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Two Los Angeles Pharmacy Owners Sentenced for Multimillion-Dollar Scheme that Billed Medicare, Cigna $11.8 Million in Fraudulent Medication Claims
justice.gov ^ | February 26, 2020 | DOJ

Posted on 02/27/2020 10:34:15 AM PST by ransomnote

Two owners and operators of a Los Angeles pharmacy were both sentenced today to 144 months in prison for their roles in a health care fraud scheme where Medicare and CIGNA were billed more than $11.8 million in fraudulent claims for prescription drugs.

Assistant Attorney General Brian A. Benczkowski of the Justice Department’s Criminal Division, U.S. Attorney Nicola T. Hanna of the Central District of California, Special Agent in Charge Timothy DeFrancesca of the U.S. Department of Health and Human Services Office of the Inspector General’s (HHS-OIG) Los Angeles Regional Office, Assistant Director in Charge Paul Delacourt of the FBI’s Los Angeles Field Office, Special Agent in Charge Ryan L. Korner of IRS Criminal Investigation’s (IRS-CI) Los Angeles Field Office and Special Agent in Charge Kris Lyle of the California Department of Justice made the announcement.

Aleksandr Suris, 51, of Sherman Oaks, California, was sentenced to 144 months in prison by U.S. District Judge S. James Otero of the Central District of California, who also ordered Suris to pay restitution of $11,826,444.65 to Medicare and $17,109.39 to CIGNA.  The court ordered Suris to make an immediate partial restitution payment of $500,000.  Maxim Sverdlov, 45, also of Sherman Oaks, was sentenced to 144 months in prison by Judge Otero, who ordered him to pay $11,826,444.65 in restitution to Medicare.  The court ordered Sverdlov to make an immediate partial restitution payment of $500,000. 

On Aug. 20, 2019, after an 11-day trial, a jury found Suris guilty of two counts of conspiracy to commit health care fraud, six counts of health care fraud, and one count of conspiracy to commit money laundering.  The jury found Sverdlov guilty of one count of conspiracy to commit health care fraud and one count of conspiracy to commit money laundering. 

Suris and Sverdlov were the co-owners and co-operators of Royal Care Pharmacy (Royal Care) in Hollywood.  According to the evidence presented at trial, from 2012 to 2015, Suris and Sverdlov fraudulently billed Medicare and CIGNA for prescription medications that Royal Care did not actually purchase or dispense to beneficiaries.  In order to hide the fraud, Suris and Sverdlov obtained fake drug invoices from co-conspirators to make it appear as if Royal Care had purchased the medicines for which it had billed Medicare and CIGNA, when it actually had not.  Suris and Sverdlov also used these fake invoices to launder the proceeds of the fraud through a co-conspirator.  In total, Suris and Sverdlov submitted more than $11.8 million in bogus claims to Medicare for prescription drugs that they never purchased or dispensed to patients.

This case was investigated by HHS-OIG, the FBI, IRS-CI and the California Department of Justice, and was brought as part of the Medicare Fraud Strike Force, under the supervision of the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Central District of California.  Trial Attorney Robyn N. Pullio and Assistant Chief Daniel J. Griffin of the Fraud Section prosecuted the case.

The Fraud Section leads the Medicare Fraud Strike Force. Since its inception in March 2007, the Medicare Fraud Strike Force, which maintains 15 strike forces operating in 24 districts, has charged more than 4,200 defendants who have collectively billed the Medicare program for nearly $19 billion.  In addition, the HHS Centers for Medicare & Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.

The year 2020 marks the 150th anniversary of the Department of Justice.  Learn more about the history of our agency at www.Justice.gov/Celebrating150Years.

Topic(s): 
Health Care Fraud
Component(s): 


TOPICS: Miscellaneous
KEYWORDS: cigna; fraud; medicare

1 posted on 02/27/2020 10:34:15 AM PST by ransomnote
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To: ransomnote

Every time you see medical fraud. It’s nearly always Russians, Muslims or Indians.


2 posted on 02/27/2020 10:36:39 AM PST by setter
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To: ransomnote

This is illustrative of the problems when government administrates programs. Why does fraud have to grow to such screaming levels before it is detected. Ans: It’s not my money so I don’t care so much.


3 posted on 02/27/2020 10:36:48 AM PST by ScarletRed
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To: ransomnote
Why did I know...they would have surnames like Jones, and Williams??

Oh they didn't...I'm embarrassed.

4 posted on 02/27/2020 10:37:54 AM PST by Osage Orange (Whiskey Tango Foxtrot)
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To: setter

Some immigrants seem to very quickly devise ways to scam the government or the general public. Medical fraud, food stamp fraud, day care fraud—you name it.


5 posted on 02/27/2020 10:39:20 AM PST by rightwingintelligentsia (Democrats: The perfect party for the helpless and stupid, and those who would rule over them.)
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To: rightwingintelligentsia

Russian and albanian mobs have been doing it forever.

no way they weren’t behind this too, wherever these guys are from


6 posted on 02/27/2020 10:42:26 AM PST by dp0622 (Radicals, racists Don't point finger at me I'm a small town white boy Just tryin' to makne ends meet)
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To: setter

Didn’t Menendez, NJ (D) have Dominican buddy involved in Medicare fraud?


7 posted on 02/27/2020 10:48:54 AM PST by Calvin Locke
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To: setter

US taxpayers and anyone who pays for their own insurance and medical care has to pick up the tab


8 posted on 02/27/2020 10:49:33 AM PST by SMARTY ("Nobility is defined by the demands it makes on us - by obligations, not by rights".)
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To: ransomnote

WOW. More crooks. Seize their assets & lock them up


9 posted on 02/27/2020 10:53:24 AM PST by FES0844
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To: rightwingintelligentsia

“Some immigrants seem to very quickly devise ways to scam the government or the general public”

That is how 2nd and 3rd world countries operate. The MO.

I had some Indian clients. All they did was rip off the system and bend rules.


10 posted on 02/27/2020 11:03:41 AM PST by setter
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To: setter

Or Hasidic Jews. In here Lakewood, NJ two years ago they arrested a dozen of them who had committed millions in welfare and Social Security fraud. Not one of them did any jail time.


11 posted on 02/27/2020 11:04:31 AM PST by jmacusa (If we're all equal how is diversity our strength?)
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To: jmacusa

It seems that they should be fingered by the AI systems before they get to this dimension. Is there a law or manpower that prevents auditing a detecting fraud?


12 posted on 02/27/2020 11:31:11 AM PST by Oldexpat (Stand strong VA.)
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To: Oldexpat
I don't know. What I would like to know in regards to the Lakewood, NJ thing was who approved all the applications?
13 posted on 02/27/2020 10:45:23 PM PST by jmacusa (If we're all equal how is diversity our strength?)
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To: ransomnote

ANYTHING the government has control over this BS happens the government is incompetent because it is NOT their money, YEAH let’s nationalize healthcare so the fraud can run rampant!!!!


14 posted on 02/27/2020 10:51:16 PM PST by Trump Girl Kit Cat (Yosemite Sam raising hell)
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To: Trump Girl Kit Cat

So far these cases have taken place during Obama’s “reign”. This one is 2012 through 2015.
I agree we shouldn’t nationalize healthcare.


15 posted on 02/27/2020 10:55:38 PM PST by ransomnote (IN GOD WE TRUST)
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