May 22, 2018

TX Clinic Owner Pleads Guilty to Insurance Fraud

Austin, TX – A Gainesville clinic owner pled 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,” said TDI Fraud Director Chris Davis. “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 earlier this month 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.”

Source: TDI-DWC

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