Friday against former state Insurance and Fire Marshal John Oxendine, accusing him of conspiring to defraud a major health care provider.
Who is John Oxendine?
The charges are the latest blow to Oxendine, who was once seen as a rising star in Georgia politics.
He was in his 30s when he broke into Georgia politics.
Mr. Oxendine was elected to four consecutive terms as Georgia Fire and Insurance Commissioner, serving in that position from 1995 to 2011.
In 2010, Oxendine ran a competitive race for the Republican gubernatorial nomination, which was ultimately won by then-Rep. Nathan Deal. Oxendine returned to the pack and finished.
FOX 5's Cal Callaway contributed to this report.
