Pharmacy owner gets 2 years in prison for defrauding Medicare of $2.5M
The former owner of a pharmacy in New Jersey has been sentenced to two years in federal prison after pleading guilty to defrauding Medicare of over $2.5 million.
In an announcement, the U.S. Department of Justice detailed how Nestor E. Jaime, 37, submitted hundreds of false reimbursement claims for prescriptions of a drug called Dificid, a narrow-spectrum antibiotic used to treat infection in the intestines.
The antibiotic is expensive. Through his pharmacy in Paterson, New Jersey, the defendant was said to have billed federal insurance programs for $4,000 per prescription dispensed. The problem was Jamie never actually provided any drugs to patients—and providers never ordered them.
As part of his scheme that operated for two years between 2019 and 2021, prosecutors said Jamie would falsify documents, using the unique ID numbers of providers to make it appear as though they actually prescribed the medication to Medicare beneficiaries who patronized the business.
Jamie admitted to his crimes, pleading guilty to healthcare fraud conspiracy in November 2025. He was sentenced in April 2026, nearly five months later and is currently serving his 24-month sentence.
Throughout the duration of the fraud, the DOJ said “dozens” of patients covered by Medicare were said to have been prescribed Dificid.
Jamie never even so much as purchased the drug for his pharmacy to fill those supposed orders, authorities said.
Judge orders restitution payment
In addition to serving a stint behind bars, the former pharmacy proprietor has also been ordered by a judge to pay back $2,505,754, the amount he was paid by federal programs for the drugs.
He will also be subjected to two years of supervised release once he’s out of prison, the DOJ confirmed.
The reduced sentence was part of a plea agreement. Jamie could have faced as much as ten years in federal prison as a penalty for healthcare fraud.
The DOJ said its National Fraud Enforcement Division was central to the investigation and prosecution of this incident of fraud. Other agencies cooperated as well, including the U.S. Department of Health and Human Services Office of Inspector General and the Health Care Fraud and Opioids Enforcement Unit in Newark, which prosecuted the case.
Chad is an award-winning writer and editor with over 15 years of experience working in media. He has a decade-long professional background in healthcare, working as a writer and in public relations.