The $2. 5 Million Pill Puzzle: A Pharmacy Owner's Fraudulent Scheme

A pharmacy owner in New Jersey has admitted to a massive fraud scheme, tricking the Medicare system out of $2.5 million by billing for a drug he never provided to patients.

The Drug and the Deception

The drug in question, Dificid, is used to treat diarrhea and costs around $4,500 per prescription.

• Nestor E. Jaime, the owner of Fabio’s Pharmacy, submitted fake claims for Dificid from late 2019 to late 2021.
• If the claims were legitimate, his pharmacy would have had to dispense over 11,000 units of the drug.
• In reality, they only purchased about 100 units.

How the Money Was Used

Jaime used the stolen funds for personal gain, including:

• Paying his mortgage
• Settling credit card bills
• Leasing luxury cars
• Purchasing high-end watches
• Spending on entertainment

The Broader Impact

This case highlights more than just financial loss. It undermines public trust in pharmacies, which are meant to be reliable sources of healthcare.

"It's about trust. Pharmacies are supposed to be places we can rely on for our health. When someone betrays that trust, it affects everyone."

Legal Consequences

• The case was announced by the U.S. Attorney’s Office.
• Jaime pleaded guilty in federal court in Newark on November 19.
• The charges were first brought in July 2023.
• His lawyer declined to comment on the case.