KINNELON BOROUGH, NJ (Morris County) – A Morris County woman was arrested and charged Friday for her role in a conspiracy to commit health care fraud, according to U.S. Attorney Philip Sellinger.
Aysha Khan, 33, of Kinnelon Borough is charged by indictment with one count of conspiracy to commit health care fraud and four counts of health care fraud. She will have her initial appearance Friday afternoon before U.S. Magistrate Judge Edward S. Kiel in Newark federal court, Sellinger said.
According to documents filed in this case, Khan controlled and operated a network of “specialty pharmacies” with locations in New Jersey, New York, Texas, and Florida. These pharmacies processed expensive medications used to treat various conditions, including Hepatitis C, Crohn’s disease, and rheumatoid arthritis.
At Khan’s direction, the pharmacies billed health insurance providers for medications that the pharmacies did not actually provide to patients. While the pharmacies generally provided medications for initial prescriptions it received, it systematically and intentionally billed for refills for those same medications without ever dispensing them. On certain occasions, the pharmacies also billed for initial prescriptions without ever shipping or dispensing them.
From 2015 through 2022, the Khan Pharmacies received over $10 million in reimbursement payments from Medicare for medications the pharmacy not only failed to give patients, but never ordered or had in stock.
The conspiracy to commit healthcare fraud count and the substantive healthcare fraud counts charged are each punishable by a maximum of 10 years in prison and a $250,000 fine, or twice the gross gain or loss from the offense, whichever is greatest.