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Prime Aid Pharmacy established relationships with pharmacy benefit managers (PBMs) to receive reimbursements for medications, including specialized medicines. The PBMs acted as a go-between with Medicare and Medicaid and Prime Aid, authorities said.
Starting a decade ago, principals connected with Prime began paying bribes and kickbacks to physicians and physicians' employees to bolster business for Prime Aid. Kickbacks came in the form of expensive meals and wire transfers as well as cash, according to authorities.
Prime Aid also allegedly sent bills to the PBMs for medications that were never dispensed. From 2013 through 2017, Prime Aid received over $65 million in reimbursement payments from Medicare, Medicaid, and private insurers for medications the pharmacy not only failed to give patients, but never even ordered or had in stock.
When an audit by the PBMs revealed discrepancies, one of the principals ordered employees to falsify records, authorities said.
Prime Aid Union City closed down, however, when the PBMs terminated their contract. Principals then opened a pharmacy in the Bronx called Your Care without disclosing their prior affiliation with Prime Aid Union City, authorities said. A PBM dealing with Your Care was defrauded out of $34 million, according to authorities.
Charged were Alex Fleyshmakher, 33, of Morganville; Ruben Sevumyants, 36, of Marlboro; and Samuel “Sam” Khaimov, 47, and Yana Shtindler, 44, both of Glen Head, New York.
Authorities have brought charges including kickback conspiracy, wire fraud and health care fraud.
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