The founders of a pharmaceutical marketing firm based in New Jersey pled guilty on Tuesday to participating in a plot to cheat insurance companies out of $38 million. The scheme involved the owners’ collaboration with patients and pharmacies.
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Fraudulent insurance claims for costly compounded pharmaceuticals were submitted by 42-year-old Samantha Zaretzky and 43-year-old Lee Nichols, under the auspices of their company, Synergy Medical LLC.
To treat conditions that have no approved drug on the market, pharmacists often compound their own. Between April 2014 and June 2016, the two defendants had sales reps find patients who would pay for pricey compound medications through prescriptions written by doctors who were in collusion with one another.
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They’d figure out which elements brought in the most money, then have the patients get in touch with a consulting firm for health care. At least once, the two accused had the inactive license of a nurse who had written prescriptions for them.
After obtaining a prescription, Samantha Zaretzky and Nichols made sure it was filled at a pharmacy that gave them a commission for sending them more business. The maximum penalties for the defendants are ten years in prison and a fine equal to two times the money gained from the scam.