NEW YORK
Federal prosecutors say a Moscow-based criminal organization used fake telemedicine visits, sham prescriptions and remotely controlled pharmacies across the nation to steal nearly $2 billion from private health insurers, officials announced this week.
At federal court in Brooklyn, Anthony Santamaria was sentenced to 10 years in prison for his role in the sprawling health care fraud conspiracy, according to the U.S. Department of Justice.
Santamaria became the third defendant sentenced this month in the international scheme. Co-defendants Hershel Tsikman and Hafizullah Ebady previously received prison sentences of 10 years and more than eight years.
Federal Judge William F. Kuntz II also ordered Santamaria to forfeit $3.2 million, while Ebady was ordered to forfeit more than $1.8 million. Prosecutors said restitution for victims will be determined later.
Quick Facts
- Fraud billed: Nearly $2 billion
- Insurance payouts: More than $758 million
- Pharmacies involved: More than 75 pharmacies nationwide
- Locations included: Brooklyn, Staten Island, Long Island, New Jersey, Texas, Michigan and Alabama
- Scheme operated: 2017 to 2022
- Lead fugitive: Brian Sutton remains at large
According to prosecutors, the organization operated call centers in Utah and later Russia, where workers contacted insured patients and offered medications at no cost.
Authorities said the conspirators generated fraudulent prescriptions even when patients never agreed to receive the drugs. In many cases, investigators said, there were no legitimate telemedicine visits and many patients never received medication at all.
The organization allegedly purchased and controlled pharmacies through straw owners and shell companies while Moscow-based billers electronically submitted reimbursement claims to insurers.
Federal prosecutors said the operation relied on aliases, encrypted communications and overseas money laundering networks to hide the conspiracy.
Three additional defendants — David Bishoff, Brycen Millett and Joshua Alegria — are awaiting sentencing. Another defendant, Dela Saidazim, previously was sentenced to time served.
Authorities said alleged ringleader Brian Sutton, a U.S. citizen believed to be living abroad, remains a fugitive.