Newark Doctor and West New York Man Charged with $3.four Million Well being Care and Wire Fraud Conspiracy, Cash Laundering, and Making False Statements | USAO-NJ

CAMDEN, NJ – A Newark physician and West New York man are scheduled to make their initial appearances today on charges of defrauding New Jersey state and local health benefits programs and other insurers out of more than $3.4 million by submitting fraudulent claims for medically unnecessary prescriptions, US Attorney Philip R. Sellinger announced.

Kaival Patel, 53, of West New York, New Jersey, and Saurabh Patel, MD, 51, a Woodbridge, New Jersey resident, are charged in a 12-count indictment with conspiracy to commit health care fraud, and wire fraud and four counts of health care fraud. Kaival Patel is also charged with conspiracy to commit money laundering, substantive counts of money laundering, and making false statements to federal agents. The defendants appeared today by videoconference before US Magistrate Judge Sharon A. King and were released on $250,000 each unsecured bond.

According to the indication:

Kaival Patel and his wife – referred to in the indictment as “Individual 1” – operated a company called ABC Healthy Living LLC (ABC) to market medical products and services, including compound prescription medications. Saurabh Patel is a medical doctor who owns and operates a clinic – referred to in the indictment as “Medical Practice 1” – in Newark. Saurabh Patel is related to Kaival Patel and Individual 1. Paul Camarda, a pharmaceutical sales representative who is listed as a conspirator, pleaded guilty before Judge Kugler in Camden federal court on July 6, 2021, to health care conspiracy and conspiring to commit money laundering and obstruct justice and is awaiting sentencing.

Compounded medications are specialty medications mixed by a pharmacist to meet the specific medical needs of an individual patient. Although compounded drugs are not approved by the Food and Drug Administration (FDA), they are properly prescribed when a physician determines that an FDA-approved medication does not meet the health needs of a particular patient, such as if a patient is allergic to a dye or other ingredient.

Kaival Patel, Saurabh Patel, Camarda, and others learned that certain state and local government employees had insurance that would reimburse up to thousands of dollars for a one-month supply of certain compounded medications. The defendants submitted fraudulent insurance claims for prescription compounded medications to a pharmacy benefits administrator, which provided management services for certain insurance plans that covered state and local government employees. The defendants steered individuals recruited to receive medications from the compounding pharmacies to Saurabh Patel’s medical practice, which enabled him to fraudulently receive insurance payments for those patient visits and procedures. The conduct caused the benefits administrator to pay out $3.4 million in fraudulent claims.

The health care fraud and wire fraud conspiracy count carries a maximum potential penalty of 20 years in prison; the health care fraud charges carry a maximum potential penalty of 10 years in prison; the false statement count carries a maximum penalty of five years in prison – all of these counts are also punishable by a fine of $250,000, or twice the gain or loss from the offense, whichever is greatest. The money laundering charges carry a maximum term of 10 years in prison and a fine of $250,000, or twice the gross gain or loss from the offense or not more than twice the amount of the criminally derived property involved in the transactions.

US Attorney Sellinger credited special agents of the IRS – Criminal Investigation, under the direction of Special Agent in Charge Michael Montanez in Newark; special agents of the FBI’s Atlantic City Resident Agency, under the direction of Special Agent in Charge George M. Crouch Jr. in Newark; and the US Department of Labor Office of Inspector General, New York Region, under the direction of Special Agent in Charge Jonathan Mellone, with the investigation leading to the indictment.

The government is represented by Assistant US Attorneys Christina O. Hud and R. David Walk Jr. of the Criminal Division in Camden.

The charges and allegations contained in the indictment are merely accusations, and the defendants are presumed innocent unless and until proven guilty.

Hogansburg Man Sentenced for Conspiracy to Distribute Marijuana and Cash Laundering | USAO-NDNY

SYRACUSE, NEW YORK – Joshua Francis, 32 years old, a Hogansburg, NY resident, was sentenced to 60 months in prison today for conspiracy to distribute marijuana and drug money laundering, said Acting U.S. Attorney Antoinette T. Bacon, Kevin. with Kelly, Special Representative for the Buffalo Field Office of Homeland Security Investigations (HSI); and Gregory S. Oakes, District Attorney for Oswego.

