Absecon, NJ, Man Sentenced For Role in $50M Health Care Fraud Conspiracy
A man from Absecon has been sentenced to 37 months in prison for his role in defrauding New Jersey state and local health benefits programs and other insurers by submitting fraudulent claims for medically unnecessary prescriptions.
Attorney for the United State Vikas Khanna says 45-year-old Brian Pugh previously pleaded guilty to one count of conspiring to defraud a health care benefits program.
Pugh was part of a criminal conspiracy in which state and local government employees were recruited and compensated to receive medically unnecessary compound prescription medications. Pugh and his conspirators defrauded New Jersey health benefits programs and other insurers of more than $50 million. Pugh directly caused the pharmacy benefits administrator to pay more than $1.4 million for medically unnecessary compound prescription medications for individuals he recruited into the scheme, and he received more than $430,000 in the conspiracy.
In addition to the prison term, Pugh was sentenced to three years of supervised release, ordered to pay more than $1.4 million in restitution, and forfeiture of $437,604.
Khanna credited the numerous law enforcement agencies for the investigation that lead to this sentencing, including the FBI's Atlantic City Resident Agency, special agents with the IRS, and the U.S. Department of Labor Office of Inspector General.