A ringleader in a scheme to defraud health insurance providers for MTA employees has been convicted in federal court after pleading guilty after two other accomplices have been sentenced to prison time.
On Monday, Christine Myers, 38, copped to insurance fraud after an indictment in U.S. federal court in the District of New Jersey. Her and two former MTA employees paid other transit workers cash bribes for fraudulent prescriptions for compounded medications, a hoodwink that that earned them $8.8 million.
“In an era when many Americans worry about securing health insurance for their families, we’ve seen far too many instances where both private and publicly funded insurance providers are being raided for millions in phony reimbursements on compounded medications,” U.S. Attorney Craig Carpenito said. “Myers admitted that she and others sought to defraud insurers by recruiting the very people who enjoy that coverage, offering them cash bribes to get medications they didn’t need. Her conviction should serve as a warning to those who would exploit their health coverage for financial gain.”
Between February 2015 and February 2017, as one of the owners of Marketing Company-1, Myers retained a portion of the payment and provided a “commission” payment to Christopher Frusci and Enver Kalaba who had formerly been employed by the MTA. Bribes were paid by the latter two two former colleagues to submit for payment of compound prescriptions through the insurance provided by MTA, known as TRICARE.
“The global pandemic brings into stark relief how critical it is to have access to affordable healthcare,” MTA Inspector General Carolyn Pokorny said. “That this individual recruited former MTA employees to help steal millions of dollars from taxpayers, riders, and other transportation stakeholders is especially despicable.”
On Feb. 7, 2019, Kalaba pleaded guilty to healthcare fraud and was sentenced to 20 months in prison before serving one year of supervised release, as well as forfeiting $138,630 of illicit income. An additional $2.9 million will need to be paid in restitutions, Newark federal court decided, while Frusci still awaits sentencing.
“Insurance fraud is outrageous because it loots scarce funds from the healthcare system which can result in colleagues and neighbors being deprived of needed treatments and services,” MTA spokesperson Meredith Daniels said. “The admission of guilt from a ringleader who recruited two MTA employees for her multi-million dollar scheme is a step in the right direction toward delivering justice to criminals who stole from all of us.”
Compound prescriptions generally come at a higher cost as they are tailor-made for patients who may depend on a certain medication while also having an allergy to certain ingredients. Some of these under the MTA’s TRICARE plan included scar creams, wound creams as well as metabolic supplements and vitamins, according to Pokorny’s office.