Federal courts recently handed down prison sentences tied to a sprawling international healthcare fraud scheme that billed nearly $2 billion, targeting private insurers and exploiting telemedicine, pharmacies, and sham operations across the United States and overseas.
Three men were sentenced this month for roles in an alleged $2 billion international healthcare fraud conspiracy, with Anthony Santamaria receiving 10 years in prison at the federal courthouse in Brooklyn. Co-defendants Hershel Tsikman and Hafizullah Ebady were sentenced earlier to 120 months and 97 months, respectively, and judges ordered forfeitures and restitution that will be determined. The case centers on a Moscow-based criminal organization that prosecutors say ran remote operations to submit fraudulent claims to private insurers.
Dela Saidazim was previously sentenced to time served in December 2022, and three additional defendants—David Bishoff, Brycen Millett and Joshua Alegria—are still awaiting sentencing. An eighth co-defendant and the alleged leader, Brian Sutton, believed to be residing abroad, remains at large. Sentences included significant forfeiture orders: Santamaria was ordered to forfeit $3.2 million and Ebady to forfeit more than $1.8 million.
Assistant Attorney General for the National Fraud Enforcement Division Colin M. McDonald issued a forceful statement on the scheme:
“This Moscow-based criminal organization provided anything but health care,” said Assistant Attorney General for the National Fraud Enforcement Division Colin M. McDonald. “Through aliases, encrypted communications, shell companies, and straw owners, these defendants siphoned nearly $2 billion from private insurers that provide services to American patients. They executed a brazen international fraud scheme involving sham call centers, ghost telemedicine visits, and remotely controlled pharmacies—with many patients never receiving the medication. The Justice Department will continue to aggressively identify, target, and prosecute those who defraud America’s health care system.”
Court filings describe activity between 2017 and 2022 in which call centers controlled by the defendants, first in Utah and later in Russia, contacted beneficiaries enrolled with private insurers and offered medications at no cost. According to filings, those offers were made without medical exams to determine necessity, and the operation generated fraudulent prescriptions even when beneficiaries did not actually get the medications. The indictment alleges doctors were recruited to rubber-stamp prescriptions that followed no real telemedicine visits.
U.S. Attorney Joseph Nocella Jr. for the Eastern District of New York emphasized the scale and sophistication of the operation and the accountability being pursued:
“For over five years, the defendants built a sophisticated, international criminal organization that employed scores of call center employees and remote-billers to steal hundreds of millions of dollars from American businesses and launder the stolen monies overseas,” said U.S. Attorney Joseph Nocella Jr. for the Eastern District of New York. “Despite the defendants’ aliases, encrypted messaging platforms, shell companies and straw owners, even operating from overseas, they are now being held accountable. Our Office and our law enforcement partners will continue to dismantle complex health care fraud networks and hold every responsible actor accountable.”
Prosecutors say the defendants set up and purchased pharmacies with existing relationships with private insurers, then trained Moscow-based billers to submit electronic reimbursement requests remotely. Billing records indicate the defendants submitted over $1.97 billion in fraudulent prescriptions and private insurers paid out more than $758 million on those submissions. The scheme reportedly involved dozens of brick-and-mortar pharmacies in multiple states, run through straw owners and shell companies to hide true ownership.
FBI leadership commented on the broader message of the takedown, underscoring cross-border accountability:
FBI Assistant Director in Charge James Barnacle Jr. said, “The takedown of this international criminal organization sends a clear message that those who exploit our American healthcare system for profit – no matter where they operate – will be identified, investigated, and prosecuted,” said FBI Assistant Director in Charge James Barnacle Jr.
Investigators allege defendants funneled hundreds of millions of dollars through pass-through companies to buy scheme pharmacies and conceal links to the organization. The operation used aliases, encrypted messaging, and overseas infrastructure to launder proceeds and shield the network. Many beneficiaries named in the schemes reportedly never received the medications listed on the fraudulent prescriptions.
- Alegria oversaw the development of custom software and forwarded fraudulent prescriptions to licensed physicians for approval;
- Bishoff coordinated logistics for the operations of multiple scheme pharmacies;
- Ebady coordinated the purchase of and was the “boots-on-the-ground manager” for at least 30 scheme pharmacies;
- Millett oversaw call centers in Utah, Russia and elsewhere overseas;
- Saidazim recruited licensed physicians and acted as Sutton’s personal assistant;
- Santamaria trained and managed teams of billers to input data and remotely submit fraudulent requests for reimbursement to insurers; and
- Tsikman coordinated the laundering of fraud proceeds through straw owners and shell entities for at least 30 scheme pharmacies, and personally wired millions of dollars internationally.
The prosecution is being handled by the Business and Securities Fraud Section for the Eastern District of New York, with Assistant U.S. Attorneys John Vagelatos, Jessica K. Weigel, Jonathan P. Lax and Tara B. McGrath leading the case and Paralegal Specialist Melina Piatti-Chayan assisting. Assistant U.S. Attorney Claire S. Kedeshian is handling the forfeiture matters, and the office continues to pursue restitution to victims. An indictment is merely an allegation, and all defendants remain presumed innocent until proven guilty beyond a reasonable doubt.
On April 7, the Department of Justice announced the creation of the National Fraud Enforcement Division (“Fraud Division”). The Fraud Division is laser-focused on investigating and prosecuting those who commit fraud against the American people, and the department said this work supports President Trump’s Task Force to Eliminate Fraud, a whole-of-government effort chaired by Vice President J.D. Vance to eliminate fraud, waste, and abuse within Federal benefit programs.
