Pharmacist Convicted for Health Care Fraud and Black-Market Prescription Drug Diversion Scheme
A federal jury convicted a California woman last Friday, Oct. 14 for a health care fraud and prescription drug diversion scheme involving two Southern California pharmacies.
According to court documents and evidence presented at trial, Irina Sadovsky, 53, of Calabasas, the owner and pharmacist-in-charge of Five Star RX doing business as Five Star Pharmacy (Five Star Pharmacy) and Ultimate Pharmacy Inc. (Ultimate Pharmacy), engaged in a health care fraud and black market prescription drug diversion conspiracy that began in or around September 2016, and continued through in or around April 2017. Sadovsky submitted claims to Medicaid of California (Medi-Cal) and Medicare for prescription drugs that were never dispensed to beneficiaries but rather were provided to co-conspirators to sell on the black market.
Sadovsky’s co-conspirators created fraudulent prescriptions, either by writing the prescriptions themselves or by paying kickbacks to marketers with access to patients and prescribers. Sadovsky recommended the combinations of prescription drugs to be written, checked the eligibility of the patients for reimbursement, and fraudulently submitted claims to Medi-Cal and Medicare.
Sadovsky was convicted of conspiracy to commit health care fraud and conspiracy to engage in the unlicensed wholesale distribution of prescription drugs. She is scheduled to be sentenced on Feb. 3, 2023 and faces a maximum penalty of 10 years in prison for the health care fraud conspiracy, and five years in prison for the unlicensed distribution conspiracy. A federal district court judge will determine any sentence after considering the U.S. Sentencing Guidelines and other statutory factors.
Assistant Attorney General Kenneth A. Polite, Jr. of the Justice Department’s Criminal Division; U.S. Attorney Martin Estrada for the Central District of California; Assistant Director in Charge Donald Alway of the FBI Los Angeles Field Office; and Special Agent in Charge Timothy B. DeFrancesca of the Department of Health and Human Services, Office of Inspector General (HHS-OIG) made the announcement.
The FBI and HHS-OIG investigated the case, which was brought as part of the Los Angeles Strike Force, supervised by the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Central District of California. The California Department of Justice provided valuable assistance.
Assistant Chief Alexis Gregorian and Trial Attorneys Justin Givens and Alex Michael of the Criminal Division’s Fraud Section are prosecuting the case.
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, comprised of 15 strike forces operating in 24 federal districts, has charged more than 4,200 defendants who collectively have billed the Medicare program for more than $19 billion. In addition, the Centers for Medicare & 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. More information can be found at https://www.justice.gov/criminal-fraud/health-care-fraud-unit.