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A former Georgia insurance coverage commissioner who made a failed Republican run for governor has pleaded guilty to conspiring to commit well being care fraud.
John W. Oxendine of Johns Creek entered the guilty plea Friday in federal courtroom in Atlanta. The 61-year-old had been indicted in May 2022 on prices of conspiracy to commit well being care fraud and conspiracy to commit cash laundering.
The crime is punishable by as much as 10 years in jail, however Oxendine is more likely to be sentenced to much less. Federal sentencing tips mentioned in the plea settlement recommend prosecutors will suggest Oxendine be imprisoned between 4 years, 3 months, and 5 years, 3 months, relying on what U.S. District Judge Steve Jones decides at a sentencing listening to set for July 12. Jones may additionally tremendous Oxendine and order him to serve supervised launch.
ALABAMA STATE LAWMAKER ROGERS TO PLEAD GUILTY TO FEDERAL CHARGES
Oxendine additionally agreed to pay almost $700,000 in restitution to well being insurers who misplaced cash in the scheme, the plea doc states. Prosecutors agreed to dismiss the cash laundering cost as a part of the plea.
“John Oxendine, as the former statewide insurance commissioner, knew the importance of honest dealings between doctors and insurance companies,” U.S. Attorney Ryan Ok. Buchanan stated in an announcement. “But for personal profit he willfully conspired with a physician to order hundreds of unnecessary lab tests, costing hundreds of thousands of dollars.”
FILE – John Oxendine talks to reporters about his unsuccessful Republican bid for governor, July 20, 2010, in Atlanta. Oxendine, a former state insurance coverage commissioner, pleaded guilty on Friday, March 22, 2024, in federal courtroom in Atlanta to well being care fraud in a kickback scheme. (AP Photo/John Amis, File)
Prosecutors say Oxendine conspired with Dr. Jeffrey Gallups to strain different physicians who practiced with Gallups to order pointless medical exams from Next Health, a lab in Texas. Prosecutors stated Oxendine pushed the plan in a September 2015 presentation to docs who labored for Gallups’ observe.
The lab firm, Oxendine and Gallups agreed the corporate would pay Gallups a kickback of fifty% of the revenue on the exams, Oxendine’s indictment stated. Next Health paid $260,000 in kickbacks by Oxendine’s insurance coverage consulting firm, prosecutors stated. Oxendine paid a $150,000 charitable contribution and $70,000 in lawyer’s charges on Gallups,’ behalf, prosecutors stated, protecting $40,000 for himself.
Some sufferers have been additionally charged, getting payments of as much as $18,000 for the exams, prosecutors stated.
Prosecutors stated Oxendine advised Gallups to lie and say the funds from Oxendine have been loans when a compliance officer at Gallups’ firm requested about them. Oxendine advised Gallups to repeat the identical lie when questioned by federal brokers, prosecutors stated. And they stated Oxendine falsely stated he didn’t work with the lab firm or get cash from Next Health when interviewed by The Atlanta Journal-Constitution.
Gallups pleaded guilty in October 2021 to at least one rely of healthcare fraud after waiving indictment. Gallups was sentenced to a few years in jail in June 2022. He was additionally ordered to pay $700,000 in restitution, and was fined $25,000.
In 2021, Gallups agreed to pay $3 million after a whistleblower filed a lawsuit saying Gallups defrauded the federal authorities by the Next Health scheme and a kickback scheme with a separate medical machine firm. That quantity was raised to just about $5.4 million in March as a result of Gallups and his firm, Milton Hall Surgical Associates, did not pay the unique quantity inside a 12 months.
Next Health has confronted different allegations of fraud. The firm and related individuals and entities have been ordered to pay well being insurer UnitedHealth $218 million in a Texas lawsuit in 2023.
Oxendine served because the elected state insurance coverage commissioner from 1995 to 2011. He ran for governor in 2010 however misplaced the Republican main. The state ethics fee started investigating and prosecuting marketing campaign finance instances towards him in 2009, alleging Oxendine broke state legislation through the use of marketing campaign funds to purchase a home, lease luxurious vehicles and be part of a personal membership.
Oxendine settled that case with the Georgia Ethics Commission in 2022, agreeing at hand over the remaining $128,000 in his marketing campaign fund whereas admitting no wrongdoing.
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He was additionally accused of accepting a $120,000 bundled contribution, 10 occasions the authorized restrict, from two Georgia insurance coverage firms in 2008 when he was working for governor. A choose dominated state officers waited too lengthy to pursue Oxendine on these prices.
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