Four people who owned or worked at pharmacies in New York City and New Jersey were charged in a $99 million prescription fraud scheme. They allegedly bribed doctors for prescriptions and received millions of dollars in reimbursements for medications they did not order, send to patients or even have in stock.
The group obtained more than $65 million in reimbursement payments from 2013 to 2017 from Medicare, Medicaid and private insurers. They later acquired another $34 million after allegedly defrauding a pharmacy benefit manager via pharmacies in the Bronx.
The defendants were charged with health care fraud, wire fraud and kickback conspiracy. Wire fraud carries a maximum prison sentence of 20 years, while health care fraud is punishable by up to 10 years in prison.
The four defendants operated the scheme via Prime Aid pharmacies in the Bronx and in Union City. The pharmacies, which are now closed, processed expensive specialty drugs for treating Crohn’s disease, Hepatitis C and rheumatoid arthritis.
Prosecutors said the pharmacies had established retail network agreements with several pharmacy benefit managers, enabling them to submit reimbursement claims for prescription medications. The defendants allegedly bribed doctors with cash, checks, wire transfers and expensive meals to get more business. In many cases, the defendants received reimbursements for medications even though they were never sent to patients. Other times, they sent patients their initial prescriptions and then submitted bills for refills of the same drug, even though the refills were never shipped to patients.
If you are facing prescription drug fraud charges in New York, contact the experienced criminal defense lawyers at Brill Legal Group. We regularly handle such cases and are willing to do what it takes to fight the charges against you.