A massive international crime ring that used fake phone calls and ghost doctors to bill American health insurance companies for nearly $2 billion has been broken up by federal authorities.
On Wednesday, a federal judge in Brooklyn sentenced Anthony Santamaria to 10 years in prison for his role in the scheme. Santamaria is the third member of the Moscow-based organization to be sentenced this month. His co-defendants, Hershel Tsikman and Hafizullah Ebady, previously received prison terms of 120 months and 97 months, respectively.
Federal officials say the group targeted private health insurance companies between 2017 and 2022. They took over more than 75 real pharmacies across the United States—including locations in Brooklyn, Staten Island, Manhattan, Long Island, New Jersey, Pennsylvania, Texas, Michigan, and Alabama.
The ring ran fake call centers, first in Utah and later in Russia. Employees called regular people and offered them free medication without any medical exams. Even if the people said no, the scammers used their information to write fake prescriptions anyway.
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To make the prescriptions look real, the group hired real doctors under false pretenses, telling them they were just reviewing notes from nurse practitioners. In reality, there were no medical visits at all. The scammers used the doctors’ names and identification numbers to submit giant bills to insurance companies. Many patients never even received the medication.
According to court records, the group submitted $1.97 billion in fake bills. Insurance companies ended up paying out more than $758 million before the fraud was stopped.
To hide the money, the group used fake names, encrypted messaging apps, and shell companies to send millions of dollars overseas.
“This Moscow-based criminal organization provided anything but health care,” said Assistant Attorney General Colin M. McDonald. “They executed a brazen international fraud scheme involving sham call centers, ghost telemedicine visits, and remotely controlled pharmacies.”
U.S. Attorney Joseph Nocella Jr. stated that the group built a sophisticated network over five years to steal hundreds of millions of dollars from American businesses and launder the money overseas.
“The takedown of this international criminal organization sends a clear message that those who exploit our American healthcare system for profit – no matter where they operate – will be identified, investigated, and prosecuted,” said FBI Assistant Director in Charge James Barnacle Jr.
The court ordered Santamaria to give up $3.2 million and Ebady to give up more than $1.8 million. All three men must also pay back their victims an amount that will be decided later.
A fourth defendant, Dela Saidazim, was sentenced to time served in late 2022. Three other defendants, David Bishoff, Brycen Millett, and Joshua Alegria, have pleaded guilty and are waiting to be sentenced. The accused leader of the ring, a U.S. citizen named Brian Sutton, is currently living abroad and remains at large.
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