World Courant
A former Georgia insurance coverage commissioner who made a failed Republican run for governor has pleaded responsible to conspiring to commit well being care fraud.
John W. Oxendine of Johns Creek entered the responsible plea Friday in federal court docket in Atlanta. The 61-year-old had been indicted in Might 2022 on fees 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 prone to be sentenced to much less. Federal sentencing pointers mentioned within the plea settlement counsel prosecutors will advocate Oxendine be imprisoned between 4 years, 3 months, and 5 years, 3 months, relying on what U.S. District Choose Steve Jones decides at a sentencing listening to set for July 12. Jones might 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 within the scheme, the plea doc states. Prosecutors agreed to dismiss the cash laundering cost as a part of the plea.
“John Oxendine, as the previous statewide insurance coverage commissioner, knew the significance of trustworthy dealings between docs and insurance coverage firms,” U.S. Legal professional Ryan Ok. Buchanan mentioned in an announcement. “However for private revenue he willfully conspired with a doctor to order tons of of pointless lab checks, costing tons of of 1000’s 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 responsible on Friday, March 22, 2024, in federal court docket in Atlanta to well being care fraud in a kickback scheme. (AP Picture/John Amis, File)
Prosecutors say Oxendine conspired with Dr. Jeffrey Gallups to stress different physicians who practiced with Gallups to order pointless medical checks from Subsequent Well being, a lab in Texas. Prosecutors mentioned Oxendine pushed the plan in a September 2015 presentation to docs who labored for Gallups’ follow.
The lab firm, Oxendine and Gallups agreed the corporate would pay Gallups a kickback of fifty% of the revenue on the checks, Oxendine’s indictment mentioned. Subsequent Well being paid $260,000 in kickbacks by means of Oxendine’s insurance coverage consulting firm, prosecutors mentioned. Oxendine paid a $150,000 charitable contribution and $70,000 in legal professional’s charges on Gallups,’ behalf, prosecutors mentioned, protecting $40,000 for himself.
Some sufferers had been additionally charged, getting payments of as much as $18,000 for the checks, prosecutors mentioned.
Prosecutors mentioned Oxendine advised Gallups to lie and say the funds from Oxendine had 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 mentioned. And so they mentioned Oxendine falsely mentioned he didn’t work with the lab firm or get cash from Subsequent Well being when interviewed by The Atlanta Journal-Structure.
Gallups pleaded responsible in October 2021 to at least one depend of healthcare fraud after waiving indictment. Gallups was sentenced to 3 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 means of the Subsequent Well being scheme and a kickback scheme with a separate medical system firm. That quantity was raised to almost $5.4 million in March as a result of Gallups and his firm, Milton Corridor Surgical Associates, did not pay the unique quantity inside a yr.
Subsequent Well being has confronted different allegations of fraud. The corporate and related individuals and entities had 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 circumstances towards him in 2009, alleging Oxendine broke state legislation by utilizing marketing campaign funds to purchase a home, lease luxurious automobiles and be a part of a personal membership.
Oxendine settled that case with the Georgia Ethics Fee in 2022, agreeing handy 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 decide dominated state officers waited too lengthy to pursue Oxendine on these fees.
Former Georgia GOP governor candidate pleads responsible in fraud case
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