What to Know
- Four workers and owners at Prime Aid pharmacies in New York and New Jersey are accused of health care fraud, wire fraud and conspiracy
- The $99M scam began in 2009. They allegedly bribed doctors to send them prescriptions and received millions of dollars in reimbursement
- In other cases, they would ship patients their original prescription and submit bills for refills even though they didn't send the refills
Four people who owned or worked at pharmacies in New Jersey and New York City bribed doctors to send them prescriptions and received millions of dollars in reimbursements for medications they didn't send to patients or even have in stock, an indictment released Monday alleged.
The $99 million scam began in 2009, the U.S. attorney's office asserted.
The indictment charged Alex Fleyshmakher, 33, of Morganville, New Jersey; Ruben Sevumyants, 36, of Marlboro, New Jersey; and Samuel Khaimov, 47, and Yana Shtindler, 44, both of Glen Head, New York.
The defendants are charged with crimes including health care fraud, wire fraud and conspiracy. Wire fraud is punishable by a maximum 20-year prison sentence, and health care fraud carries a 10-year maximum sentence.
Sevumyants, Khaimov and Shtindler were previously charged. Fleyshmakher was charged and arrested Monday and scheduled for a court appearance later in the day.
Lawrence Lustberg, an attorney for Shtindler, said his client "is confident that when the entire story is told to a fair and impartial jury, she will be totally exonerated of any wrongdoing, as she has done nothing wrong."
Khaimov's attorney, Anthony Iacullo, said his client "is innocent of the allegations and looks forward to his day in court to prove that."
An attorney for Sevumyants didn't immediately answer an email seeking comment, and it wasn't known whether Fleyshmakher had an attorney who could comment.
The four owned or worked for Prime Aid pharmacies in Union City, New Jersey, and the Bronx that provided specialty medications to treat conditions such as Hepatitis C, Crohn's disease and rheumatoid arthritis, according to the indictment.
They allegedly bribed doctors with cash and expensive meals to send them prescriptions, and in many cases received reimbursements for those prescriptions even though they never sent them to patients, according to authorities.
In other cases, they would ship patients their original prescription and submit bills for refills even though they didn't send the refills to patients or confirm they wanted them, the indictment alleges.
The group was reimbursed for more than $65 million from 2013 to 2017 by Medicare, Medicaid and private insurers for medications they never ordered, sent to patients or had in stock, according to the indictment.
Sevumyants allegedly forged shipping documents at the Union City pharmacy to try to hide the scam from auditors.
After some pharmacy benefits managers dropped Prime Aid from their networks, Khaimov and Shtindler allegedly opened other pharmacies in the Bronx to avoid scrutiny and used those to defraud a pharmacy benefit manager out of another $34 million.