National Health Care Fraud Takedown Results in 324 Defendants Charged in Connection with Over $14.6 Billion in Alleged Fraud

NEWARK - Today, United States Attorney Alina Habba announced criminal charges and civil settlements against 15 defendants in connection with alleged schemes to defraud Medicare, Medicaid, TRICARE, and private health insurers. The charges and settlements filed in federal court are part of the Department of Justice’s 2025 National Health Care Fraud Takedown. The charges and settlements filed in the District of New Jersey involve physicians and pharmacies submitting reimbursements for drugs, devices, and tests that patients didn’t need, pharmacies seeking reimbursement for drugs they never sold, and healthcare providers who received kickbacks to drive phony prescriptions.

“My Office, in lockstep with the Department’s nationwide Health Care Fraud Takedown, is cracking down on corrupt physicians, pharmacies, and healthcare providers who exploit Medicare and Medicaid with shameless kickback schemes, unnecessary prescriptions, and phony reimbursements for unneeded drugs, medical devices, and genetic tests – or drugs never even delivered. These predatory schemes prioritize profits over patients, and the District of New Jersey is fiercely committed to rooting out this fraud and ensuring those responsible face justice.”

- U.S. Attorney Alina Habba

“This record-setting Health Care Fraud Takedown delivers justice to criminal actors who prey upon our most vulnerable citizens and steal from hardworking American taxpayers,” said Attorney General Pamela Bondi. “Make no mistake – this administration will not tolerate criminals who line their pockets with taxpayer dollars while endangering the health and safety of our communities.”

The charges announced today by U.S. Attorney Habba are part of a strategically coordinated, nationwide law enforcement action that resulted in criminal charges against 324 defendants, including 96 doctors, nurse practitioners, pharmacists, and other licensed medical professionals, in 50 federal districts and 12 State Attorneys General’s Offices across the United States, for their alleged participation in various health care fraud schemes involving over $14.6 billion in intended loss. The Takedown involved federal and state law enforcement agencies across the country and represents an unprecedented effort to combat health care fraud schemes that exploit patients and taxpayers. 

The following individuals were charged and entered settlements in the District of New Jersey:

• Alan Vaughan, 56, of the United Kingdom, was charged with conspiracy to violate the federal anti-kickback statute in connection with a scheme to generate referrals for durable medical equipment and cancer genetic tests. As alleged in the indictment, Vaughan paid kickbacks to several marketers in exchange for personal health and insurance information about Medicare beneficiaries, transmitted that information to telemedicine companies, and then received kickbacks from genetic testing laboratories and durable medical equipment supply companies for each item of durable medical equipment and/or each cancer genetic test for which Medicare provided reimbursement. As further alleged, to conceal the scheme, Vaughan and his co-conspirators received millions of dollars in kickbacks through a shell company in New Zealand. As a result of the alleged scheme, Vaughan and his co-conspirators caused a loss to Medicare of more than $80 million. The case is being prosecuted by Assistant U.S. Attorney Garrett J. Schuman of the U.S. Attorney’s Office for the District of New Jersey.
• Taejin Kim, 43, of River Vale, New Jersey, was charged by information with conspiracy to commit health care fraud in connection with a scheme to submit false and fraudulent claims to Amtrak’s health care plan for services that were never provided and were medically unnecessary. As alleged in the information, Kim, a licensed physical therapist, participated in a conspiracy to use Amtrak employees’ insurance information to submit false and fraudulent claims for services that were medically unnecessary and never provided to the Amtrak employees. Amtrak paid approximately $2,253,453 on these claims. The case is being prosecuted by Assistant U.S. Attorneys Jessica R. Ecker and Katie M. Romano of the U.S. Attorney’s Office for the District of New Jersey.
• Nestor E. Jaime, 36, of Pine Brook, New Jersey, was charged by indictment with health care fraud in connection with a scheme to submit fraudulent prescription drug claims to Medicare. As alleged in the indictment, Jaime, a pharmacy owner, engaged in a scheme to submit fraudulent claims to Medicare for a high-reimbursement medication that the pharmacy never dispensed and for which the pharmacy never received any prescriptions from the purported beneficiaries’ health care providers for the medication. Medicare paid Jaime’s pharmacy $2,505,754 for these false and fraudulent claims. The case is being prosecuted by Assistant U.S. Attorney Jessica R. Ecker of the U.S. Attorney’s Office for the District of New Jersey.
• Newark Beth Israel Medical Center (“NBIMC”), located in Newark, New Jersey, has agreed to pay the United States $250,000 to resolve allegations that from January 1, 2018 through December 31, 2019, doctors working in NBIMC’s Heart Transplant Program failed to adequately disclose to patients and their family members material medical information about patients’ conditions. The United States contends that this conduct resulted in NBIMC performing medically unnecessary treatment on these patients. The case is being handled by Assistant U.S. Attorney Robert Toll of the U.S. Attorney’s Office for the District of New Jersey.
• Excel Pharmacy Inc., located in Jersey City, New Jersey, agreed to pay the United States and the State of New Jersey $3,000,000 to resolve allegations that from January 2, 2015, through January 25, 2022, it caused the submission of claims for reimbursement to the Medicare Part D Program and the New Jersey Medicaid Program for drugs that were never dispensed to beneficiaries. The case is being handled by Assistant U.S. Attorneys Kruti Dharia and Robert Toll of the U.S. Attorney’s Office for the District of New Jersey.
• QuickRx LLC, an entity affiliated with Community Pharmacy, located in Elizabeth, New Jersey, agreed to pay the United States and the State of New Jersey $962,821 to resolve allegations that from January 7, 2015, through January 24, 2022, it caused the submission of claims for reimbursement to the Medicare Part D Program and the New Jersey Medicaid Program for drugs that were never dispensed to beneficiaries. The case is being handled by Assistant U.S. Attorneys Kruti Dharia and Robert Toll of the U.S. Attorney’s Office for the District of New Jersey.
• Raghu Ram Inc. d/b/a Camden Discount Pharmacy, located in Camden, New Jersey, agreed to pay the United States and the State of New Jersey $310,000 to resolve allegations that from January 2, 2015, through January 24, 2022, it caused the submission of claims for reimbursement to the Medicare Part D Program and the New Jersey Medicaid Program for drugs that were never dispensed to beneficiaries. The case is being handled by Assistant U.S. Attorneys Kruti Dharia and Robert Toll of the U.S. Attorney’s Office for the District of New Jersey.
• Rachit Drug Inc., located in Newark, New Jersey, has agreed to pay the United States and the State of New Jersey $225,000 to resolve allegations that, from January 2, 2015, through January 25, 2022, it caused the submission of claims for reimbursement to the Medicare Part D Program and the New Jersey Medicaid Program for drugs that were never dispensed to beneficiaries. The case is being handled by Assistant U.S. Attorneys Kruti Dharia and Robert Toll of the U.S. Attorney’s Office for the District of New Jersey.
• Premier Dental Holdings, Inc. d/b/a Sonrava Health, Element Dental Partners Holdco, LLC, Element Dental Partners, LLC, Mid-Atlantic Dental Services Holdings LLC, and The Jersey Dental Group have agreed to pay the United States and the State of New Jersey $540,000 to resolve allegations that from January 1, 2021 through July 31, 2023, it submitted or caused the submission of claims for reimbursement to the Medicare Part D Program and the New Jersey Medicaid Program (“NJ FamilyCare”) for: (a) services that were performed by providers who were not credentialed with NJ FamilyCare or the applicable managed care organization, but billed for by using the National Provider Identifiers of dentists who did not perform the services but had the necessary credentials; or (b) services that were performed and billed by uncredentialed providers at the time the service was rendered. The case is being handled by Assistant U.S. Attorney Robert Toll of the U.S. Attorney’s Office for the District of New Jersey.

