Three men headed to prison for $2B healthcare fraud – but kingpin is in the wind

Three men are headed to prison for their roles in an elaborate international scheme to con health insurers by sending $2 billion of phony telemedicine prescriptions – but the plot’s alleged kingpin is on the lam.

Anthony Santamaria, 33, was sentenced Tuesday to serve 10 years behind bars – and forfeit $3.2 million – for his role in a massive insurance scam between 2017 and 2022, federal prosecutors said.

Two other fraudsters, 33-year-old Hershel Tsikman and 48-year-old Hafizullah Ebady, were sentenced earlier this month to 10 and eight years in prison, respectively, for their roles in the scheme, according to the US Department of Justice.

But Brian Sutton, 32, a US citizen and leader of the Russia-based criminal crew that allegedly orchestrated the plot, remains at large, government officials said.

The sprawling scheme – in which the crew bought up pharmacies in Brooklyn, Staten Island, Long Island and New Jersey and ran them through phony “straw owners” – allegedly involved the plotters contacting patients enrolled with the private insurers and offering medication to them at no cost.

The fraudsters then ordered prescriptions for the patients whether they agreed to try the medicine or not, and claimed to have held telemedicine visits that never actually happened, court papers say. Many of the patients never received the medicine.

“This Moscow-based criminal organization provided anything but health care,” said Colin McDonald, Assistant Attorney General for the DOJ’s National Fraud Enforcement Division, in a statement calling the plot a “brazen international fraud scheme involving sham call centers” and “ghost telemedicine visits.”

In total, the schemers submitted more than $1.97 billion in fraudulent prescriptions – with private insurers coughing up a whopping $758 million as a result, court papers say. The insurers were not identified.

A fourth defendant in the case, 36-year-old Dela Saidazim, was sentenced to time served in December 2022. Three more people, 41-year-old David Bishoff, 35-year-old Brycen Millett and 35-year-old Joshua Alegria, are awaiting sentencing, according to federal prosecutors.

Attorneys repping the seven people who have been arrested in connection to the case did not immediately respond Tuesday to requests for comment.

The alleged mastermind Sutton – who also goes by Mike Summers, Mike Miller and Ryan White, according to the court docket – could not be reached.