John Oxendine, a former Georgia insurance commissioner, was sentenced to 3.5 years in prison for his role in a healthcare fraud scheme involving ENT clinics.
Mr. Oxendine, who was Georgia's insurance commissioner from 1995 to 2011, conspired with a physician owner of an ENT practice chain to submit unnecessary claims to a Texas-based lab, the Justice Department said July 12.
Jeffery Gallups, MD, the owner of the ENT clinics, was sentenced in 2022 to three years in prison for his role in the scheme.
The scheme, which took place after Mr. Oxendine left office, billed private insurers for over $3 million in false claims. Mr. Oxendine would give a presentation to physicians at Dr. Gallups' practice pressuring them to bill medically unnecessary tests.
The lab, Next Health, paid a 50% kickback to Mr. Oxendine and Dr. Gallups from net profits it made from the false claims.
According to the Justice Department, Next Health charged private insurers for the tests ordered from the practice and was paid more than $750,000 in reimbursements. Mr. Oxendine and Dr. Gallups received $260,000 in kickbacks.
Mr. Oxendine was also ordered to pay over $760,000 in restitution and a $25,000 fine.