PHARMACY OWNER AND TECHNICIAN SENTENCED FOR FALSIFYING AUDIT DOCUMENTS AND SUBMITTING FRAUDULENT CLAIMS

The following information was released by the U.S. Department of Justice:

The owner of a pharmacy and a pharmacy technician were sentenced today for their roles in a scheme that involved submitting fraudulent claims and materially false documents to health care benefit programs.

According to court documents and statements made in court, Kirtan S. Patel, 34, of Allentown, New Jersey, and a lawful permanent resident originally from India, owned a pharmacy in Jersey City, New Jersey. In November 2020, Patel caused falsified documents to be submitted to a health insurance company in response to an audit. These documents falsely represented that medical providers had authorized certain prescriptions when they had not. Patel also submitted fraudulent prescription pick-up records that falsely represented that certain customers of the pharmacy had picked up prescriptions when they had not.

During the scheme, Patel sent text messages to a friend describing how Patel "bill[ed] around 8-10k every month to [his own] insurance" and did not "take any medications so that's basically free money[.]" Patel also described how he plied doctors with trips to "strip clubs," "night clubs," and "cash" to keep them "as corrupt as possible." In total, Patel caused over $620,000 in losses to health insurance companies. Patel was sentenced to 30 months in prison and ordered to pay over $620,000 in restitution and $620,000 in forfeiture.

According to court documents and statements made in in court, Christopher Lugo, 36, of Jersey City, New Jersey, was a pharmacy technician at the pharmacy owned by Patel. In January 2020, Lugo submitted, or caused the submission of, a fraudulent claim to his own health insurer for a drug that he was not prescribed and was not dispensed. In total, Lugo caused over $565,000 in losses to health insurance companies and Medicare.Lugo was sentenced to 24 months in prison and ordered to pay over $565,000 in restitution.

In April 2025, Patel pleaded guilty to making false statements relating to health care matters, and Lugo pleaded guilty to health care fraud.

Assistant Attorney General Colin M. McDonald of the Justice Department's National Fraud Enforcement Division; Special Agent in Charge Stefanie Roddie of the FBI Newark Field Office; Special Agent in Charge Naomi Gruchaczof the U.S. Department of Health and Human Services Office of Inspector General's (HHS-OIG) New York Regional Office; and Acting Special Agent in Charge Spiros Karabinas of Homeland Security Investigations (HSI) made the announcement.

FBI, HHS-OIG, and HSI investigated the case.

Trial Attorneys Nicholas K. Peone and Paul J. Koob of the Criminal Division's Fraud Section prosecuted the case.

On April 7, the Department of Justice announced the creation of the National Fraud Enforcement Division (Fraud Division). The Fraud Division is laser-focused on investigating and prosecuting those who commit fraud against the American people. The Department's work to combat fraud supports President Trump's Task Force to Eliminate Fraud, a whole-of-government effort chaired by Vice President J.D. Vance to eliminate fraud, waste, and abuse within Federal benefit programs.

The Fraud Section leads the Criminal Division's efforts to combat health care fraud through the Health Care Fraud Strike Force Program. Since March 2007, this program, currently comprised of nine strike forces operating in federal districts across the country, has charged more than 6,200 defendants who collectively billed federal health care programs and private insurers more than $45 billion. In addition, the Centers for Medicare and Medicaid Services, working in conjunction with the Office of the Inspector General for the Department of Health and Human Services, are taking steps to hold providers accountable for their involvement in health care fraud schemes.