Morris County woman charged in $10 million scheme to commit health care fraud

 

Date: March 24, 2023

Contact: newsroom@ci.irs.gov

Newark, NJ — A Morris County woman has been charged for her role in a conspiracy to commit health care fraud, U.S. Attorney Philip Sellinger announced today.

Aysha Khan of Kinnelon, New Jersey, is charged by indictment with one count of conspiracy to commit health care fraud and four counts of health care fraud. She was arrested today and will have her initial appearance this afternoon before U.S. Magistrate Judge Edward S. Kiel in Newark federal court.

According to documents filed in this case:

Khan controlled and operated a network of "specialty pharmacies" with locations in New Jersey, New York, Texas, and Florida. These pharmacies processed expensive medications used to treat various conditions, including Hepatitis C, Crohn's disease, and rheumatoid arthritis.

At Khan's direction, the pharmacies billed health insurance providers for medications that the pharmacies did not actually provide to patients. While the pharmacies generally provided medications for initial prescriptions it received, it systematically and intentionally billed for refills for those same medications without ever dispensing them. On certain occasions, the pharmacies also billed for initial prescriptions without ever shipping or dispensing them.

From 2015 through 2022, the Khan Pharmacies received over $10 million in reimbursement payments from Medicare for medications the pharmacy not only failed to give patients, but never ordered or had in stock.

The conspiracy to commit healthcare fraud count and the substantive healthcare fraud counts charged are each punishable by a maximum of 10 years in prison and a $250,000 fine, or twice the gross gain or loss from the offense, whichever is greatest.

U.S. Attorney Sellinger credited special agents and an analyst of IRS – Criminal Investigation, under the direction of Acting Special Agent in Charge Tammy L. Tomlins; postal inspectors of the U.S. Postal Inspection Service, under the direction of Inspector in Charge Daniel B. Brubaker, New York Division; special agents of the FBI, under the direction of Special Agent in Charge James E. Dennehy in Newark; and the Kinnelon Police Department, under the direction of Chief Joseph Napoletano, with the investigation leading to the charges and arrest.

The government is represented by Assistant U.S. Attorney George L. Brandley of the Health Care Fraud Unit in Newark.

The charges and allegations contained in the indictment are merely accusations, and the defendant is presumed innocent unless and until proven guilty.