As part of his earlier admission of guilt, Francis admitted that he had smuggled large quantities of marijuana from Canada into the United States by boat via the Akwesasne Mohawk Reservation in New York State between January 2017 and August 2017. Francis also admitted that he had directed couriers in the United States to deliver marijuana to redistributors in the Syracuse area and elsewhere, and also to collect the proceeds from marijuana sales. Francis distributed at least 317 kilograms of marijuana.

In addition to his prison sentence, the court also sentenced Francis to four years’ supervised release and sentenced him to pay a fine of $ 501,850, the equivalent of proceeds from distributing marijuana.

This case was investigated by Homeland Security Investigations (HSI), the US Internal Revenue Service-Criminal Investigation (IRS-CI), the Syracuse Police Department, and the Oswego County Drug Task Force, made up of special agents from HSI, members of the City Oswego Police Department, Oswego County Sheriff’s Office, Oswego County District Attorney’s Office investigators, SUNY Oswego Police Department, and US Border Patrol agents. The case was being prosecuted by US Assistant Attorney Thomas Sutcliffe.

Pharmaceutical Gross sales Consultant Admits Well being Care Fraud Conspiracy and Conspiring to Interact in Cash Laundering and Impede Justice | USAO-NJ

CAMDEN, NJ – A pharmaceutical sales rep admitted today that he was conspiring to defraud New Jersey County’s health programs and to engage in money laundering and obstructing justice, US Attorney General Rachael A. Honig said.

Paul Camarda, 39, of Holmdel, New Jersey, pleaded guilty to U.S. District Judge Robert B. Kugler in Camden Federal Court over information alleging a health fraud and obstruction of justice conspiracy and engagement Money laundering.

According to documents filed in this case and statements made in court:

Camarda was a sales representative for a pharmaceutical company. He started a side business called Dynasty Capital LLC to independently commercialize medical products and services for other businesses, including compound prescription drugs for specialty pharmacies. Camarda marketed compound drugs for several pharmacies, including New Jersey and out of state pharmacies, identified in court documents as “Compounding Pharmacy 1”, “Compounding Pharmacy 2”, “Compounding Pharmacy 3” and “Compounding Pharmacy 4”. As part of his agreements with the pharmacies and his conspirators, Camarda received a percentage of the insurance payments he received for prescriptions arranged by him and his staff.

Compound drugs are specialty drugs that are mixed by a pharmacist to meet the specific medical needs of an individual patient. Although compound drugs are not approved by the Food and Drug Administration (FDA), they are properly prescribed when a doctor determines that an FDA-approved drug, such as dye or other ingredient, does not meet a particular patient’s health needs.

Camarda learned that certain local government employees had insurance coverage for these particular compound drugs. A facility identified as a “pharmacist benefits administrator” on court documents provided pharmacy benefits administration services for the Bergen County’s Prescription Benefits Program (BCPBP), which covered certain local government employees, including county jailers. The pharmacy benefits administrator paid prescription drug claims and then billed the BCPBP for the amounts paid.

Camarda was a leader and manager of the conspiracy. He and his conspirators discovered that certain compound drugs – including vitamins and pain, scar, antifungal, migraine, and libido creams – reimbursed up to thousands of dollars for a month’s supply. Camarda recruited individuals with BCPBP coverage to fraudulently obtain medically unnecessary compound drugs. He provided the recruits with blank prescription forms and directed them to see an unnamed doctor – referred to as “Person 1” in court documents – to obtain his approval for the compound prescription drugs. The investigation found that all recruits visit Person 1 to get the prescriptions within days, and all Person 1 received prescriptions authorized by Person 1 for the same specialty drugs on the same day or within days. The recruits agreed to receive the very expensive compound drugs, not because they needed them, but because they were paid for by Camarda. Camarda instructed the recruits that the more compound drugs they were given and the more people they recruited to get the drugs, the more money they could make from the conspiracy.