“The scale of today’s Takedown is unprecedented, and so is the harm we’re confronting. Individuals who attempt to steal from the federal health care system and put vulnerable patients at risk will be held accountable,” said HHS-OIG Acting Inspector General Juliet T. Hodgkins. “Our agents at HHS-OIG work relentlessly to detect, investigate, and dismantle these fraud schemes. We are proud to stand with our law enforcement partners in protecting taxpayer dollars and safeguarding patient care.”

“Today’s announcement provides insight into the complex and costly nature of the health care fraud threat. More importantly, this coordinated effort highlights the professionalism of the FBI and our partners to find, expose and hold accountable those practitioners, business owners and facilitators who took advantage of our system for personal gain,” said Special Agent in Charge Stefanie Roddy.

“Today’s actions represent the sheer dedication, professionalism, and commitment of our agents, joint partners, and U.S. Attorneys in holding accountable those who put greed ahead of patient care and basic ethics,” said Mike Waters, Special Agent In Charge of Amtrak’s Northeast Region. “We hope these actions serve as a deterrent for health care providers and others who choose to engage in such schemes, and we ask anyone who suspects or observes such fraud to report it to our fraud, waste, and abuse hotline.”

The Health Care Fraud Unit’s National Rapid Response, Florida, Gulf Coast, Los Angeles, Midwest, New England, Northeast, and Texas Strike Forces; U.S. Attorneys’ Offices for the District of Arizona, Central District of California, Northern District of California, Southern District of California, District of Columbia, District of Connecticut, District of Delaware, Middle, District of Florida, Northern District of Florida, Southern District of Florida, Middle, District of Georgia, District of Idaho, Northern District of Illinois, Eastern District of Kentucky, Western District of Kentucky, Eastern District of Louisiana, Middle District of Louisiana, District of Maine, District of Massachusetts, Eastern District of Michigan, Northern District of Mississippi, Southern District of Mississippi, District of Montana, District of Nevada, District of New Hampshire, District of New Jersey, Eastern District of New York, Northern District of New York, Southern District of New York, Western District of New York, Eastern District of North Carolina, Western District of North Carolina, District of North Dakota, Northern District of Ohio, Southern District of Ohio, Northern District of Oklahoma, Western District of Oklahoma, District of Oregon, Eastern District of Pennsylvania, District of South Carolina, Middle District of Tennessee, Western District of Tennessee, Northern District of Texas, Southern District of Texas, Western District of Texas, District of Vermont, Eastern District of Virginia, Western District of Washington, and Northern District of West Virginia; and State Attorney Generals’ Offices for Arizona, California, Georgia, Illinois, Indiana, Louisiana, Massachusetts, Missouri, New York, Ohio, and Pennsylvania are prosecuting the cases in the National Health Care Fraud Takedown, with assistance from the Health Care Fraud Unit’s Data Analytics Team. Descriptions of each case involved in today’s enforcement action are available on the Department’s website here.

The District of New Jersey, in particular, worked with the Department’s Criminal and Civil Division and the following law enforcement organizations to investigate and prosecute the cases filed during the enforcement period: the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG); FBI; and Amtrak’s Office of Inspector General.

A complaint, information, or indictment is merely an allegation. All defendants are presumed innocent until proven guilty beyond a reasonable doubt in a court of law.

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