Jersey Shore Doctor Sentenced In Massive Health Care Fraud Scheme

MARGATE, NJ — A Margate doctor will spend time in federal prison for his role in a multimillion health care fraud conspiracy, the U.S. Attorney's Office said Wednesday.

Brian Sokalsky, 46, was sentenced to 15 months after admitting to defrauding New Jersey state and local health benefits programs and other insurers by submitting fraudulent claims for medically unnecessary prescriptions, Attorney for the United States Vikas Khanna said.

Sokalsky, pharmaceutical sales representative Vincent Tornari, 50, of Linwood, and former advanced nurse practitioner Ashley Lyons-Valenti, 67, of Swedesboro were charged in a 33-count indictment in June 2020. Tornari pleaded guilty on March 14, 2023, and Lyons-Valenti pleaded guilty on Feb. 28, 2023, to their respective roles in the conspiracy. Tornari and Lyons-Valenti are both awaiting sentencing.

The scheme involved compounded medications, which are specialty medications mixed by a pharmacist to meet specific needs of patients. They aren't FDA approved, but are prescribed when a FDA approved medication can't be used on a patient.

Sokalsky and the others learned that some compounded medications can be reimbursed for up to thousands of dollars for an individual's one-month supply, and certain insurance plans – including insurance plans for state and local government employees and certain other insurance plans – covered these medications, officials said.

Sokalsky agreed to authorize prescriptions for ex-pharmaceutical sales rep Matthew Tedesco, 49, of Linwood, who pleaded guilty to health care fraud conspiracy in June 2017, and others working with him, authorities said.

In exchange, Tedesco referred about 30 patients to Sokalsky's new medical practice, officials said. And then in turn, Sokalsky billed insurance for patient visits for those people steered to his practice by Tedesco. Sokalsky also authorized prescriptions for the medications for existing patients of his practice, which he did to financially benefit Tedesco and encourage him to refer more patients to his new practice.

Some unnecessary prescriptions include libido creams for young women and excessive quantities of medication with the maximum amount of refills, officials said.

When insurance stopped covering certain formulations, Tedesco told Sokalsky he needed to authorize new prescriptions, authorities said. Sokalsky did so, often without seeing the patient for a follow-up visit or even telling them of the change in medication, authorities said.

In total, insurance paid more than $5 million for fraudulent prescriptions authorized by Sokalsky, according to officials.

In addition to the prison term, Sokalsky was sentenced to three years of supervised release and ordered restitution of $5.13 million.