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Defendant Admits Role in $32 Million Health Care Kickback Scheme
NEWARK, N.J. – Elan Yaish, 53, of Israel, pleaded guilty on Aug. 16, 2023, before U.S. District Judge Esther Salas in Newark federal court to an information charging him with conspiracy to violate the Federal Anti-Kickback statute.
According to documents filed in this case and statements made in court, Yaish participated in operating pharmacies, including Apogee Bio-Pharm LLC, in Edison, New Jersey.
Yaish and others agreed to engage in a scheme to pay marketing companies to direct prescriptions for expensive medications to the pharmacies. The marketing companies identified Medicare and TRICARE beneficiaries to target for expensive drugs and contacted the beneficiaries by telephone to pressure them to agree to try expensive medications, such as pain creams, scar creams, eczema creams, and migraine medication.
The marketing companies then transmitted recordings of telephone calls with the beneficiaries, together with pre-marked prescription pads for particular drugs that would yield exorbitant reimbursements, to telemedicine companies. The marketers paid the telemedicine companies kickbacks for every beneficiary referred for a prescription, and the telemedicine companies paid doctors to approve the prescriptions.
The marketing companies then directed the prescriptions to pharmacies, including Apogee, with which they had kickback arrangements. The pharmacies filled the prescriptions and sought reimbursement from federal health care benefit programs, including Medicare and TRICARE. The pharmacies, including Apogee, then paid a portion of each reimbursement to the marketing companies as a kickback.
As a result of the scheme, Yaish and his conspirators caused a loss to Medicare and other federal health care benefit programs of over $32 million. The charge of conspiracy to violate the Anti-Kickback Statute is punishable by a maximum potential penalty of five years in prison, and a maximum fine of $250,000, or twice the gross gain or loss from the offense, whichever is greatest.
Sentencing is scheduled for Dec. 20, 2023. Attorney for the United States Vikas Khanna credited special agents of the FBI, under the direction of Special Agent in Charge James E. Dennehy in Newark; the U.S. Department of Health and Human Services Office of Inspector General, under the direction of Special Agent in Charge Naomi Gruchacz; and U.S. Department of Defense, Office of Inspector General, Defense Criminal Investigative Service, Northeast Field Office, under the direction of Special Agent in Charge Patrick J. Hegarty, with the investigation leading to the guilty plea.
The government is represented by Assistant U.S. Attorney Katherine M. Romano of the Health Care Fraud Unit and Barbara Ward, Senior Trial Counsel of the Asset Recovery and Money Laundering Unit, in Newark.
Yaish’s guilty plea is a significant blow to those who would exploit the health care system for personal gain. We will continue to work tirelessly to protect the integrity of our health care system and hold accountable those who commit health care fraud.
Key Facts
- State: New Jersey
- Category: Health Care Fraud
- Source: DOJ Press Release â†â€â€
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