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Eight Charged in Multimillion-Dollar Compounding Pharmacy Fraud Scheme

August 12, 2016 - WorkCompWire

Tampa, FL – Eight Florida residents were charged in an indictment that was recently unsealed for their alleged participation in a multimillion-dollar fraud scheme involving prescription compounding pharmacies located in the Tampa Bay, Florida, area and in Miami.

Assistant Attorney General Leslie R. Caldwell of the Justice Department’s Criminal Division, U.S. Attorney A. Lee Bentley III of the Middle District of Florida, Special Agent in Charge Paul Wysopal of the FBI’s Tampa Field Office and Special Agent in Charge George Piro of the FBI’s Miami Field Office made the announcement.

Nicholas A. Borgesano Jr., 43, of New Port Richey, Florida; Bradley Sirkin, 54, of Boca Raton, Florida; Scott D. Piccininni, 47, of Fort Lauderdale, Florida; Edwin Patrick Young, 48, of New Port Richey; Wayne M. Kreisberg, 39, of Parkland, Florida; Matthew N. Sterner, 47, of New Port Richey; Peter D. Williams, 55, of New Port Richey; and Joseph Degregorio, 71, of New Port Richey, were each charged in a 12-count indictment returned on Aug. 3, 2016, with conspiracy to commit health care fraud and wire fraud. Borgesano, Sirkin, Piccininni, Kreisberg and Sterner were each also charged with three money laundering counts. Several defendants were arrested today and will have their initial appearances in federal courts in the Middle and Southern Districts of Florida.

According to the indictment, from approximately October 2012 through December 2015, the co-conspirators allegedly used A to Z Pharmacy Inc., located in New Port Richey, and several Miami-area pharmacies to cause the submission of false and fraudulent reimbursement claims for prescription compounded medications to private insurance companies, Medicare and Tricare. These reimbursement claims were allegedly based on prescriptions generated as a result of illegal kickbacks and bribes, prescriptions that were not based on legitimate provider/patient relationships and misuse of patient information. Additionally, the reimbursement claims allegedly represented that medications contained certain pharmaceutical ingredients when they did not. In addition to A to Z Pharmacy, the defendants used Medplus/New Life Pharmacy, Metropolitan Pharmacy, Havana Pharmacy, Jaimy Pharmacy and Prestige Pharmacy to submit the reimbursement claims, according to the indictment.

The pharmacies submitted approximately $633 million in claims for prescription compounded medications and received approximately $157 million in reimbursement based on the claims, the indictment alleges. The conspirators allegedly used shell companies to transfer and disburse the money and to conceal the conspirators’ activities in the fraud scheme.

An indictment is merely an accusation, and the defendants are presumed innocent unless and until proven guilty beyond a reasonable doubt in a court of law.

The FBI investigated the case, which was brought as part of the Medicare Fraud Strike Force, under the supervision of the Criminal Division’s Fraud Section and U.S. Attorney’s Office of the Middle District of Florida. Senior Trial Attorney Christopher J. Hunter of the Criminal Division’s Fraud Section is prosecuting the case.

Source: US DOJ

Filed Under: Industry News, Top Stories, Workers' Compensation

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