Major Fraud Scheme: Defendants Accused of Defrauding Medicaid, Medicare, and Private Insurers of $20 Million

The United States Attorney for the Southern District of New York, the FBI, and the U.S. Department of Health and Human Services, Office of Inspector General have announced the unsealing of Superseding Indictments against individuals charged with participating in a years-long scheme to defraud Medicaid, Medicare, and private insurance companies out of at least approximately $20 million. The defendants allegedly engaged in a scheme that exploited low-income individuals who had been prescribed HIV medication, jeopardizing the health and safety of these vulnerable patients. The defendants distributed black-market HIV medications to various pharmacies, dispensed the medication to patients, and paid illegal kickbacks to patients to recruit them to their pharmacies. The proceeds from the scheme were used to purchase luxury items, including vehicles and real estate.

The charges include conspiracy to commit wire fraud, health care fraud, money laundering, violation of the Anti-Kickback Statute, mail fraud, and conspiracy to defraud the United States. The maximum potential sentences for these charges vary but can go up to 20 years in prison.