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Date: 12-14-2020
Case Style:
Case Number: 1:20-cr-00009-SPB
Judge: Susan Paradise Baxter
Court: United States District Court for the Western District of Pennsylvania (Allegheny County)
Plaintiff's Attorney: United States District Attorney’s Office, Pittsburgh, Pennsylvania
Defendant's Attorney:
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Description: Pittsburgh, Pennsylvania health care fraud criminal defense lawyers represented defendants, Mehran David Kohanbash, oseph Kohan and Nima Rodefshalom, who were charged with healthcare fraud, conspiracy to commit fraud, and conspiracy to violate the federal anti-kickback statutes.
Brothers Mehran David Kohanbash, and Joseph Kohan and their nephew, Nima Rodefshalom, entered pleas of guilty to three counts of a criminal Information before United States District Judge Susan Paradise Baxter. In addition to the three individual defendants, 16 pharmacies scattered between California, Texas, Wyoming, Arizona and Nevada also entered guilty pleas. Those pleading guilty included Insure Nutrition, Inc., Affordable Pharmacy, Inc., ASC Pharmaceutical, LLC, DQD Enterprise Corporation, DTST Ventures, LLC, Econo Pharmacy, Inc., Emerson Pharmacy, Inc., Genorex Pharmaceutical, LLC, Nutrition Plus, Inc., Pharmatek Pharmacy, Inc., Premier Med Services, Inc., Rexford Pharmacy, Inc., Specialty Pharmacy Management of America, Inc., Solutech Pharmaceuticals, LLC, Village Drug & Compounding, Inc., and Vitamed LLC.
"For nearly five years, these defendants executed elaborate schemes to steal millions of dollars from health care systems across the United States, including both Highmark and TRICARE beneficiaries in Erie, Pennsylvania," said U.S. Attorney Brady. "Where fraudsters target our veterans or vulnerable members of our community, especially relating to their health care, we will come after them."
"These defendants intended to defraud our healthcare systems and deprive patients of their right to honest services," said FBI Pittsburgh Special Agent in Charge Michael Christman. "They manipulated patients who were seeking bariatric treatment and preyed on their emotions, all to get the patient’s health insurance information. Without thinking twice, these defendants lined their pockets while putting a burden on our taxpayer-funded and private healthcare systems that in turn drives up insurance costs for everyone. Thank you to our partners, the United States Attorney’s Office and Department of Defense, Defense Criminal Investigative Service for their efforts on this investigation and prosecution."
"These Plea Agreements demonstrate the continued commitment of the Defense Criminal Investigative Service, partnering with the Federal Bureau of Investigation, the Defense Health Agency, and the United States Attorney's Office in the Western District of Pennsylvania, to protect the American taxpayer and its military members from those that exploit our nation's healthcare programs including TRICARE," said Bryan Denny, Patrick Hegarty, and Chris Dillard, Special Agents in Charge, U.S. Department of Defense Inspector General, Defense Criminal Investigative Service. "False and inappropriate billings, by virtue of intended schemes or willful ignorance, place the American Warfighter in danger, erode public confidence and undermine the mission of our military services. DCIS and its law enforcement partners will continue to investigate healthcare fraud allegations in order to protect U.S. military members and the American taxpayer."
According to the information presented to the Court at the time of the pleas the three defendants conspired together to execute health care fraud schemes that targeted patients that had undergone, or were to undergo, bariatric surgical procedures. The individual defendants together with the defendant pharmacies engaged in a series of interconnected actions that resulted in misleading advertising associated with supplying what were described to the Court as nutritional shakes; the inducement to enlist various patients in ordering the nutritional shakes resulted in the defendants and the pharmacies securing the patients’ insurance information which in turn resulted in the defendants (individual defendants and by and through the pharmacies) soliciting the patients to appeal to their respective physicians to prescribe what were described for the Court as High Yield (expensive) medications.
These medications were often compounded, meaning that one or more of the pharmacies mixed together preexisting medications or substances to provide a new or different product. It was a part of the scheme(s) involved in the guilty pleas that the defendants conspired to promote these medications that often yielded extremely high profits. It was a part of the healthcare fraud scheme that the defendants defrauded healthcare benefit programs, both private insurance carriers and the government run health care program, TRICARE, for military members and their families, by manipulating the collection of co pays on various medications to make it appear that co pays were being collected when in fact they were not. An honest reporting of the failure to collect co pays would have resulted in the defendants being unable to bill insurance carriers for the cost of the various medications. The various schemes in which the defendants were involved were overlapping and ran from September of 2013 through May of 2018.
Judge Susan Paradise Baxter scheduled sentencing for April 7-8, 2020 for the individual defendants. Sentencing for the defendant pharmacies has not been scheduled. For each individual defendant, the law provides for a maximum total sentence of 35 years in prison, a fine of $750,000, or both.The three defendants and the 16 corporations agreed to forfeiture, restitution, fines and civil penalties amounting to more than $60,000,000. Under the Federal Sentencing Guidelines, the actual sentence imposed is based upon the seriousness of the offense and the prior criminal history, if any, of the defendant(s).
Pending sentencing, the court released each of the individual defendants on bail.
Assistant United States Attorneys Shardul S. Desai and James R. Wilson are prosecuting this case on behalf of the government.
18:371 CONSPIRACY (ANTI-KICKBACK)
(1)
18:1349 FRAUD CONSPIRACY
(2)
18:1347 HEALTH CARE FRAUD
(3)
Outcome: 12/14/2020 34 ORDER granting 33 Oral Motion to Conduct Waiver and Plea Hearing via Videoconference as to NIMA RODEFSHALOM (1). Signed by Judge Susan Paradise Baxter on 12/7/2020. Text-only entry; no PDF will issue. This Text-only entry constitutes the Order of the Court or Notice on the matter. (esa) (Entered: 12/14/2020)
12/14/2020 35 Minute Entry for proceedings held before Judge Susan Paradise Baxter: Waiver & Plea Hearing as to NIMA RODEFSHALOM held on 12/7/2020. Defendant sworn. Defendant wishes to waive his right to an Indictment by a Grand Jury and plead guilty to Counts One, Two, and Three of the Information. Defendant and Attorney Stallings executed the Waiver of Indictment form and the Judge accepted the Waiver and executed the same. There is a Plea Agreement in this case. Defendant and Attorney Stallings executed the plea form and Defendant was adjudge guilty to Counts One, Two, and Three of the Information. Sentencing is set for April 7, 2021 at 1:30 PM. (Court Reporter: Janis Ferguson) (Attachments: # 1 Plea Agreement) (esa) (Entered: 12/14/2020)
12/14/2020 36 WAIVER OF INDICTMENT by NIMA RODEFSHALOM (esa) (Entered: 12/14/2020)
12/14/2020 37 PLEA ENTERED: Defendant pleads Guilty to Count(s) 1-3 as to NIMA RODEFSHALOM (esa) (Entered: 12/14/2020)
12/14/2020 38 Sealed Plea Supplement as to NIMA RODEFSHALOM, filed in accordance with the Court's Standing Order at Miscellaneous No. 17-447. (Attachments: # 1 Second Supplement) (esa) (Entered: 12/14/2020)
12/14/2020 39 Order of Referral to Probation for Presentence Investigation and Report as to NIMA RODEFSHALOM. Signed by Judge Susan Paradise Baxter on 12/7/2020. (esa) (Entered: 12/14/2020)
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