California pharmacist sentenced to 15 years in prison, $11.1 million in restitution for defrauding Amtrak and military health care plans

April 25, 2023 |  Investigations Press Release

For Immediate Release

April 25, 2023

LOS ANGELES – A pharmacist based in Orange County was sentenced to 15 years in prison April 3, 2023, and was ordered to pay more than $11 million in restitution for defrauding health care plans for Amtrak and the U.S. military.

 

Sandy Mai Trang Nguyen, 42, of Irvine, was found guilty in November 2022 of 21 counts of health care fraud and one count of obstruction of a federal audit after it was found that she and others under her supervision filled approximately 1,150 fraudulent compounded prescriptions for pain, scarring, and migraines from late 2014 to May 2015. During the scheme, Amtrak’s health care plan was billed $32,489 of which $26,962 was paid, and Tricare, the U.S. military’s health care plan, paid $11,098,756 on the fraudulently submitted claims.

 

As part of the scheme, beneficiaries were solicited to provide their insurance information for medications they did not seek out or need, and most were never examined by a physician. The prescriptions were electronically sent by so-called marketers or telemedicine businesses and submitted to insurers by the pharmacy for reimbursement. The marketers who sent the prescriptions were paid kickbacks of upwards of 50% of the health care plans’ reimbursements.

 

A co-defendant in the case, Marcus Orlando Armstrong, 56, of Miami, was sentenced to 9 1/2 years in federal prison on March 20, 2023, for his role in the scheme to defraud the health care plans. Armstrong was the pharmacy’s director of operations when the criminal activity occurred.

 

Co-defendants Leslie Andre Ezidore, 53, of West Los Angeles, and Alexander Michael Semenik, 51, of Las Vegas, have pleaded guilty to felony charges in this case and await sentencing.

 

In addition to the Amtrak Office of Inspector General, the case was investigated by the Defense Criminal Investigative Service; the FBI; IRS Criminal Investigation; the U.S. Department of Labor Employee Benefits Security Administration; the California Department of Insurance; and the Office of Personnel Management OIG. Assistant United States Attorneys Mark R. Aveis and Ali Moghaddas of the Major Frauds Section are prosecuting this case. More information is available in the press release from the U.S. Attorney’s Office: https://direc.to/jhnW.

 

Reports of fraud, waste, or abuse; criminal or unethical acts affecting Amtrak’s property or operations; or mismanagement in Amtrak programs or operations can be made 24 hours a day via the Amtrak OIG Hotline at 1-800-468-5469 or online at https://direc.to/hPAu.

 

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