Seven defendants have pleaded guilty to conspiracy to commit health care fraud and, while awaiting sentencing,
have watched the government seize a number of expensive toys, including a 1936 Ford Deluxe, a 1964
Chevrolet Corvette convertible, a 1967 Chevrolet Camaro, a 1970 Chevrolet Monte Carlo and a 2008
Lamborghini convertible. Also recovered was a 50’ “Cigarette” racing boat. The cars, boat, and several
properties had all been purchased with the proceeds of a $100 million fraud scheme involving prescription
According to the court documents, defendants in the case, including ringleader Nicholas A. Borgesano, Jr.,
admitted to manipulating billing codes in reimbursement claims to Medicare, Tricare, and a number of private
insurance companies. The conspirators also submitted reimbursement claims for pharmaceutical ingredients
they did not have, and paid kickbacks and bribes in exchange for prescriptions and patient identifying
information, including paying kickbacks to a physician in exchange for the physician signing prescriptions for
patients he never saw.
Borgesano, in furtherance of the scheme, acquired a number of pharmacies in the Miami, Florida area (six in
total). He and his co-conspirators utilized the pharmacies to submit false and fraudulent reimbursement claims
for the prescription compounded medications, primarily pain creams and scar creams.
This is another example of the government pursuing healthcare fraud charges filed for private healthcare payors
as well as government payors. The scheme was uncovered by the Medicare Fraud Strike Force and included
elements of the FBI, Department of Health and Human Services, Office of Inspector General, and the Defense
Criminal Investigative Service. Since its creation in 2007, the Strike Force has charged over 3,500 defendants in
schemes to defraud Medicare.
All eight defendants are currently awaiting sentencing.
The FisherBroyles Pharmacy and Health Care Law team will continue to track issues of importance, along
with notable accounts of fraud and wrongdoing, in the pharmaceutical and health care industries. We
welcome your questions. Please contact any of the following attorneys: