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A total of 54 defendants – 15 of them doctors -- have been charged for their roles in submitting nearly $800 million in bogus health insurance claims, the Justice Department said.
Others include marketing executives, pharmacists, and the owners and operators of a genetic testing laboratory.
Some have taken guilty pleas, while others are awaiting trial on a variety of charges, the government said, including:
- criminally prescribing highly-addictive opioid pills to patients with no medical need;
- paying kickbacks, amid other fraud, for unnecessary genetic testing;
- fraud and abuse in the compounded medicines business;
- other crimes “that victimize federal health care programs like Medicare and Medicaid, as well as patients across New Jersey who need medical care.”
According to the Centers for Disease Control, roughly 115 Americans die every day of an opioid-related overdose. That comes out to nearly 42,000 a year.
U.S. Attorney for New Jersey Craig Carpenito said some defendants fool patients -- often the elderly or vulnerable – into seeking expensive genetic testing or compounded prescriptions they don’t need.
“Today’s message should be clear,” Carpenito said. “If you put patients’ health at risk with criminal intent, you will be dealt with as a criminal.”
“The FBI does not care about your status in life, your professional standing, your level of income, or your personal connections when you break the law,” Assistant Special Agent in Charge Wayne Jacobs of the FBI’s Newark Field Office said. “If you try to scam the system, if you exploit your professional license just to pad your pockets, if you mortgage your morals just to inflate your bank account, you will only find yourself in deeper debt.
“We are committed to protecting the public; we are intent on rooting out fraud and corruption; we are duty-bound to track down and arrest anyone who is breaking our federal laws. Don’t be next.”
The massive undertaking stems from the Justice Department’s creation a year ago of a special Newark/Philadelphia Regional Medicare Fraud Strike Force.
The group combines the resources and expertise of the Health Care Fraud Unit in the Criminal Division’s Fraud Section, the U.S. Attorney’s Offices for the District of New Jersey and the Eastern District of Pennsylvania and various other law enforcement agencies.
Among those charged in New Jersey:
Eduard “Eddy” Shtindler, 36, of Paramus, who owned and operated Empire Pharmacy on Bergenline Avenue in West New York.
Prosecutors said Shtindler was caught on a wiretap bribing a local doctor with $100 bills stuffed into pill bottles to steer patients to his business.
He also produced bogus documents that generated even more income, raking in nearly $5 million in illegal proceeds through both schemes combined, Carpenito said last month in announcing Shtindler’s arrest by the FBI.
Federal agents raided Shtindler’s since-closed Empire Pharmacy on Bergenline Avenue in West New York in August 2017 ( see video above ).
WIRED: Feds Charge Pharmacy Owner From Paramus In $5M Fraud, Bribery Schemes
Yana Shtindler, 44, and Samuel “Sam” Khaimov, 47, both of Glen Head, New York; Alex Fleyshmakher, 33, of Morganville, NJ; and Ruben Sevumyants, 36, of Marlboro, NJ. They “engaged in a slew of fraudulent activities” for nearly eight years at Prime Aid pharmacies they owned and operated in Union City and the Bronx, the Justice Department charged.
This included: “(a) paying illegal bribes and kickbacks to doctors and doctors’ employees in exchange for prescription referrals to Prime Aid; (b) billing health insurance providers for medications that were never actually provided to patients; and (c) opening new pharmacies and concealing the true ownership of those pharmacies to obtain lucrative contracts they otherwise would not have obtained.
“The scheme of billing for medications that were never dispensed to patients was so egregious that Prime Aid received reimbursement payments of over $65 million for prescription medications that it never even ordered from distributors or had in stock,” the government said, putting the total scammed from Medicare, Medicaid, and private insurers at nearly $100 million.
Evangelos Megariotis, 66, of Clifton, who owns and operates Clifton Orthopedic Associates. In two years, authorities said, Megariotis prescribed more than 1.4 million tablets of Oxycodone and over 450 gallons of promethazine with codeine cough syrup to his patients.
He also treated patient complaints of hyper tension, upper respiratory issues, ADD, PTS and other conditions with drugs -- among them, Xanax, Adderall, and cough syrup with codeine – without a complete history and physical exam or referrals to specialists, they said.
Megariotis told one patient that "anything that drugs can do on the street, my medications will do better and safer” and to “just call me,” New Jersey Attorney General Gurbir S. Grewal said last year.
SEE: NJAG: Clifton Ortho Doc Who Freely Doled Out Opioids Barred From Practice
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