Pharmacy Owner Sentenced to Four Years in Prison for Health Care Fraud

www.Justice.gov, Press Release, April 18, 2024

Damian Williams, the United States Attorney for the Southern District of New York, announced that NERIK ILYAYEV was sentenced today to four years in prison for his involvement in a multimillion-dollar health care fraud scheme that targeted the Medicare and Medicaid programs and private insurance companies.  ILYAYEV owned and operated two different pharmacies and submitted millions of dollars in fraudulent claims to the government health care programs and private insurers.  ILYAYEV previously pled guilty to one count of conspiracy to commit health care fraud before U.S. District Judge Gregory H. Woods, who imposed today’s sentence.  

According to the Complaint, Information, court filings, and statements made in public court proceedings:

From approximately February 2021 through March 2022, ILYAYEV owned and operated a pharmacy in Manhattan (“Pharmacy-1”).  ILYAYEV used Pharmacy-1 to pay illegal kickbacks to low-income HIV patients to recruit them to fill prescriptions for expensive HIV medications at Pharmacy-1.  ILYAYEV did not actually obtain or provide HIV medications to these illegally recruited patients, but instead bought unopened bottles of pills back from the patients at a small fraction of their true value so he could re-use the same pills over and over again.  ILYAYEV, on behalf of Pharmacy-1, then submitted fraudulent insurance claims to Medicare and Medicaid to cover the cost of the HIV medications he claimed to be dispensing.  In order to conceal his role in the fraud scheme, ILYAYEV used the identity of another person (“Individual-1”) and pretended to be Individual-1 to own and operate Pharmacy-1.  Medicare and Medicaid collectively paid approximately $5.2 million in fraudulent claims for HIV medications to Pharmacy-1. Continue Press Release