Pharmacy Business Head Pleads Guilty in $32M Health Care Fraud: A Deep Dive

Hoboken Harassment Guilty Plea

Pharmacy Business Head Pleads Guilty in $32M Health Care Fraud: A Deep Dive

Newark, New Jersey, August 18, 2023 – In a shocking revelation, Elan Yaish, the former president of a prominent pharmacy business, has admitted to his involvement in a massive health care kickback scheme. The conspiracy, which targeted Medicare and TRICARE beneficiaries, has resulted in a staggering loss of over $32 million to federal health care benefit programs.

The Mastermind Behind the Scheme

Elan Yaish, a 53-year-old from Israel, recently pleaded guilty in the Newark federal court. The charge against him? Conspiracy to violate the Federal Anti-Kickback statute. The confession came before U.S. District Judge Esther Salas on August 16, 2023.

The Modus Operandi

From September 2017 to December 2020, Yaish was actively involved in running pharmacies, including the notable Apogee Bio-Pharm LLC located in Edison, New Jersey. The conspiracy revolved around a well-orchestrated plan where marketing companies were paid to direct prescriptions of high-priced medications to these pharmacies.

These marketing firms specifically targeted Medicare and TRICARE beneficiaries, pressuring them over phone calls to opt for expensive medications like pain creams, scar creams, eczema creams, and migraine medication. The telemedicine companies, in turn, received kickbacks for every beneficiary referred for a prescription. These companies then paid doctors to approve these prescriptions. The final step involved directing these prescriptions to pharmacies, such as Apogee, which had kickback arrangements in place. The pharmacies then claimed reimbursements from federal health care benefit programs, including Medicare and TRICARE. A portion of these reimbursements was then paid back to the marketing companies as kickbacks.

The Aftermath

The repercussions of this conspiracy are severe. The charge of conspiracy to violate the Anti-Kickback Statute can lead to a maximum penalty of five years in prison. Additionally, the accused can face a fine of up to $250,000 or twice the gross gain or loss from the offense, whichever amount is higher. Yaish’s sentencing is slated for December 20, 2023.

Acknowledgment

The United States Attorney, Vikas Khanna, has credited the FBI, the U.S. Department of Health and Human Services Office of Inspector General, and the U.S. Department of Defense, Office of Inspector General, Defense Criminal Investigative Service, Northeast Field Office, for their relentless efforts in the investigation leading to the guilty plea.

The prosecution is represented by Assistant U.S. Attorney Katherine M. Romano of the Health Care Fraud Unit and Barbara Ward, Senior Trial Counsel of the Asset Recovery and Money Laundering Unit, in Newark. On the defense side, Joel B. Rudin Esq. from New York is representing Yaish.

For more updates on this case and other breaking news, stay tuned.