Phony Conflict

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Calculator and stethoscope on paperwork

Social studies teachers instruct students in understanding history, geography, and human society, typically teaching about how people interact, govern themselves and solve conflicts.  A Nutley, N.J., social studies teacher has a huge conflict to solve regarding his involvement in a healthcare fraud scheme that defrauded the N.J. School Employees’ Health Benefits Program (SEHBP) of more than $500,000. (No doubt his case could be used as an example for future Social Studies students to learn about fraudsters as part of society and ponder appropriate punishment.)

Jason Nardachone, 51, of Essex County, participated in a healthcare fraud scheme that billed SEHBP for medically unnecessary compounded medications including metabolic vitamins, pain, creams, and scar creams. (Some of these compounded creams cost between $3,300 and $22,800 each.) He submitted the bills for himself and on behalf of three other unnamed teachers he bribed for $500 in exchange for their willingness to order compounded medications they did not need. (There was no reason mentioned for the fraud. Perhaps he sold the medications on the black market.)

The former high school teacher pleaded guilty to healthcare fraud for submitting phony claims for medically unnecessary prescriptions over approximately six months. The crime that stole more than $550,000 could land Nardachone in prison for up to a decade and require him to pay a $250,000 fine, or twice the gross gain or loss from the offense. His sentencing is scheduled for February 2022. (There’s no medicine or compounded cream that will make him feel better for what he has done.)

Today’s Fraud of the Day comes from an article, “Feds: Ex-Lodi HS Teacher Admits Scamming Insurance Out of $550,000 For Compound Meds,” dated September 22, 2021.

NEWARK, N.J. – An Essex County, New Jersey, public school teacher today admitted his role in conspiring to defraud the N.J. School Employees’ Health Benefits Program (SEHBP) with phony claims for medically unnecessary prescriptions, Acting U.S. Attorney Rachael A. Honig announced.

Jason Nardachone, 51, of Nutley, New Jersey, pleaded guilty by videoconference before U.S. District Judge John Michael Vazquez to an indictment charging him with one count of conspiracy to commit health care fraud.

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Larry Benson is currently the Director of Strategic Alliances for Revenue Discovery and Recovery at LexisNexis Risk Solutions. In this role, Benson is responsible for developing partnerships for the tax and revenue and child support enforcement verticals. He focuses on embedded companies that have a need for third-party analytics to enhance their current offerings.