2 Long Island Pharmacy Workers Charged In $99M Kickback Scheme

GLEN HEAD, NY — Two Glen Head residents are among four people facing federal charges in connection with a $99-million health care and wire fraud case, in which authorities said they submitted reimbursement claims for drugs that were never given to patients and gave kickbacks to doctors and doctors' workers.

Samuel "Sam" Khaimov, 47, and Yana Shtindler, 44, were the two Long Island defendants charged in the scheme, along with New Jersey residents Alex Fleyshmakher, 33, of Morganville and Ruben Sevumyants, 36, of Marlboro.

Federal prosecutors in New Jersey said Monday that Sevumyants was previously indicted while Khaimov and Shtindler were each previously charged by complaint. Fleyshmakher was arrested Monday morning.

The now-shuttered Prime Aid Pharmacies, with locations in Union City, New Jersey and the Bronx, processed expensive drugs used to treat conditions including Hepatitis C, Crohn’s disease, and rheumatoid arthritis.

Fleyshmakher worked in Union City and was an owner of the Bronx location. Khaimov was an owner of one in Union City and the lead pharmacist of the Bronx location. Shtindler was the Union City administrator while Sevumyants was its operations manager.

The pharmacies entered into retail network agreements with several pharmacy benefit managers, prosecutors said, allowing them to receive reimbursement payments for prescription drugs, including specialty medications. When a pharmacy recieved a prescription, the pharmacy then sent the pharmacy managers a claim for reimnursement that represented the beneficiary's drug plan, authorities said.

Beginning in 2009, three of the defendants and other pharmacy workers bribed and gave kickbacks to doctors and doctors' workers to get more business, prosecutors said. Lavish meals, cash, checks and wire transfers were used as kickbacks, authorities said, and at least one worker was paid to work inside a doctor's office for the doctor's benefit.

The Union City location was also accused of pervasive fraud, as it charged health insurance providers for drugs that were never given to patients, prosecutors said. The pharmacies usually gave out medications for initial prescriptions it received, but would regularly charge for refills for the same drugs and never gave them to patients, court documents allege.

The Union City location raked in more than $65 million in bogus reimbursement payments from 2013 through 2017, prosecutors said. The medications were never given to patients, were never ordered and weren't even in stock.

Furthermore, when pharmacy benefit managers learned about the fraudulent practice through routine audits, workers were told to forge documents to make it look like the drugs had been shipped to patients, authorities said.

After some benefit managers stopped doing business with Prime Aid Pharmacies, the Glen Head defendants opened new pharmacies, transferring over patients from the original company and then lying to benefit managers about who actually owned the new companies.

The group faces charges including health care fraud, wire fraud, and kickback conspiracy.