By: Najla Alexander
Authorities in NJ reported that a former president of a pharmacy business admitted his role in a healthcare kickback conspiracy involving prescriptions for Medicare and TRICARE beneficiaries.
U.S. Attorney Vikas Khanna said Elan Yaish, 53, of Israel, pleaded guilty on August 16, before U.S. District Judge Esther Salas in Newark federal court to information charging him with conspiracy to violate the Federal Anti-Kickback statute.
According to documents filed in this case and statements made in court:
Authorities say from September 2017 to around December 2020, Yaish participated in operating pharmacies, including Apogee Bio-Pharm LLC, in Edison.
Yaish and others agreed to engage in a scheme to pay marketing companies to direct prescriptions for expensive medications to the pharmacies.
According to officials, 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, officials said.
Officials say 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, then paid a portion of each reimbursement to the marketing companies as a kickback, officials said.
As a result of the scheme, officials say, Yaish and his conspirators caused a loss to Medicare and other federal healthcare benefit programs of over $32 million.
According to officials, 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 December 20, 2023.
