A Margate doctor is among three people federally indicted for defrauding state health benefits programs out of millions.
Brian Sokalsky, D.O., who also has a practice in Somers Point, is charged in a 33-count indictment along with Vincent Tornari, 46, of Linwood, and advanced practice nurse Ashley Lyons-Valenti, 63, of Swedesboro.
The three allegedly cost the companies $6 million.
The indictments are the latest moves in a far-reaching scheme that enlisted doctors, public employees and pharmaceutical representatives to take advantage of health benefits through prescriptions for expensive and unnecessary compounding medications.
Michael Goldis, a 64-year-old doctor from Mt. Laurel, pleaded guilty Thursday to signing four prescriptions for individuals who were not his patients.
Goldis admitted that he received $1,000 checks on the same days he signed two of the prescriptions and received a total of $4,700.
He faces a maximum penalty on each count of five years in prison and a $250,000 fine, or twice the gross gain or loss from the offense. Sentencing is scheduled for Nov. 6.
Sokalsky, Tornari and Lyons-Valenti are charged in several conspiracies.
In the first conspiracy, Matthew Tedesco — who previously pleaded guilty to conspiracy to commit health care fraud — had an arrangement with Sokalsky to send the doctor new patients in exchange for Sokalsky prescribing them Compounding Pharmacy 1 medications, according to the indictment.
Tedesco sent the recruited individuals to Sokalsky and often tipped him off that they were coming. Sokalsky prescribed Compounding Pharmacy 1 medications for the patients, including medications that patients did not need or discuss with him.
Sokalsky profited by billing insurance for more than 30 new patients.
The completed prescriptions were faxed to Compounding Pharmacy 1, which filled the prescriptions and billed the Pharmacy Benefits Administrator. The Pharmacy Benefits Administrator paid Compounding Pharmacy 1 over $5 million for compounded medications prescribed by Sokalsky.
The indictment charges Sokalsky and Tornari with a similar scheme to write fraudulent prescriptions for Compounding Pharmacy 2.
Tornari’s company had an agreement with Compounding Pharmacy 2 to receive 50 percent of the insurance payment for prescriptions they arranged.
Tornari then hired Mark Bruno to find patients who would agree to receive Compounding Pharmacy 2 medications in exchange for cash payments.
Tornari had Sokalsky agree to write Compounding Pharmacy 2 prescriptions for new patients sent to him.
Bruno found patients and sent them to Sokalsky, often after letting Sokalsky know that they were coming.
Sokalsky wrote Compounding Pharmacy 2 prescriptions that the patients did not need or discuss with Sokalsky, sometimes without even seeing the patients.
These prescriptions cost insurers more than $500,000.
In a third charged scheme, Tornari hired Lyons-Valenti’s boyfriend and agreed to pay him commissions on each Compounding Pharmacy 2 prescription that Lyons-Valenti wrote, according to the indictment.
Lyons-Valenti then started writing Compounding Pharmacy 2 prescriptions and Tornari paid commissions to the boyfriend, who gave Lyons-Valenti half of the commission payments.
Lyons-Valenti persuaded her workers and subordinates at her medical office to receive Compounding Pharmacy 2 prescription medications that they did not need, often without giving them a medical examination or recording the prescriptions in their medical records.
Lyons-Valenti wrote Compounding Pharmacy 2 prescriptions for which insurance paid more than $1.25 million and received more than $90,000 in kickbacks in return, the charges claim.
In a fourth scheme, Lyons-Valenti signed five Compounding Pharmacy 1 prescriptions for Judd Holt, who previously pleaded guilty to conspiracy to commit health care fraud for his role in the scheme.
On each of the five prescriptions, Lyons-Valenti falsely stated that she had examined the patient’s medical records, conducted a face-to-face examination of the patient, and determined that the prescribed medications were medically necessary, when in fact she had never met or examined any of the five patients, the indictment claims.
Lyons-Valenti also was charged with witness tampering for allegedly making false and misleading statements to a co-worker who was a federal grand jury witness.
Lyons-Valenti called and texted the witness before and after the witness talked to the FBI and before the witness was scheduled to testify in the grand jury, the government claims.
Lyons-Valenti allegedly told the witness to tell the FBI that Lyons-Valenti had examined the witness before prescribing medications for the witness.
Lyons-Valenti also falsely told the witness that Lyons-Valenti had never received any money for writing the prescriptions, the government claims.
The health care fraud and wire fraud conspiracy count carries a maximum potential penalty of 20 years in prison and a $250,000 fine, or twice the gain or loss from the offense.
Each wire fraud count carries a maximum potential penalty of 20 years in prison and a $250,000 fine, or twice the gain or loss from the offense.
Each health care fraud count carries a maximum penalty of 10 years in prison and a $250,000 fine, or twice the gross gain or loss from the offense.
The honest services conspiracy count and the false statement counts each carry a maximum penalty of five years in prison and a $250,000 fine, or twice the gross gain or loss from the offense. The witness tampering charge carries a maximum penalty of 20 years in prison and a $250,000 fine, or twice the gross gain or loss from the offense.
Dr. John Gaffney, 55, of Linwood: Margate doctor must forfeit $25,000. Cost: $24.9 million
Mike Pepper, 45, of Northfield: Atlantic City firefighter must forfeit $113,627.54. Cost: $719,000
Nicholas Tedesco, 44, of Linwood: local candy retailer must forfeit $782,766.56. Cost: $2 million
Tara LaMonaca, 43, of Linwood: Pharmaceutical representative must forfeit $89,855.13. Cost: $530,527
William Hunter, 43, of Sewell: Salesman must forfeit $245,020.08. Cost: $1.3 million
Judd Holt, 42, of Marlton: Pharmaceutical representative must forfeit $95,574.49. Cost: $769,762
Steven Urbanski, 37, of Marlton: Pharmaceutical representative must forfeit $113,600. Cost: $250,000
Corey Sutor, 37, of Ventnor: Ventnor firefighter, must forfeit $150,397.79. Cost: $2 million.
Mark Bruno, 45, of Northfield: Pharmaceutical representative, received $68,872. Cost: $524,935
