Mark Belter, $24 Million Health Care Fraud, New Jersey 2020

Newark, New Jersey - In a shocking turn of events, Ohio man Mark Belter, 49, of North Ridgeville, Ohio, pleaded guilty to his role in a $24 million health care fraud and kickback scheme in New Jersey.

According to documents filed in this case and statements made in court, Belter participated in a scheme with pharmacies, telemedicine companies, and doctors to submit false claims to health care benefit programs, including Medicare and TRICARE, based on a circular scheme of kickbacks and bribes.

From June 2017 through September 2020, Belter controlled several marketing companies through which he and his conspirators identified Medicare and TRICARE beneficiaries to target for expensive drugs. The marketing companies called beneficiaries to pressure them to agree to try expensive medications, regardless of medical necessity.

Belter and others would deliberately conceal the name of the prescribing doctor – whom the beneficiary had never met before – to increase the likelihood that the beneficiary would agree to accept the medications. Portions of the telephone calls were recorded.

Belter and his companies then paid kickbacks to telemedicine companies, which in turn paid kickbacks to doctors, to obtain prescriptions for the medications. Belter transmitted to the telemedicine companies the beneficiaries’ medical information, the telephone call recording, and pre-marked prescription pads for particular drugs that would yield exorbitant reimbursements.

In total, Belter and his conspirators caused the submission of false and fraudulent claims to health care benefit programs totaling in excess of $24 million of prescription drugs. Belter and his companies received kickbacks and bribes totaling more than $6 million in exchange for prescription referrals to a pharmacy located in New Jersey.

The conspiracy charges are each punishable by a maximum of five years in prison, along with fines, restitution, and penalties as to both counts. Both charges are punishable by a fine of $250,000, or twice the gross gain or loss from the offense.

Sentencing is scheduled for September 27, 2023.

Source: https://www.justice.gov/usao-nj/pr/ohio-man-admits-role-24-million-health-care-fraud-and-kickback-scheme