ATLANTA — A former Georgia state insurance commissioner pleaded guilty in a health care fraud scheme that involved hundreds of thousands of dollars in kickbacks, officials said.
According to the U.S. Attorney's Office for the Northern District of Georgia, John Oxendine pleaded guilty Friday to conspiracy to commit health care fraud. They said Oxendine conspired with others to submit fraudulent insurance claims for unnecessary medical tests to a lab company in Texas in return for money.
“This scheme to bill for unnecessary services has no place in our healthcare system,” said Keri Farley, Special Agent in Charge of FBI Atlanta. “It not only increased healthcare costs for all beneficiaries, but they also violated the trust of patients. John Oxendine not only profited from this scheme but took it a step farther and directed another to lie to federal agents to try and cover up the fraud.”
The lab in Texas submitted insurance claims seeking more than $2,500,000 in payments from private health insurers for the unnecessary tests, officials said.
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The insurance companies paid close to $700,000 to the lab because of the fraudulent claims. The lab then paid $260,000, according to the U.S. Attorney's Office, in kickbacks to Oxendine and the doctor who was a co-conspirator.
“John Oxendine, as the former state-wide insurance commissioner, knew the importance of honest dealings between doctors and insurance companies,” said U.S. Attorney Ryan K. Buchanan. “But for personal profit he willfully conspired with a physician to order hundreds of unnecessary lab tests, costing hundreds of thousands of dollars. He will now be held accountable for violating the public’s trust.”
The 61-year-old of Johns Creek is scheduled to be sentenced on July 12 at 10 a.m. before U.S. District Judge Steve C. Jones.
