By: Richard L. Smith
According to information released by the U.S. Department of Justice, federal authorities have charged multiple individuals and reached civil settlements with healthcare providers and companies—some based in New Jersey—as part of a national effort to combat health care fraud schemes targeting Medicare, Medicaid, TRICARE, and private insurers.
In total, 15 defendants connected to the District of New Jersey were charged or settled allegations as part of the DOJ’s 2025 National Health Care Fraud Takedown.
The coordinated enforcement action involved over 300 individuals across the country and addressed more than $14.6 billion in intended fraud.
Among the New Jersey-related matters:
• Alan Vaughan, 56, of the United Kingdom, was charged with conspiracy to pay illegal kickbacks in a scheme involving cancer genetic testing and durable medical equipment. Vaughan allegedly routed millions in kickbacks through a shell company in New Zealand, resulting in more than $80 million in losses to Medicare.
• Taejin Kim, 43, a licensed physical therapist from River Vale, was charged with conspiring to submit fraudulent claims to Amtrak’s healthcare plan for services never rendered. The scheme caused over $2.2 million in losses.
• Nestor E. Jaime, 36, of Pine Brook, and the owner of a pharmacy, is accused of submitting false Medicare claims for expensive drugs that were neither prescribed nor dispensed. Medicare paid his pharmacy over $2.5 million in connection with the alleged fraud.
• Newark Beth Israel Medical Center agreed to pay $250,000 to settle allegations that its Heart Transplant Program performed medically unnecessary procedures between 2018 and 2019 by failing to provide critical health information to patients and their families.
Several New Jersey pharmacies and dental groups also settled allegations involving fraudulent claims:
• Excel Pharmacy Inc. (Jersey City): $3 million
• QuickRx LLC/Community Pharmacy (Elizabeth): $962,821
• Raghu Ram Inc./Camden Discount Pharmacy (Camden): $310,000
• Rachit Drug Inc. (Newark): $225,000
• Premier Dental Holdings and affiliates: $540,000 for billing violations involving uncredentialed providers.
These actions reflect a broader federal initiative to dismantle fraudulent operations in the healthcare industry.
Officials emphasized the gravity of the threat and the collaborative effort among federal and state agencies.
The cases in New Jersey are being prosecuted by Assistant U.S. Attorneys from the District of New Jersey, and investigations were conducted by federal health care fraud task forces in coordination with HHS-OIG, FBI, and other law enforcement agencies.
Authorities reiterated their commitment to protecting public funds and ensuring patient safety by holding fraudulent actors accountable.