Camarda received more than $ 2.2 million in payments for the prescriptions he and his staff arranged, and Camarda and his recruits created more than $ 3.4 million in fraudulent claims filed by the pharmacy benefits administrator for compound drugs were presented. Camarda’s payments from the blending pharmacies and his conspirators, as well as Camarda’s payments to his recruits, served as the basis for the money laundering conspiracy charge, which Camarda pleaded guilty to.

In 2017, Camarda learned that federal agents and a federal grand jury were investigating the health fraud conspiracy. Camarda has plotted to obstruct the federal investigation by providing and instructing false information to other federal agents and the grand jury.

The number of healthcare conspiracies Camarda is guilty of has a maximum potential sentence of 10 years in prison and a fine of $ 250,000 or double the gain or loss from the crime, whichever is greater. Obstruction of justice and the money laundering conspiracy count carry a maximum penalty of five years in prison and a fine of $ 250,000 or double the gross profit or loss of the crime, whichever is greater. The conviction is scheduled for November 18, 2021.

Acting US Attorney Rachael A. Honig has credited special agents to the IRS Criminal Investigation, under the direction of Special Agent in Charge Michael Montanez in Newark; Special Agent for the FBI’s Atlantic City Resident Agency under the direction of Special Agent in Charge George M. Crouch Jr. of Newark; and special agents from the US Department of Labor Office of Inspector General, New York Region, under the direction of Special Agent in Charge Michael C. Mikulka, whose investigation resulted in today’s admission of guilt.

The government is represented by US Assistant Attorneys Christina O. Hud and R. David Walk Jr. of the US Attorney’s Office in Camden.

Union County Man Admits Function in Cocaine Trafficking and Cash Laundering Conspiracy | USAO-NJ

NEWARK, NJ – A Union County, New Jersey man today admitted his role in a conspiracy against cocaine trafficking and money laundering, current US attorney Rachael A. Honig announced.

Jose A. Rivera Jr., 48, of Union Township, New Jersey, videoconference pleaded guilty to money laundering before US District Judge Stanley R. Chesler.

According to the documents submitted in this case and statements made in court:

Rivera is a leader in a drug trafficking and money laundering organization. Police officers learned that Rivera used various locations to conduct drug trafficking and money laundering on behalf of the organization, including his residence and a stash location in Union.

On November 6, 2020, law enforcement officers conducted lawful searches of the residence and hiding location and recovered over $ 1 million in cash, financial documents, and notes related to drug revenues and transactions. On November 7, 2020, police officers conducted a lawful search of Rivera’s vehicle and retrieved 191 grams of cocaine from a hidden compartment in the vehicle’s glove compartment.

Charges of conspiracy with intent to distribute cocaine carry a maximum sentence of 20 years in prison and a maximum legal penalty of $ 1 million or double the amount of the offense. The money laundering conspiracy charge has a maximum sentence of 20 years in prison and a maximum penalty of $ 500,000 or double the value of the property involved in the transaction. The conviction is scheduled for September 29, 2021.

Acting US attorney Honig has credited special agents to the US Drug Enforcement Administration under the direction of the responsible special agent Raymond Donovan in New York. Department of Homeland Security Special Agents, Homeland Security Investigations, under the direction of Special Agent Jason J. Molina in Newark; and US Postal Inspection Inspectors, led by Acting Inspector Rodney M. Hopkins in Newark, the investigation leading to today’s admission of guilt.

The indictment is part of an Organized Crime Drug Enforcement Task Forces (OCDETF) strike force initiative to set up permanent task force teams with multiple agencies working side by side in the same location. This same-location model enables agents from different agencies to collaborate on multi-jurisdictional intelligence operations to disrupt and dismantle major drug traffickers, money launderers, gangs and transnational criminal organizations. The New York Strike Force is a crime-fighting unit made up of federal, state, and local law enforcement agencies, led by the New York, New York, New York, New York, New York, New York, New York, New York, New York, New York, New York, New York, New York, Jersey are supported. The New York OCDETF Strike Force is housed in the DEA’s New York Division and includes agents and officers from the DEA. the NYPD; the New York State Police; HSI; IRS-CI; the alcohol, tobacco, firearms and explosives bureau; US Customs and Border Protection; US Secret Service; the US Marshals Service; New York National Guard; the Clarkstown Police Department; US Coast Guard; Port Washington Police Department; and New York State Department for Corrections and Community Oversight.

