Former GA insurance commissioner John Oxendine indicted for conspiracy to commit health care fraud

ATLANTA — Former Georgia insurance commissioner John Oxendine has been indicted by a federal grand jury for conspiracy to commit health care fraud.

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Channel 2 Investigative reporter Mark Winne has learned he made a court appearance earlier today. The scheme allegedly involved fraudulent insurance claims to major insurance companies such as Aetna, Blue Cross/Blue Shield and United Healthcare.

High-profile Drew Findling, who is representing Oxendine, said his law partner Marissa Goldberg and Oxendine met an FBI agent outside the Russell Federal building Friday morning by pre-arrangement and Oxendine surrendered on the charges against him.

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The claims allegedly involve medically unnecessary pharmacogenetic molecular genetic and toxicology testing. One of the allegations is that in Sept 2015, a doctor’s practice held a meeting at the Ritz Carlton hotel in Buckhead and Oxendine gave a speech where he told doctors they needed to order such testing for their patients.

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He’s also charged with conspiracy to commit money laundering.

“The indictment alleges that Oxendine conspired to obtain kickbacks for unnecessary genetic and toxicology lab 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 with the expectation that their treatment or test is necessary, not a scam for fraud.”

According to the indictment, doctors with Jeffrey Gallups ENT practice were pressured to order unnecessary testing from labs in Texsas. The lab company agreed to pay Oxendine and Gallups a kickback of 50% of the net profit for the specimens submitted by Gallup’s practice to the lab.

According to the indictment, in total, the lab company submitted claims seeking over $2,500,000 in payment for laboratory tests ordered by Gallups’s practice. The insurance companies paid over $600,000 to the lab company as a result of these claims. The lab company then paid $260,000 in kickbacks through Oxendine’s insurance services business. Oxendine used a portion of the kickback money to pay debts on behalf of Gallups, paying a $150,000 charitable contribution and $70,000 in attorney’s fees.

Keri Farley, Special Agent in Charge of the FBI in Atlanta, said that Oxendine and others involved in the scheme were “more motivated by personal greed than their duty to provide appropriate and necessary care to patients.”

Findling sent Winne a statement, saying:

“As the son of a well-respected Judge, a former public servant dedicated to the State of Georgia and a long-standing member of bar, John Oxendine understands the importance of the pursuit of justice. We appreciate the faith that he has put in our office. We will pursue justice for him by aggressively investigating and analyzing the allegations in order to prove his innocence. John Oxendine is a husband, a father, a step-father, and a grandfather; at the same time he maintains a successful law practice and zealously represents his clients across the country. He has been targeted in this investigation because of his name and gravitas, but to be clear, he has not broken any laws and is innocent of this indictment.”

Documents indicate Gallups pled guilty in October to a scheme to defraud health care insurance providers. A February document said Gallups has cooperated and is continuing to cooperate in an ongoing investigation.

Attorney Ray Moss of Moss and Gilmore said he’s representing Dr. Myron Jones, a retired Army colonel who worked at Gallups’ practice. He said Jones objected to the genetic testing, recognized it was fraudulent, refused to comply and brought a whistleblower lawsuit that eventually led to a criminal investigation and a multi-million-dollar civil settlement that involved not just the testing but unrelated allegations.

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. In 2009, the state started investigating campaign finance violations after Oxendine accepted $120,000 from insurance companies. Then in 2015, an Atlanta Journal-Constitution investigation found that he never returned $50,000 from a campaign for governor and spent some of that money on a house and cars.

Just last week, the state settled the last of those ethics cases.