15 Charged in New Jersey as Part of $14.6 Billion National Health Care Fraud Crackdown

Federal authorities target physicians, pharmacies, and clinics across New Jersey in coordinated effort to curb widespread medical fraud affecting Medicare and Medicaid.

As part of a sweeping national initiative targeting health care fraud, federal authorities have charged 15 individuals and entities in New Jersey with participating in schemes that allegedly defrauded public health programs of millions of dollars. The enforcement action is part of the Department of Justice’s 2025 National Health Care Fraud Takedown, which announced charges against 324 defendants nationwide involving over $14.6 billion in intended losses.

The coordinated federal crackdown spans 50 judicial districts and includes criminal and civil actions against doctors, pharmacists, and medical businesses accused of exploiting Medicare, Medicaid, TRICARE, and private insurers. In the District of New Jersey, the accused are alleged to have submitted false claims for unnecessary treatments, billed for undelivered medications, and participated in kickback schemes designed to drive prescriptions and testing orders.

“My Office, in lockstep with the Department’s nationwide Health Care Fraud Takedown, is cracking down on corrupt physicians, pharmacies, and healthcare providers who exploit Medicare and Medicaid with shameless kickback schemes, unnecessary prescriptions, and phony reimbursements for unneeded drugs, medical devices, and genetic tests – or drugs never even delivered. These predatory schemes prioritize profits over patients, and the District of New Jersey is fiercely committed to rooting out this fraud and ensuring those responsible face justice.” - U.S. Attorney Alina Habba

Among those charged is Alan Vaughan, 56, of the United Kingdom, accused of orchestrating a kickback scheme involving durable medical equipment and cancer genetic tests. Prosecutors allege Vaughan funneled Medicare patient information to telemedicine firms and laboratories in exchange for illegal payments, causing an estimated $80 million loss to Medicare.

Taejin Kim, 43, a licensed physical therapist from River Vale, New Jersey, faces charges for a separate conspiracy involving fraudulent claims submitted under Amtrak’s health plan. Allegedly, Kim used employee insurance data to bill for services that were never rendered, leading to $2.25 million in improper reimbursements.

Also charged is Nestor E. Jaime, 36, of Pine Brook, a pharmacy owner accused of submitting false prescription drug claims to Medicare totaling over $2.5 million. Prosecutors assert that his pharmacy neither dispensed the medications nor had valid prescriptions on file.

In addition to criminal charges, several New Jersey-based health care businesses have agreed to civil settlements. Newark Beth Israel Medical Center will pay $250,000 to resolve claims that doctors in its Heart Transplant Program failed to adequately inform patients of their medical conditions, allegedly resulting in medically unnecessary treatments between 2018 and 2019.

Four pharmacies—Excel Pharmacy Inc. in Jersey City, QuickRx LLC in Elizabeth, Camden Discount Pharmacy, and Rachit Drug Inc. in Newark—will collectively pay over $4.4 million to settle allegations of billing for drugs never dispensed.

Dental provider Premier Dental Holdings and its affiliates agreed to pay $540,000 to resolve allegations involving services rendered by uncredentialed providers who billed under the credentials of other dentists.

The U.S. Attorney’s Office for the District of New Jersey collaborated with the Department of Health and Human Services’ Office of Inspector General (HHS-OIG), the FBI, and Amtrak’s Office of Inspector General during the investigation. All criminal defendants are presumed innocent unless proven guilty in a court of law.

Federal officials emphasized the scale and impact of these schemes, asserting that they endanger patient care and drain resources from vital public health programs. The takedown represents one of the largest concerted efforts to date to address fraud in the U.S. health care system.

The following individuals were charged and entered settlements in the District of New Jersey:

