Related Federal Cases
- Shawn Sypherd, Health Care Fraud Conspiracy, New Jersey · Pennsylvania
- Vincent J. Gamuzza, Health Care Fraud, NJ, 2023 · Pennsylvania
- Sergio Acosta, Health Care Benefits Fraud, NJ 2024 · Pennsylvania
- Nicholas Tedesco, Health Care Fraud Conspiracy, NJ 2024 · Pennsylvania
- Vincent J Gamuzza, Health Care Fraud, NJ 2023 · Pennsylvania
Defendants Charged in $4.5 Million Health Care Fraud Scheme
CAMDEN, N.J. – Four people, including two doctors, are scheduled to appear in court today on charges they defrauded New Jersey state health benefits programs and other insurers of $4.5 million by submitting fraudulent claims for medically unnecessary prescriptions, U.S. Attorney Craig Carpenito announced.
A fifth individual, a physician’s assistant, has pleaded guilty to participating in the health care fraud conspiracy.
Steven Monaco, 37, of Sewell, New Jersey; Daniel Oswari M.D., 48, of Bordentown, New Jersey; Michael Goldis D.O., of Mt. Laurel, New Jersey; and Aaron Jones, 25, of Willingboro, New Jersey, were all charged in a 33-count indictment with conspiracy to commit health care fraud and wire fraud.
Monaco, Oswari, and Goldis also were each charged with individual acts of health care fraud and wire fraud, and Jones was charged with 10 false statement counts. Monaco and Oswari were charged with a conspiracy involving kickbacks for referrals for laboratory work.
The cases are assigned to U.S. District Judge Robert B. Kugler in Camden. The indicted defendants are expected to appear today before U.S. Magistrate Judge Karen M. Williams in Camden federal court.
According to the indictment, compounded medications are specialty medications mixed by a pharmacist to meet the specific medical needs of an individual patient. Although compounded drugs are not approved by the Food and Drug Administration (FDA), they are properly prescribed when a physician determines that an FDA-approved medication does not meet the health needs of a particular patient, such as if a patient is allergic to a dye or other ingredient.
From January 2014 through April 2016, the conspirators recruited individuals in New Jersey to obtain very expensive and medically unnecessary compounded medications from a Louisiana pharmacy, identified in the indictment as the “Compounding Pharmacy 1,” and a Pennsylvania pharmacy, identified in the indictment as “Compounding Pharmacy 2.”
The conspirators also learned that some New Jersey state and local government and education employees, including teachers, firefighters, municipal police officers, and state troopers, had insurance coverage for these particular compound medications.
An entity referred to in the indictment as the “Pharmacy Benefits Administrator” provided pharmacy benefit management services for the State Health Benefits Program, which covers qualified state and local government employees, retirees, and eligible dependents, and the School Employees’ Health Benefits Program, which covers qualified local education employees, retirees, and eligible dependents, and other insurance plans.
The Pharmacy Benefits Administrator would pay prescription drug claims and then bill the State of New Jersey or the other insurance plans for the amounts paid.
Richard Zappala, who previously pleaded guilty to conspiracy to commit health care fraud, had agreements to receive a percentage of the amount that Compounding Pharmacies 1 and 2 received for prescriptions obtained by Zappala and his associates.
Key Facts
- State: New Jersey
- Category: Fraud & Financial Crimes
- Source: DOJ Press Release â†â€â€
ðŸâ€Â’ Get the grimiest stories delivered weekly. Subscribe free →
MORE FEDERAL CRIME NEWS
US NewsUS NewsUS NewsUS News