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NJ Man Sentenced to Three Years in Federal Prison for Defrauding State Healthcare Program of $50M


By: Richard L. Smith 

A federal Judge in South Jersey sentenced an N.J. man to just over three years in jail for his role in defrauding New Jersey state and local health benefits programs and other insurers by submitting fraudulent claims for medically unnecessary prescriptions, Attorney for the United State Vikas Khanna reported. 

Federal officials said Brian Pugh, 45, of Absecon, previously pleaded guilty before U.S. District Judge Robert B. Kugler to a superseding information charging him with one count of conspiring to defraud a health care benefits program. Judge Kugler imposed the sentence Monday in Camden federal court.

According to documents in this matter and statements made in court:

Pugh was part of a criminal conspiracy in which state and local government employees were recruited and compensated to receive medically unnecessary compound prescription medications.

Federal officials said Pugh and his conspirators defrauded New Jersey health benefits programs and other insurers of more than $50 million.

Pugh directly caused the pharmacy benefits administrator to pay more than $1.4 million for medically unnecessary compound prescription medications for individuals he recruited into the scheme. 

He also received more than $430,000 in the conspiracy.

In addition to the prison term, Judge Kugler sentenced Pugh to three years of supervised release and ordered restitution of more than $1.4 million and forfeiture of $437,604.