Linwood man pleads guilty to health fraud Linwood man pleads guilty to role in ongoing health care fraud case - Insurance News | InsuranceNewsNet

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March 15, 2023 Newswires
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Linwood man pleads guilty to health fraud Linwood man pleads guilty to role in ongoing health care fraud case

Press of Atlantic City (NJ)

A former pharmaceutical sales representative on Tuesday admitted his role in a health care benefits scheme that defrauded the state and local insurance programs by getting kickbacks for unnecessary prescriptions.

Vincent Tornari, 49, of Linwood, pleaded guilty in a virtual hearing before New Jersey District Court Judge Robert B. Kugler to one count of conspiracy to commit health care fraud and wire fraud, U.S. Attorney Vikas Khanna said.

Tornari was initially charged along with Dr. Brian Sokalsky, 44, of Margate, and former nurse practitioner Ashley Lyons-Valenti, 66, of Swedesboro, Gloucester County, in June 2020.

Tornari faces up to 20 years in prison and a $250,000 fine when he is sentenced July 25.

Lyons-Valenti pleaded guilty Feb. 28 to health care fraud conspiracy, Khanna said.

Sokalsky is taking his charges to trial, which is scheduled to start April 24.

Tornari's plea is the latest in a slew of charges that arose in 2017, when Margate was subpoenaed for its employees' health insurance information.

The scheme, in which more than 45 people have been charged, worked by targeting holders of state-funded health insurance programs. The conspirators would use prescriptions for compound medications, which are not approved by the U.S. Food and Drug Administration and are made by a pharmacist for specific needs, to receive thousands of dollars generated from the orders.

Investigators have said the conspiracy cost the program roughly $50 million.

Tornari's company had an agreement with a compounding pharmacy in Pennsylvania to receive 50% of the insurance reimbursement for prescriptions that were arranged by him and those working with him, such as Mark Bruno, 48, of Northfield, who pleaded guilty in December 2019 to health care fraud conspiracy and obstruction of justice, Khanna said, citing court records.

Tornari then paid Bruno 20% of that amount.

He and Bruno approached Sokalsky, assuring he'd sign off on prescriptions provided by the pharmacy. Sokalsky, in turn, would be paid cash and other remuneration.

Sokalsky prescribed the medications to people Bruno paid cash to agree to receive the medications, without a medical reason for them. Sokalsky then billed insurance plans for patient visits for the people Bruno directed to his medical practice.

Sokalsky also prescribed the medications to his existing patients as a means of profiting Tornari, Bruno and himself. When insurance stopped covering certain ingredients in the medications, Tornari and Bruno informed Sokalsky that he needed to authorize new prescriptions.

Sokalsky then did so, often without seeing the individual for a follow-up visit or informing the person of the change in medication.

The fraudulent prescriptions cost insurers more than $541,000, and Tornari personally received more than $359,000 through the scheme, Khanna said.

Contact Eric Conklin:[email protected] @ACPressConklin

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