The U.S. Attorney General announced that a Bordentown doctor was sentenced this month for an admitted role in defrauding state health benefits programs and accepting kickback in exchange for referring laboratory work.
U.S. Attorney Craig Carpenito released a Dec. 16 announcement that 48-year-old Dr. Daniel Oswari of Bordentown pleaded guilty before U.S. District Judge Robert B. Kugler in the United States District Court for the District of New Jersey in Camden to two counts of an indictment charging him with conspiracy to commit health care fraud and wire fraud (count one) and conspiracy to violate the Anti-Kickback Statute and the Travel Act (count 23).
Oswari was charged in October 2019 along with Steven Monaco, Michael Goldis and Aaron Jones, and charges remain pending against those three defendants, officials said.
According to documents filed in these cases and statements made in court, compounded medications are specialty medications mixed by a pharmacist to meet the specific medical needs of an individual patient.
Although compounded drugs are not approved by the Food and Drug Administration (FDA), they are properly prescribed when a physician determines that an FDA-approved medication does not meet the health needs of a particular patient, such as if a patient is allergic to a dye or other ingredient.
Between January 2014 and April 2016, officials said Oswari participated in a conspiracy that discovered that certain insurance plans paid for certain prescription compound medications – including vitamins and pain creams – from a Louisiana pharmacy, identified in the indictment as the “Compounding Pharmacy 1,” and a Pennsylvania pharmacy, identified in the indictment as “Compounding Pharmacy 2.”
The conspirators targeted patients with these insurance plans that provided coverage for the compound medications, particularly New Jersey state and local government and education employees, according to officials.
An entity referred to in the indictment as the “Pharmacy Benefits Administrator,” provided pharmacy benefit management services for the State Health Benefits Program, which covers qualified state and local government employees, retirees and eligible dependents, the school employees’ Health Benefits Program, which covers qualified local education employees, retirees and eligible dependents, and other insurance plans.
The pharmacy benefits administrator paid prescription drug claims and then billed the State of New Jersey or the other insurance plans for the amounts paid.
Officials reported that Oswari and members of his staff tried to persuade patients to receive the prescription compound medications, even if the patients did not have a medical necessity for the medications.
Oswari signed printed prescription forms from Compounding Pharmacies 1 and 2 that had pre-selected the highest number of refills to obtain the highest possible insurance reimbursement and signed some prescriptions without seeing or evaluating the individuals, including for individuals who were not his patients, according to officials.
Oswari signed approximately 285 prescriptions for compounded medications, and the Pharmacy Benefits Administrator paid Compounding Pharmacies 1 and 2 approximately $1.9 million for the prescriptions he signed, officials reported. In exchange for signing the prescriptions, Oswari received cash kickbacks.
Oswari also pleaded guilty to a separate conspiracy to take kickbacks for referring laboratory work and signing prescriptions. Officials said Oswari had a laboratory hire his medical assistant as a phlebotomist.
The medical assistant continued to work for Oswari, but laboratory paid her salary for over two years. In return, Oswari referred his blood and urine samples to the laboratory for testing, according to officials. This lab work was insured by Medicare, New Jersey Medicaid and other insurance companies, officials reported.
The health care fraud and wire fraud conspiracy count to which Oswari pleaded guilty carries a maximum potential penalty of 20 years in prison and a $250,000 fine, or twice the gain or loss from the offense.
The kickbacks conspiracy count to which Oswari also pleaded guilty carries a maximum penalty of five years in prison and a $250,000 fine, or twice the gross gain or loss from the offense.
Sentencing for Oswari is scheduled for March 23, and sentencing for Bruno is scheduled for March 24.