CAMDEN, N.J. – An Atlantic County, New Jersey, physician right this moment admitted his position in defrauding New Jersey state and native well being advantages applications and different insurers by submitting fraudulent claims for medically pointless prescriptions, Legal professional for the US Vikas Khanna introduced.
Brian Sokalsky, 44, of Margate, New Jersey, pleaded responsible earlier than U.S. District Choose Robert B. Kugler to a superseding info charging him with one depend of conspiring to commit well being care fraud.
Sokalsky, pharmaceutical gross sales consultant Vincent Tornari, 49, of Linwood, New Jersey, and former superior nurse practitioner Ashley Lyons-Valenti, 66, of Swedesboro, New Jersey, have been charged in a 33-count indictment in June 2020. Tornari pleaded responsible on March 14, 2023, and Lyons-Valenti pleaded responsible on Feb. 28, 2023, to their respective roles within the conspiracy.
In line with courtroom paperwork filed on this case and statements made in courtroom:
Compounded drugs are specialty drugs blended by a pharmacist to fulfill the precise medical wants of a person affected person. Though compounded medication usually are not authorised by the Meals and Drug Administration (FDA), they’re correctly prescribed when a doctor determines that an FDA-approved medicine doesn’t meet the well being wants of a selected affected person, similar to if a affected person is allergic to a dye or different ingredient.
The conspirators realized that sure drugs made by compounding pharmacies reimbursed for as much as 1000’s of {dollars} for a person’s one-month provide. They realized that sure insurance policy – together with insurance policy for state and native authorities workers and sure different insurance policy – coated these drugs.
Sokalsky agreed to authorize prescriptions for former pharmaceutical gross sales consultant Matthew Tedesco, 47, of Linwood, New Jersey, who pleaded responsible to well being care fraud conspiracy in June 2017, and others working with Tedesco. In alternate for authorizing these prescriptions, Tedesco referred roughly 30 sufferers to Sokalsky’s new medical apply. Sokalsky, in flip, billed insurance coverage for affected person visits for these folks steered to his apply by Tedesco. Sokalsky additionally approved prescriptions for the drugs for current sufferers of his apply, which he did to financially profit Tedesco and encourage him to refer extra sufferers to his new apply. Sokalsky approved medically pointless drugs, together with libido lotions for younger females and extreme portions of the drugs with the utmost variety of refills chosen. When insurance coverage stopped overlaying sure formulations of the drugs, Tedesco knowledgeable Sokalsky that he wanted to authorize new prescriptions. Sokalsky did so, typically with out seeing the person for a follow-up go to or informing the individual of the change in medicine. In whole, insurance coverage paid greater than $5 million for fraudulent prescriptions approved by Sokalsky.
Sokalsky faces a most penalty of 10 years in jail and a $250,000 positive. Sentencing is scheduled for Aug. 22, 2023.
Legal professional for the US Khanna credited brokers of the FBI’s Atlantic Metropolis Resident Company, beneath the path of Particular Agent in Cost James E. Dennehy in Newark; particular brokers of IRS – Felony Investigation, beneath the path of Performing Particular Agent in Cost Tammy Tomlins in Newark; and the U.S. Division of Labor Workplace of Inspector Normal, New York Area, beneath the path of Particular Agent in Cost Jonathan Mellone, with the investigation resulting in right this moment’s responsible plea.
The federal government is represented by Christina O. Hud, Senior Trial Counsel within the Well being Care Fraud Unit; R. David Stroll, Jr., Deputy Chief of the Felony Division; and Assistant U.S. Legal professional Daniel A. Friedman.