U.S. Attorney for New Jersey Philip Sellinger announced Nov. 29 that two owners of a Garden State pharmaceutical marketing company admitted their roles in a $38 million compounded medication health care fraud scheme.
Samantha Zaretzky and Lee Nichols, owners of Synergy Medical LLC, pleaded guilty by video conference to one count each of conspiracy to commit health care fraud.
According to court documents and statements, the two were accused of exploiting the manner in which health insurance plans processed, screened and paid for customized drugs, known as “compound medications,” causing tens of millions of dollars in losses to several health insurance plans over two years.
The pair pocketed millions of dollars through this scheme.
“From April 2014 to June 2016, Zaretsky and Nichols used Synergy as a platform through which they could market prescription-based compound medications without regard to whether a health insurance beneficiary actually needed such a medication or whether an FDA-approved medication would have been appropriate and sufficient,” the court documents said. “Zaretsky and Nichols and their conspirators determined which combination of compounded ingredients was most financially lucrative. Through their sales representatives, they recruited health insurance beneficiaries who were willing to obtain these expensive, but medically unnecessary, compounded medications before a medical professional had evaluated the beneficiaries’ unique and individualized need for the medications.”
The health care fraud conspiracy charge carries a maximum prison sentence of 10 years and a fine of $250,000 or twice the gross gain or loss from the scheme, whichever is greatest.
Sentencing is scheduled for April 23, 2023.