Doctors Got Bribes In Huge $99 Million Drug Scheme In NJ: Feds

Doctors in New Jersey got bribes in a $99 million statewide drug scheme, according to authorities. The kickbacks allegedly included expensive meals and payments by cash, check and wire transfers.

Four people were charged this week for their roles in conspiracies to commit health care fraud and wire fraud and to pay kickbacks to the doctors – who were not identified or charged – and the doctors’ employees, U.S. Attorney Craig Carpenito announced Monday.

Alex Fleyshmakher, 33, of Morganville was arrested and was scheduled to have his initial appearance on Monday before U.S. Magistrate Judge Douglas Arpert in Trenton federal court.

Also charged were: Ruben Sevumyants, 36, of Marlboro; and Samuel “Sam” Khaimov, 47, and Yana Shtindler, 44, both of Glen Head, N.Y.

According to documents filed in this case:

Starting in 2009, Khaimov, Sevumyants, Fleyshmakher and others paid bribes and kickbacks to doctors and doctors’ employees to induce them to steer prescriptions to their compamy, Prime Aid Pharmacies, according to a release from Carpenito's office.

The kickbacks included the expensive meals and payments by cash, check and wire transfers. Another method of bribery also involved paying an employee to work inside a doctor’s office for the doctor’s benefit, according to the release.

Prime Aid Union City – at the direction of Shtindler, Khaimov, and Sevumyants – also engaged in the fraudulent practice of billing health insurance providers for medications that were never provided to patients, according to the release.

Prime Aid Pharmacies – now closed – operated as “specialty pharmacies” out of locations in New Jersey and the Bronx. The company processed expensive medications used to treat various conditions, including Hepatitis C, Crohn’s disease, and rheumatoid arthritis, according to the release from Carpenito's office.

Fleyshmakher worked at Prime Aid Union City and was an owner of Prime Aid Bronx. Khaimov was an owner of Prime Aid Union City and the lead pharmacist of Prime Aid Bronx.

Shtindler was Prime Aid Union City’s administrator, and Sevumyants was its operations manager, according to the release.

Here are the accused and their charges:

Initially, Prime Aid Pharmacies obtained retail network agreements with several pharmacy benefit managers, which allowed them to receive reimbursement payments for prescription medications, including specialty medications, according to the release.

The managers acted as intermediaries on behalf of Medicare, Medicaid and private healthcare insurance providers, so that when a pharmacy received a prescription, the pharmacy then submitted a claim for reimbursement, according to the reimbursement.

While Prime Aid generally provided medications for initial prescriptions it received, it systematically billed for refills for those same medications without ever dispensing them to patients, according to the release.

From 2013 through 2017, Prime Aid Union City received over $65 million in reimbursement payments from Medicare, Medicaid and private insurers for medications the pharmacy not only failed to give patients, but never even ordered or had in stock, according to the release.

Managers conducted routine audits of Prime Aid and discovered its practice of billing but not dispensing medications. In response to these audits, Shtindler instructed Prime Aid employees to falsify records submitted to the managers, according to the release.

Sevumyants forged shipping records of a private commercial shipping company to make it appear as if medications were shipped to the patients when, in fact, they were not, according to the release.

Despite these concealment efforts, some managers terminated the Prime Aid Pharmacies from their networks. Khaimov and Shtindler then opened new pharmacies, including Your Care Pharmacy in the Bronx, and transferred patients from the terminated Prime Aid Pharmacies to Your Care, according to the release.

To facilitate this scheme, Shtindler and Khaimov lied to the managers about the true ownership of those pharmacies, including Your Care, to conceal their involvement.

This scheme resulted in one manager being defrauded into paying Your Care over $34 million in reimbursement payments.