Ten people — two pharmacists, three physicians and five website operators — were indicted last week in a scheme to sell prescription drugs over the Internet without a valid prescription. The pharmacists, operating from New Jersey and Pennsylvania, are said to have made at least $13 million in the scheme, which began in 2010 and involved both controlled and noncontrolled substances. The website operators allegedly used an online medical questionnaire method, in lieu of requiring an in-person medical examination, to acquire prescriptions for customers who ordered drugs from their websites.
Of particular importance, the drugs that were sold without a valid prescription were not merely controlled substances, but also included non-controlled substance prescription drugs.
Here’s how the operation worked, according to the indictment:
The website operators — Timothy Kear, Christopher Riley, Adam Risolia, Gergana Chervenkova and Paul Gryszkiewicz — are alleged to have sent their customers’ completed medical questionnaires to the physicians, identified as John Nicholas Burling of South Carolina, Robert P. Imbernino of California and Edmond S. Kaplan of New York. Those doctors would then write prescriptions for the customers without conducting an in-person exam or verifying the provided medical history, according to the Department of Justice. (The online questionnaire forms would have “yes” and “no” answers that “were often prepopulated with the answer that did not disqualify the customer from receiving the prescription drugs that he or she ordered,” the indictment says.) The sites’ operators would then send those prescriptions to a pharmacy owned or run by Peter James Riccio or Lena Lasher, also known as Lena Congtang (the name on her pharmacy license). Riccio owns Towne Pharmacy in Dunellen, N.J., as well as Hellertown Pharmacy, which Lasher operated since 2011, in Hellertown, Pa. Finally, it is alleged, those pharmacists filled the prescriptions and sent the drugs — including Fioricet, Ultram and Butalbital (a controlled substance) — to customers via the US Postal Service, FedEx or UPS, sometimes across state lines.
The indictment did not identify the websites involved or any larger rogue Internet pharmacy network. But LegitScript’s analysis suggests that the primary network in question was likely MottoNetwork, as well as one that we refer to as PGW Management — networks that have long been “rogue” in LegitScript’s database.
One Internet pharmacy website run by one of the website operators facing charges states: “The process couldn’t be easier! Just select the medication that you need, fill out the brief questionnaire and submit your order…and before you know it, USPS is at your door!” That MottoNetwork website, onlineushealth.com, offers such drugs as Fioricet, Cialis and Prozac — all without requiring a valid prescription based on a prior in-person examination. The domain name is registered to Risolia with a Boca Raton, Fla., address; Risolia stated on his Facebook page (which has gone offline in the days since he was charged) that he is a “self-made millionaire/philanderer” living in Miami and is a graduate of Boca Raton High School. His Facebook and Twitter accounts, when they were online, made no secret of his link to onlineushealth.com.
On his LinkedIn profile, which lists his company website as onlineushealth.com, Risolia also identifies himself as president of Marketing US Solutions, the name of the parent company provided on onlineushealth.com‘s contact page: “Your transaction will be processed in US dollars through our parent corporation. (sic) MARKETING US SOLUTIONS CORPORATION, INC.” Risolia is the registered agent for Marketing US Solutions in Miami. Risolia is alleged to have sent a wire transfer of about $10,465 from a bank account in Florida to a bank account controlled by Riccio and Lasher in 2011.
Other domain names registered to Risolia that host rogue Internet drug websites are onlineushealthdesk.com, also part of MottoNetwork, and fastsolmeds.com. (Fast Solutions Capital, also listed on the contact page of fastsolmeds.com, is another Risolia-owned corporation that, like Marketing US Solutions, apparently was moved offshore to Panama.)
MottoNetwork, which at one time consisted of several dozen rogue pharmacy websites, advertised on search engines until the search engines switched to requiring NABP approval for online pharmacies, and engaged in SEO practices that would send Internet users searching for specific drug names to its core pharmacy sites. In keeping with MottoNetwork websites that are currently online, the defunct rogue pharmacies in the network tended to offer painkillers such as Tramadol, Fioricet and Soma. These product types may suggest a link to a bigger network that also largely deals in those medications, like RxPayouts.
Also connected to MottoNetwork is defendant Gryszkiewicz, who owns PGW Management and once operated Motto affiliate website wellingtonrx.com with his partner Luis Mieses. wellingtonrx.com currently displays text that is cited in the indictment about doctor consultations being required for “all pain, sleep/stress/anxiety, muscle relaxers and migraine headache medications.” The indictment suggests, however, that the doctor consultations were a sham: “…customers purchased and received certain prescription drugs, including pain medications; muscle relaxers, and migraine headache medications, by ordering from Gryszkiewicz’s website without receiving a doctor consultation.”
Chervenkova was the financial controller for EuroMedOnline, a small network of pharmacy websites that are not connected to MottoNetwork. EuroMedOnline claims it provides “US customers with the convenience of home shopping for all their regular medication in a secure and safe way. All our physicians and pharmacies are fully U.S. Licensed.” It’s alleged that after placing orders on Chervenkova’s website (which, because it displays the same wording about requiring a valid prescription that’s cited in the indictment, could refer to euromedonline.com), customers received prescription drugs based solely on the medical questionnaire, and often these prescriptions were issued by doctors not residing in the customers’ jurisdiction. (Some Internet pharmacy website operators seem to cut and paste content from other, unrelated websites for use on their FAQ pages, and in this case, we also found the exact prescription-requirement text on a handful of PharmaWeb unapproved Internet pharmacy websites such as canada-pharmacies-online.com, but this appears to be a coincidence.)
As for the products on offer in the pharmacy scheme, purchases by undercover agents in 2012 are alleged to have resulted in completed orders for Butalbital, a controlled substance, from websites run by some of the five operators listed above. But it’s important to note that even selling noncontrolled prescription-only drugs (Fioricet, for example) without a valid prescription violates US law. In fact, an undercover agent in this case successfully ordered Soma from one of the websites in 2011, before it became a controlled substance, and was able to obtain it without a valid prescription; orders for Soma appear among the conspiracy charges for several of the website operators. This underscores the falsehood that as long as pharmacy website operators do not offer controlled substances without requiring a prescription based on a prior in-person examination, they are staying on the right side of the law. Furthermore, because a valid prescription is required to purchase any prescription drug, a medical “consultation” (by a physician who has no relationship with the patient) is not an acceptable practice, as evident from this case.
Riccio is scheduled to appear in court in Manhattan on Dec. 6 and could face up to 20 years in prison if convicted, according to a statement from the DEA’s Robert G. Koval and Preet Bharara, U.S. Attorney for the Southern District of New York.
“As alleged, this multimillion-dollar Internet pharmacy pill scheme involved pharmacists and doctors who placed cash over care by partnering with corrupt website operators to peddle massive quantities of addictive pain pills without valid prescriptions,” Bharara said in the statement. “We will not tolerate the violation of laws and regulations governing the pharmaceutical industry, and [the] arrests underscore our ongoing commitment to pursuing those who illegally put profit over public health and safety.”
Websites in the MottoNetwork, PGW Management and EuroMedOnline networks will remain rogue, and LegitScript will continue to monitor websites in these networks for ongoing activity.