The government is represented by US assistant attorneys Lauren E. Repole of the Economic Crime Unit and Alexandra Tsakopoulos Saker of the OCDETF / Narcotics Unit in Newark.

Three Florida Males Charged in $46 Million Well being Care Fraud, Kickback, and Cash Laundering Conspiracy | OPA

Three telemarketing company owners were charged with allegedly participating in a $ 47 million healthcare fraud, kickback and money laundering system that referred medically unnecessary cancer genetic tests to laboratories in exchange for kickbacks.

In an indictment unsealed today, Christian McKeon (35) and Athanasios Ziros (42) from Boca Raton (Florida) are charged with a conspiracy to commit health fraud, a conspiracy to pay and receive setbacks, and multiple charges of fraud. and backlash in healthcare, conspiracy to commit money laundering and the number of money laundering offenses. In a piece of information unsealed today, Gregory Orr, 64, is charged by Boca Raton with a conspiracy to pay and receive setbacks and a substantial number of setbacks for his alleged role in the system.

According to the indictment, McKeon and Ziros allegedly participated in a program to run a telemarketing campaign for Medicare beneficiaries to get them to accept cancer genetic testing, whether the tests were medically necessary or for a Medicare reimbursement Question came. Under the program, McKeon and Ziros telemedicine companies have allegedly offered and paid illegal kickbacks and bribes in exchange for medical instructions for expensive cancer genetic testing. Doctors’ instructions were written by doctors hired with telemedicine companies even though those telemedicine doctors had no prior relationship with beneficiaries, did not treat beneficiaries for cancer or cancer symptoms, and did not use the test results to treat beneficiaries and did not conduct a proper visit to telemedicine.

According to court records, all three men sold these signed cancer genetic testing medical instructions to laboratories in exchange for illegal setbacks. The charges and information state that the defendants caused one of the laboratories to file claims with Medicare for approximately $ 46 million, of which over $ 27 million was paid. The indictment also alleges that the lab paid McKeon, Ziros, and other setbacks totaling over $ 14 million, and that McKeon and Ziros laundered those unlawful receipts knowing that the transactions in question were intended to the manner, source and control of hiding and disguising the proceeds.

McKeon appeared before Judge William Matthewman of the US District Court for the South Florida District, West Palm Division, for the first time today. Ziros and Orr are expected to appear before Judge Matthewman on May 5th.

Charges of conspiracy to commit healthcare fraud and wire fraud, conspiracy to commit money laundering, and substantial money laundering each carry a maximum sentence of 20 years in prison. Charges of healthcare fraud and backlash violations each carry a maximum possible sentence of 10 years in prison. Eventually, the conspiracy to pay and receive setbacks carries a maximum penalty of five years in prison. A federal district judge determines each sentence based on U.S. sentencing guidelines and other legal factors.

Deputy Attorney General Nicholas L. McQuaid of the Department of Justice’s Department of Criminal Investigation; US Assistant Attorney Juan Antonio Gonzalez of the Southern District of Florida; Special Agent in Charge George L. Piro of the FBI Field Office in Miami; and special agent in charge Omar Perez of the US Department of Health (HHS), Inspector General’s Office (HHS-OIG), Miami, announced this.

Trial attorney Patrick Queenan of the Criminal Division’s fraud division is pursuing the case. U.S. Assistant Attorney Richard Brown from the Southern District of Florida is handling the decay aspect of the case.

The Fraud Section heads the Medicare Fraud Strike Force. Since its inception in March 2007, the Medicare Fraud Strike Force, which maintains 15 strike forces in 24 districts, has indicted more than 4,200 defendants who billed the Medicare program a total of nearly $ 19 billion. In addition, the HHS Centers for Medicare & Medicaid Services, in partnership with the HHS-OIG, are taking steps to increase accountability and reduce the presence of fraudulent providers.

Any physician or health care professional involved in suspected fraudulent telemedicine or genetic testing marketing programs should call to report this behavior to the FBI helpline at 1-800-CALL-FBI.

An indictment and information are just accusations, and all defendants are presumed innocent until found unequivocally guilty in a court of law.