Former Pharmacy President Pleads Guilty in $32 Million Medicare, Tricare Scheme
A former president of a pharmacy enterprise has entered a guilty plea for his involvement in a complex plot aimed at defrauding Medicare and Tricare through the manipulation of prescription costs in exchange for kickbacks.
Elan Yaish, once at the helm of Apogee Bio-Pharm LLC based in Edison, N.J., confessed to orchestrating this elaborate scheme, as disclosed in a news release by the U.S. Department of Justice on August 21. This operation involved Yaish and his co-conspirators deploying telemarketers to offer enticing kickbacks to Medicare and Tricare beneficiaries, strategically persuading them to experiment with high-cost medications. The subsequent sequence saw these beneficiaries seeking prescriptions from a telemedicine firm, with physicians on the payroll of this operation greenlighting the prescriptions as part of the conspiracy, per the official statement from the Justice Department.
In this intricate web of deceit, Mr. Yaish’s pharmacies then executed the fraudulent billing process, invoicing Medicare and Tricare for these medications. The repercussions of this manipulation resulted in a staggering $32 million loss to Medicare and other federal health programs. Moreover, a calculated portion of the illicit reimbursements was funneled back to the telemarketing company in the form of kickbacks, the Justice Department confirmed.
As a consequence of his actions, Elan Yaish now faces a potential prison sentence of up to five years, representing the gravity of his involvement in the scheme that preyed on vulnerable healthcare programs. This guilty plea not only underscores the systemic vulnerabilities within the healthcare system but also emphasizes the ongoing commitment of the justice system to curbing such fraudulent activities that undermine the integrity of federally funded healthcare programs.
