Here’s a selection of recent healthcare frauds from New Jersey. On April 17, John Sher of Margate was sentenced to 37 months in prison and ordered to pay $2.77 million in restitution and $327,987 in forfeiture for defrauding New Jersey state and local health benefits programs and other insurers. Sher and a co-conspirator recruited state and local government employees who were compensated to receive medically unnecessary compounded prescription medications.
The U.S. Attorney’s Office for the District of New Jersey announced on March 23 that Raheel Naviwala, the owner and operator of call centers, was charged with conspiracy to violate the federal Anti-Kickback Statute (AKS) for participating in a $101 million kickback scheme involving durable medical equipment (DME). Naviwala and his conspirators obtained doctors’ orders for DME for Medicare beneficiaries without regard to medical necessity, and provided the orders to DME companies in exchange for bribes. The conspiracy charge could bring Naviwala five years in jail if convicted.
Daniel Oswari, a doctor from Bordentown, was sentenced on March 28 to 15 months in prison and ordered to pay $1.9 million in restitution after pleading guilty to conspiracy to violate the AKS and the federal Travel Act. Oswari and members of his staff persuaded patients to receive expensive compounded medications, even without medical necessity, and signed some prescriptions without ever seeing or evaluating the individuals. Two compounding pharmacies received $1.9 million for the prescriptions Oswari signed, and paid him cash kickbacks in exchange for the prescriptions. Oswari also pleaded guilty to a separate conspiracy to accept kickbacks for referring blood and urine samples to a laboratory for testing, and by billing for the testing the lab, in turn, defrauded the Medicare and Medicaid programs and private insurers.
On March 24, Aysha Khan of Kinnelon was arrested and charged with four counts of healthcare fraud and one count of conspiracy to commit healthcare fraud. Khan operated specialty pharmacies in New Jersey, New York, Texas, and Florida, and is charged with directing them to bill health insurance programs for medications that were never provided to patients. The pharmacies fraudulently received more than $10 million in Medicare reimbursements. Khan could face up to 10 years in jail if convicted.
Finally (for now), Saurabh Patel, a doctor and owner of a medical clinic owner in Newark, recently pleaded guilty to conspiring to commit healthcare fraud. Patel conspired with a family member and a pharmaceutical sales representative to fraudulently submit (you guessed it) medically unnecessary compounded drug prescriptions to private insurers for individuals who were recruited for the purpose. Patel faces up to 10 years in jail when sentenced in June.
