Inspections, Compliance, Enforcement, and Criminal Investigations
July 12, 2010: New Jersey Woman Sentenced for Committing Insurance Fraud and Selling Prescription Fertility Drugs via the Internet
BOSTON, Mass. - A Hackensack, New Jersey woman was sentenced today in federal court for selling via the internet prescription fertility drugs that were paid for by her health insurance company.
United States Attorney Carmen M. Ortiz; Mark Dragonetti, Special Agent in Charge of the Food & Drug Administration - Office of Criminal Investigations; Robert Bethel, Inspector in Charge of the U.S. Postal Inspection Service; and Susan Dukes, Special Agent in Charge of the Internal Revenue’s Criminal Investigations - Boston Field Division, announced today that HEIDI BENHAM, 44, formerly of Newton, was sentenced today by U.S. District Judge Douglas P. Woodlock to three years imprisonment, to be followed by three years of supervised release, and restitution of $518,335.58 to Blue Cross/Blue Shield of Massachusetts.
At the earlier plea hearing, the prosecutor told the Court that had the case proceeded to trial the Government’s evidence would have proven that beginning in approximately February 2001 and continuing through October 2005, BENHAM created a scheme to obtain prescription fertility drugs through fraud. As part of this scheme, BENHAM caused her health insurance plan, Blue Cross/Blue Shield of Massachusetts, to pay for the drugs and that BENHAM then sold these drugs for profit via classified advertisements that BENHAM placed on the internet.
BENHAM had been a patient seeking fertility treatments when she began her fraudulent scheme, and according to the prosecutor, BENHAM called certain specialty pharmacies that carried prescription drugs used in fertility treatments and falsely claimed that she was a representative of a physician’s office. In the call, BENHAM told the pharmacies that the physician had either prescribed or authorized a refill of a prescription of certain fertility drugs for herself. Relying upon these false statements, the pharmacies sent various prescription fertility drugs to BENHAM’s residence and billed Blue Cross/Blue Shield of Massachusetts for the drugs. The Government stated that Blue Cross/Blue Shield of Massachusetts paid $518,335.58 in insurance claims in connection with fraudulent prescriptions for fertility drugs that were provided to BENHAM.
Upon receipt of the prescription fertility drugs, BENHAM sold the drugs for profit to customers throughout the country using internet classified advertisements that she posted on various internet bulletin boards. The Government estimated that BENHAM received approximately $160,000 from her sales of these drugs.
The case was investigated by the FDA’s Office of Criminal Investigations, the United States Postal Inspection Service and the Internal evenue Service. It is being prosecuted by Assistant U.S. Attorneys Amanda P.M. Strachan and James E. Arnold of Ortiz’s Health Care Fraud Unit.