2 Ocean County Men Admit Roles In $50M Medicare, Tricare Fraud Scheme

NEWARK, NJ — Three men, including a pair of Toms River residents, have pleaded guilty to their roles in health care fraud and kickback schemes that cost Medicare, TRICARE, and CHAMPVA at least $50 million, authorities said.

Nicholas Defonte, 73, and Christopher Cirri, 63, both of Toms River, and Pat Truglia, 53, of Parkland, Florida, each pleaded guilty before U.S. District Court Judge Kevin McNulty in Newark to conspiracy to commit health care fraud, U.S. Attorney Rachael A. Honig announced.

According to court documents and testimony, the three men were involved in defrauding health care benefit programs by offering, paying, soliciting, and receiving kickbacks and bribes in exchange for completed doctors’ orders for durable medical equipment, namely orthotic braces.

Truglia and his conspirators had financial interests in multiple durable medical equipment companies. Those companies paid kickbacks to suppliers of durable medical equipment orders, including Cirri, Defonte, and Truglia, in exchange for the equipment orders.

Those companies subsequently fraudulently billed to Medicare, Tricare (which serves active duty military, reservists, and their families) and CHAMPVA (the Civilian Health and Medical Program of the Department of Veterans Affairs), and other health care benefit programs.

Truglia and his conspirators concealed their ownership of the durable medical equipment companies by using straw owners who were falsely reported to Medicare as the owners of the companies.

Truglia, Cirri, Defonte, and their conspirators owned and operated multiple call centers through which they obtained durable medical equipment orders for beneficiaries of Medicare and other federal health care programs. The call centers paid illegal kickbacks and bribes to telemedicine companies to obtain durable medical equipment orders for these beneficiaries. The telemedicine companies then paid physicians to write medically unnecessary durable medical equipment orders. The orders were provided to supply companies owned by Truglia and others in exchange for bribes. The supply companies in turn provided the braces to beneficiaries and fraudulently billed the health care programs.

Cirri, Defonte, and their conspirators had business relationships with call centers through which they obtained prescriptions for compounded medications and other medical products reimbursable by federal and private health care benefit programs. Cirri and Defonte provided these prescriptions for compounded medical prescriptions and other medical products in exchange for kickbacks and bribes from companies that fraudulently billed them to the health care programs.

The charge of conspiracy to commit health care fraud is punishable by up to 10 years in prison and a fine of $250,000, or twice the gross profit or loss caused by the offense, whichever is greatest.

Sentencing for all three defendants is scheduled for March 22.

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