Margate, New Jersey, Firefighter Admits $7 Million Health Care Fraud Conspiracy Targeting State Health Benefits Programs
District of
FOR IMMEDIATE RELEASE
Margate,
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"Firemen take an oath to uphold the law. The
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According to documents filed in this case and statements made in court:
From
The conspirators knew that certain compound medication prescriptions - including pain, scar, antifungal, and libido creams, as well as vitamin combinations - were reimbursed for thousands of dollars for a one-month supply. They also knew that some
An entity referred to in the information 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. The Pharmacy Benefits Administrator would pay prescription drug claims and then bill the
Sher and conspirators working under him recruited public employees and other individuals covered by the Pharmacy Benefits Administrator to fraudulently obtain compounded medications. Sher and others often used pre-printed prescription forms in which they selected medications with the highest possible reimbursement, without any consideration for medical necessity. The prescriptions were faxed to the
The pharmacy paid one of Sher's conspirators a percentage of each prescription filled and paid by the Pharmacy Benefits Administrator, which was then distributed to Sher and other members of the conspiracy. Sher admitted paying one of the doctors to reward the doctor for signing prescriptions. Sher also paid individuals covered by the Pharmacy Benefits Administrator, as well as the other recruiters who worked under him during the conspiracy.
According to the information, the Pharmacy Benefits Administrator paid
Sher faces a maximum penalty of 10 years in prison and a
Fifteen other conspirators -
The government is represented by Assistant
Defense counsel:
Press Release Number:
18-079
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