Pharmacy Employee Charged In $1.5 Million Health Care Fraud Conspiracy
NEWARK, N.J. – A Marlboro, New Jersey, man was charged today for his role in a conspiracy to falsely bill public and private insurance providers for medications that were never dispensed to patients, U.S. Attorney Craig Carpenito announced.
Ruben Sevumyants, 34, is charged by criminal complaint with one count of conspiracy to commit health care fraud. He appeared today before U.S. Magistrate Judge Joseph A. Dickson in Newark federal court and was released on $100,000 unsecured bond.
According to the complaint:
From June 2014 through Sept. 11, 2017, Sevumyants worked as the operations manager for a specialty pharmacy in Union City, New Jersey.
While employed at the pharmacy, Sevumyants allegedly forged documents and submitted false bills to Medicare, Medicaid, and other payors for medications that were never actually dispensed to patients. When health insurance providers, such as Amerihealth Caritas and Connecticut Medicaid, questioned the specialty pharmacy and Sevumyants about charges for medications that patients never received, Sevumyants allegedly forged Federal Express shipping records to make it appear that the medications were shipped to the patients.
Based on billing and shipping records, the specialty pharmacy received over $1.5 million from health insurance providers for prescriptions that were never actually dispensed to patients.
The count of conspiracy to commit health care fraud carries a maximum potential penalty of 10 years in prison and a $250,000 fine, or twice the gross gain or loss from the offense.
U.S. Attorney Carpenito credited special agents of the FBI, under the direction of Special Agent in Charge Timothy Gallagher in Newark; and the U.S. Department of Health and Human Services – Office of the Inspector General, under the direction of Special Agent in Charge Scott J. Lampert, with the ongoing investigation.
The charge and allegations in the complaint are merely accusations, and the defendant is considered innocent unless and until proven guilty.
The government is represented by Assistant U.S. Attorney Brian Urbano of the U.S. Attorney’s Office Health Care and Government Fraud Unit in Newark.
The New Jersey U.S. Attorney’s Office reorganized its health care practice in 2010 and created a stand-alone Health Care and Government Fraud Unit to handle both criminal and civil investigations and prosecutions of health care fraud offenses. Since that time, the office has recovered more than $1.38 billion in health care fraud and government fraud settlements, judgments, fines, restitution and forfeiture under the False Claims Act, the Food, Drug and Cosmetic Act and other statutes.
Defense Counsel: Thomas Calcagni Esq., Newark