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You are here: www.tdi.texas.gov . news . 2016 . news1

December 21, 2016

Gainesville clinic owner pleads guilty to insurance fraud

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.”

TDI investigators are certified peace officers and work closely with law enforcement authorities around the state when investigating fraud cases. You can report suspected cases of insurance fraud by calling TDI’s Consumer Help Line at 1-800-252-3439 or by visiting www.tdi.texas.gov/fraud/report.html.



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Last updated: 12/21/2016

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