• Alan Vaughan, 56, of the United Kingdom, was charged with conspiracy to violate the federal anti-kickback statute in connection with a scheme to generate referrals for durable medical equipment and cancer genetic tests. As alleged in the indictment, Vaughan paid kickbacks to several marketers in exchange for personal health and insurance information about Medicare beneficiaries, transmitted that information to telemedicine companies, and then received kickbacks from genetic testing laboratories and durable medical equipment supply companies for each item of durable medical equipment and/or each cancer genetic test for which Medicare provided reimbursement. As further alleged, to conceal the scheme, Vaughan and his co-conspirators received millions of dollars in kickbacks through a shell company in New Zealand. As a result of the alleged scheme, Vaughan and his co-conspirators caused a loss to Medicare of more than $80 million. The case is being prosecuted by Assistant U.S. Attorney Garrett J. Schuman of the U.S. Attorney’s Office for the District of New Jersey.
• Taejin Kim, 43, of River Vale, New Jersey, was charged by information with conspiracy to commit health care fraud in connection with a scheme to submit false and fraudulent claims to Amtrak’s health care plan for services that were never provided and were medically unnecessary. As alleged in the information, Kim, a licensed physical therapist, participated in a conspiracy to use Amtrak employees’ insurance information to submit false and fraudulent claims for services that were medically unnecessary and never provided to the Amtrak employees. Amtrak paid approximately $2,253,453 on these claims. The case is being prosecuted by Assistant U.S. Attorneys Jessica R. Ecker and Katie M. Romano of the U.S. Attorney’s Office for the District of New Jersey.
• Nestor E. Jaime, 36, of Pine Brook, New Jersey, was charged by indictment with health care fraud in connection with a scheme to submit fraudulent prescription drug claims to Medicare. As alleged in the indictment, Jaime, a pharmacy owner, engaged in a scheme to submit fraudulent claims to Medicare for a high-reimbursement medication that the pharmacy never dispensed and for which the pharmacy never received any prescriptions from the purported beneficiaries’ health care providers for the medication. Medicare paid Jaime’s pharmacy $2,505,754 for these false and fraudulent claims. The case is being prosecuted by Assistant U.S. Attorney Jessica R. Ecker of the U.S. Attorney’s Office for the District of New Jersey.
• Newark Beth Israel Medical Center (“NBIMC”), located in Newark, New Jersey, has agreed to pay the United States $250,000 to resolve allegations that from January 1, 2018 through December 31, 2019, doctors working in NBIMC’s Heart Transplant Program failed to adequately disclose to patients and their family members material medical information about patients’ conditions. The United States contends that this conduct resulted in NBIMC performing medically unnecessary treatment on these patients. The case is being handled by Assistant U.S. Attorney Robert Toll of the U.S. Attorney’s Office for the District of New Jersey.
• Excel Pharmacy Inc., located in Jersey City, New Jersey, agreed to pay the United States and the State of New Jersey $3,000,000 to resolve allegations that from January 2, 2015, through January 25, 2022, it caused the submission of claims for reimbursement to the Medicare Part D Program and the New Jersey Medicaid Program for drugs that were never dispensed to beneficiaries. The case is being handled by Assistant U.S. Attorneys Kruti Dharia and Robert Toll of the U.S. Attorney’s Office for the District of New Jersey.
• QuickRx LLC, an entity affiliated with Community Pharmacy, located in Elizabeth, New Jersey, agreed to pay the United States and the State of New Jersey $962,821 to resolve allegations that from January 7, 2015, through January 24, 2022, it caused the submission of claims for reimbursement to the Medicare Part D Program and the New Jersey Medicaid Program for drugs that were never dispensed to beneficiaries. The case is being handled by Assistant U.S. Attorneys Kruti Dharia and Robert Toll of the U.S. Attorney’s Office for the District of New Jersey.
• Raghu Ram Inc. d/b/a Camden Discount Pharmacy, located in Camden, New Jersey, agreed to pay the United States and the State of New Jersey $310,000 to resolve allegations that from January 2, 2015, through January 24, 2022, it caused the submission of claims for reimbursement to the Medicare Part D Program and the New Jersey Medicaid Program for drugs that were never dispensed to beneficiaries. The case is being handled by Assistant U.S. Attorneys Kruti Dharia and Robert Toll of the U.S. Attorney’s Office for the District of New Jersey.
• Rachit Drug Inc., located in Newark, New Jersey, has agreed to pay the United States and the State of New Jersey $225,000 to resolve allegations that, from January 2, 2015, through January 25, 2022, it caused the submission of claims for reimbursement to the Medicare Part D Program and the New Jersey Medicaid Program for drugs that were never dispensed to beneficiaries. The case is being handled by Assistant U.S. Attorneys Kruti Dharia and Robert Toll of the U.S. Attorney’s Office for the District of New Jersey.
• Premier Dental Holdings, Inc. d/b/a Sonrava Health, Element Dental Partners Holdco, LLC, Element Dental Partners, LLC, Mid-Atlantic Dental Services Holdings LLC, and The Jersey Dental Group have agreed to pay the United States and the State of New Jersey $540,000 to resolve allegations that from January 1, 2021 through July 31, 2023, it submitted or caused the submission of claims for reimbursement to the Medicare Part D Program and the New Jersey Medicaid Program (“NJ FamilyCare”) for: (a) services that were performed by providers who were not credentialed with NJ FamilyCare or the applicable managed care organization, but billed for by using the National Provider Identifiers of dentists who did not perform the services but had the necessary credentials; or (b) services that were performed and billed by uncredentialed providers at the time the service was rendered. The case is being handled by Assistant U.S. Attorney Robert Toll of the U.S. Attorney’s Office for the District of New Jersey.