Seven defendants have pleaded guilty to conspiracy to commit health care fraud and, while awaiting sentencing, have watched the government seize a number of expensive toys, including a 1936 Ford Deluxe, a 1964 Chevrolet Corvette convertible, a 1967 Chevrolet Camaro, a 1970 Chevrolet Monte Carlo and a 2008 Lamborghini convertible. Also recovered was a 50’ “Cigarette” racing boat. The cars, boat, and several properties had all been purchased with the proceeds of a $100 million fraud scheme involving prescription compounded medications.

According to the court documents, defendants in the case, including ringleader Nicholas A. Borgesano, Jr., admitted to manipulating billing codes in reimbursement claims to Medicare, Tricare, and a number of private insurance companies. The conspirators also submitted reimbursement claims for pharmaceutical ingredients they did not have, and paid kickbacks and bribes in exchange for prescriptions and patient identifying information, including paying kickbacks to a physician in exchange for the physician signing prescriptions for patients he never saw.

Borgesano, in furtherance of the scheme, acquired a number of pharmacies in the Miami, Florida area (six in total). He and his co-conspirators utilized the pharmacies to submit false and fraudulent reimbursement claims for the prescription compounded medications, primarily pain creams and scar creams.

This is another example of the government pursuing healthcare fraud charges filed r private healthcare payors aa well as government payors. The scheme was uncovered by the Medicare Fraud Strike Force and included elements of the FBI, Department of Health and Human Services, Office of Inspector General, and the Defense Criminal Investigative Service. Since its creation in 2007, the Strike Force has charged over 3,500 defendants in schemes to defraud Medicare. 

All eight defendants are currently awaiting sentencing.