A Gainesville, Texas, clinic owner has pleaded guilty to insurance fraud and was ordered to repay $1 million after an investigation by the Texas Department of Insurance found that he billed for chiropractic services without having a licensed chiropractor on staff.
“In a case like this, we’re able to reduce fraudulent claims and improve the quality of care people get,” TDI Fraud Director Chris Davis said in the department’s announcement. “Insurance fraud is never a victimless crime, but the problem is magnified when someone puts patients at risk.”
Mark A. Cox entered a guilty plea to first degree felony insurance fraud in December and was sentenced to 10 years deferred probation and ordered to pay $1 million in restitution.
The TDI investigation found that Cox had submitted billings for chiropractic services from 2010 through 2015 but wasn’t a licensed chiropractor. The restitution is equal to the amount he received in insurance payments for the services.
“The Cooke County District Attorney’s Office was a great partner in this case,” said TDI investigator Donald McWhorter. “John Warren helped us get a search warrant and a resolution that’s good for insurance consumers across the state.”
TDI investigators are certified peace officers and work closely with law enforcement authorities around the state when investigating fraud cases.
Source: TDI
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