Pharmacist Admits Role In Multimillion-Dollar Health Care Fraud Scheme
NEWARK, N.J. – A Bergen County, New Jersey, woman today admitted participating in a conspiracy to commit health care fraud, U.S. Attorney Craig Carpenito announced.
Estela Blaustein, 55, of Mahwah, New Jersey, pleaded guilty today before U.S. District Judge Susan D. Wigenton in Newark federal court to an information charging her with one count of conspiracy to commit health care fraud with four individuals who have been previously charged by complaint in the District of New Jersey: Mark Filippone M.D., 71, of Wallington, New Jersey; Joseph Vangelas, a/k/a “Joseph Miller,” 33, of Fort Lee, New Jersey; Marlene Vangelas, 58, of River Vale, New Jersey; and Zachary Ohebshalom, 33, of Edgewater, New Jersey. The charges against those four defendants remain pending.
According to documents filed in this case and statements made in court:
Beginning in November 2016, Blaustein participated in a scheme to obtain millions of dollars in health benefits from the federal workers’ compensation program by prescribing and dispensing expensive, but medically unnecessary, pain creams. Filippone treated hundreds of now-former U.S. Postal Service employees for injuries they purportedly suffered on the job. He allegedly facilitated their disability claims by submitting forms and medical reports to the Department of Labor, Office of Workers’ Compensation Program, for patients who were not, in fact, disabled.
Filippone also prescribed expensive topical pain creams, which were not needed or wanted by many of his patients. The information alleges that Filippone steered these prescriptions to a pharmacy in Fair Lawn, New Jersey, where Blaustein was the pharmacist-in-charge. The Fairlawn Pharmacy was owned and operated by Joseph Vangelas and Marlene Vangelas, who, along with Ohebshalom, directed Blaustein and others to research reimbursement rates within the federal workers’ compensation program for the ingredients of the pain creams in order to determine the most lucrative formulations. Joseph Vangelas, Marlene Vangelas, and Ohebshalom directed Blaustein and others to print prescription labels for Filippone to use with his patients. Filippone used the pre-printed labels and sent the prescriptions back to the Fair Lawn Pharmacy. To induce Filippone to prescribe the medically unnecessary pain creams in the exact formulations they desired, Joseph Vangelas and Marlene Vangelas purchased Filippone’s medical office and then permitted Filippone to continue to use the premises, for which he routinely failed to pay rent. Miller, the Vangelases, and Ohebshalom conspired to leverage the property to force Filippone to continue to send prescriptions to their pharmacy. Filippone continued to send prescriptions to the pharmacy, so long as Miller and the Vangelases permitted him to remain rent-free in the property.
The count of conspiracy to commit health care fraud is punishable by a maximum of 10 years in prison and a fine of $250,000, or twice the gross gain or loss derived from the offense, whichever is greater. As part of her plea agreement, Blaustein agreed that the charged healthcare fraud conspiracy caused losses of $1.5 million to $3.5 million. Sentencing is scheduled for April 22, 2020.
U.S. Attorney Carpenito credited special agents of the FBI, under the direction of Special Agent in Charge Gregory W. Ehrie in Newark; the U.S. Postal Service, Office of Inspector General, under the direction of Special Agent in Charge of the Northeast Area Field Office Matthew M. Modafferi; the Department of Labor, Office of Inspector General, New York Region, under the direction of Special Agent in Charge Michael C. Mikulka; and special agents of IRS-Criminal Investigation, under the direction of Special Agent in Charge John R. Tafur, with the investigation leading to the charges and today’s guilty plea.
The government is represented by Assistant U.S. Attorney Joshua L. Haber of the Healthcare Fraud Unit in the Criminal Division, Newark.
The charges and allegations in the information pertaining to Filippone, Joseph Vangelas, Marlene Vangelas, and Ohebshalom are merely accusations, and those four defendants are presumed innocent unless and until proven guilty.
Defense counsel: Jerome A. Ballarotto Esq., Trenton, New Jersey