Three individuals are set to serve prison sentences for their involvement in a sophisticated international fraud scheme that defrauded health insurers of $2 billion through fake telemedicine prescriptions. Meanwhile, the alleged mastermind behind the operation remains on the run.
On Tuesday, Anthony Santamaria, aged 33, was sentenced to a decade in prison and ordered to forfeit $3.2 million for his significant participation in the extensive insurance scam that spanned from 2017 to 2022, according to federal prosecutors.
Earlier in the month, two additional conspirators, Hershel Tsikman, also 33, and Hafizullah Ebady, 48, received sentences of 10 years and 8 years respectively for their parts in the fraudulent operation, as reported by the U.S. Department of Justice.
Despite these convictions, Brian Sutton, a 32-year-old U.S. citizen identified as the leader of the Russia-based criminal network suspected of orchestrating the scheme, is still at large, according to government officials.
The extensive scam involved the acquisition of pharmacies located in Brooklyn, Staten Island, Long Island, and New Jersey, which were then deceptively operated through fake “straw owners.” The plotters allegedly reached out to patients enrolled with private insurance companies, offering them medications at no charge.
However, the fraudsters proceeded to order prescriptions for these patients regardless of their consent and falsely claimed to have conducted telemedicine consultations that never took place, as detailed in court documents. Many patients reportedly never received the medications they were purportedly prescribed.
âThis Moscow-based criminal organization provided anything but health care,â said Colin McDonald, Assistant Attorney General for the DOJ’s National Fraud Enforcement Division, in a statement calling the plot a “brazen international fraud scheme involving sham call centers” and “ghost telemedicine visits.”
In total, the schemers submitted more than $1.97 billion in fraudulent prescriptions â with private insurers coughing up a whopping $758 million as a result, court papers say. The insurers were not identified.
A fourth defendant in the case, 36-year-old Dela Saidazim, was sentenced to time served in December 2022. Three more people, 41-year-old David Bishoff, 35-year-old Brycen Millett and 35-year-old Joshua Alegria, are awaiting sentencing, according to federal prosecutors.
Attorneys repping the seven people who have been arrested in connection to the case did not immediately respond Tuesday to requests for comment.
The alleged mastermind Sutton â who also goes by Mike Summers, Mike Miller and Ryan White, according to the court docket â could not be reached.
