Article

Pharmacy Owners Charged in $158 Million Health Care Fraud Scheme

Eight individuals from Texas have been charged for their participation in a health care fraud scheme involving at least 3 pharmacies and $158 million in false claims for costly compound medications, according to the Department of Justice (DOJ).

Eight individuals from Texas have been charged for their participation in a health care fraud scheme involving at least 3 pharmacies and $158 million in false claims for costly compound medications, according to the Department of Justice (DOJ).

The alleged co-conspirators include Jamshid Noryian, Dehshid Nourian, Christopher Rydberg, Ashraf Mofid, Leyla Nourian, Leslie Benson, Michael Taba, and Kevin Williams. All have been charged with 1 count conspiracy to commit health care fraud, and several have also been charged with money laundering.

According to the DOJ, Noryian, Nourian, and Rydberg controlled 3 pharmacies: Ability Pharmacy, Industrial & Family Pharmacy, and Park Row Pharmacy. Allegedly, the defendants filed forms to transmit payments electronically from the Department of Labor-Office of Workers’ Compensation (DOL-OWCP) for pricey creams used to treat scars, wounds, and pain, some of which had reimbursement rates of up to $28,000 per container.

The indictment also alleges that Bandoola Pharmaceutical was used to pay kickbacks, disguised as loans, to physicians for referring DOL-OWCP patient prescriptions to the pharmacies.

Noryian allegedly marketed the creams to physicians treating DOL-OWCP patients, bribing them to send unnecessary prescription for the medications to the pharmacies in exchange for payments, free rent, and other benefits.

According to the indictment, prescriptions were written for all patients regardless of whether they were needed. Noryian allegedly instructed Ability staff to request refills from physicians when the pharmacy wasn’t processing enough prescriptions and prescribe pain creams to patients who were already prescribed controlled substances.

Approximately $158 million in fraudulent claims were submitted through DOL-OWCP, and $82 million in payment for those claims were received.

If convicted, each count of conspiracy to commit health care fraud carries a maximum statutory penalty of 10 years in federal prison and a $250,000 fine. Money laundering counts carry a maximum statutory penalty of 20 years in federal prison and a $500,000 fine or twice the value of the property involved.

Reference

Federal Grand Jury Indicts Eight Individuals Charged In a $158 Million Health Care Fraud Scheme [news release]. Texas. DOJ’s website. https://www.justice.gov/usao-ndtx/pr/federal-grand-jury-indicts-eight-individuals-charged-158-million-health-care-fraud. Accessed Mar. 27, 2017.

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