John Oxendine was sentenced for conspiracy to commit healthcare fraud in connection with unnecessary lab testing.
July, 16, 2024 – Jeff Lagasse, Editor
Former Georgia Insurance Commissioner John Oxendine was sentenced to three and a half years in prison this week for conspiracy to commit healthcare fraud in connection with unnecessary lab testing, according to the U.S. Department of Justice.
U.S. Attorney Ryan K. Buchanan said that Oxendine conspired with Dr. Jeffrey Gallups and others to submit fraudulent insurance claims for medically unnecessary pharmacogenetic, molecular genetic and toxicology testing.
Physicians associated with Dr. Gallups’ ENT practice were reportedly pressured to order these medically unnecessary tests from Next Health, a lab in Texas. As part of Oxendine’s alleged scheme, Next Health agreed to pay Oxendine and Gallups a kickback of 50% of the net profit for eligible specimens submitted by Gallups’ practice to the lab company.
In connection with the scheme, Oxendine gave a presentation at the Ritz Carlton in Buckhead, Georgia where allegedly he pressured doctors in Gallups’ practice to order the unnecessary tests. Next Health later submitted insurance claims seeking more than $3 million in payments from private health insurers for the unnecessary tests.
The insurance companies paid more than $750,000 to Next Health because of these fraudulent claims, the DOJ said. Next Health then paid $260,000 in kickbacks to Oxendine and Gallups. Some patients were also charged for the tests, receiving bills of up to $18,000.
