Three Sentenced in $2 Billion Telemedicine Fraud as Alleged Ringleader Remains at Large in Russia

Federal prosecutors have spent years pursuing fraud that borrows the infrastructure of telehealth: a call center recruits insured patients, a doctor is paid to sign off on prescriptions after a nominal online review, and pharmacies then bill insurers for drugs that were never medically necessary and sometimes never delivered. In May 2026, a federal court in Brooklyn put numbers on one of the largest such cases on record, a roughly $2 billion scheme that ran between the United States and Moscow. Two months later, an investigation by the Organized Crime and Corruption Reporting Project (OCCRP) reported that the man prosecutors call the ringleader is living freely in Russia, an unresolved thread that keeps the case current.

What the Justice Department said happened

According to the U.S. Attorney's Office for the Eastern District of New York and the Department of Justice, an international criminal organization ran a health care fraud conspiracy from roughly 2017 to 2022. The Justice Department said operatives used call centers, first based in Utah and later relocated to Russia, to contact people with private health insurance and offer them medications at little or no cost, often without any medical examination.

Prosecutors said the organization acquired and controlled dozens of brick and mortar pharmacies across multiple states, including in Brooklyn, Staten Island, Manhattan, Long Island, New Jersey, Pennsylvania, Texas, Michigan, and Alabama, using straw owners to hide who was really in charge. Billers described by the Justice Department as based in Moscow then submitted electronic reimbursement claims through those pharmacies to private insurers.

The three sentences

In May 2026, Judge William F. Kuntz II sentenced three defendants in the Eastern District of New York (docket 21-CR-564). According to the Justice Department, Anthony Santamaria received 120 months in prison, Hershel Tsikman received 120 months, and Hafizullah Ebady received 97 months. The court ordered Santamaria to forfeit $3.2 million and Ebady to forfeit more than $1.8 million.

The Justice Department said a fourth defendant, Dela Saidazim, had earlier been sentenced to time served in December 2022, and that three others, David Bishoff, Brycen Millett, and Joshua Alegria, were awaiting sentencing. These sentencings are settled outcomes on the court record, distinct from the charges that remain pending against the alleged leader described below.

How the telemedicine piece worked

The telehealth layer is what made the paperwork look legitimate. Prosecutors said the organization recruited doctors to review prescriptions purportedly written by nurse practitioners and physician assistants after telemedicine visits. In most cases, according to the Justice Department, there were no actual telemedicine visits between the insured beneficiaries and any medical professional. The prescriptions were generated regardless of whether the beneficiary wanted or needed the medication, and in some instances the drugs were billed but never delivered.

That structure mirrors a pattern federal agencies have described in other cases, sometimes called telefraud: a marketing operation supplies patient information, a telemedicine layer produces a physician signature, and a pharmacy, laboratory, or equipment supplier bills for the result. The signature detached from any real clinical encounter is the element prosecutors treat as the core of the fraud.

The money

The Justice Department said the organization submitted about $1.97 billion in fraudulent prescription claims and that private health insurers paid roughly $758 million before the scheme was disrupted. Prosecutors emphasized that the victims were private insurance benefit programs rather than Medicare or Medicaid. Assistant Attorney General Colin M. McDonald said the defendants, working through aliases, encrypted communications, shell companies, and straw owners, siphoned nearly $2 billion from private insurers that provide services to American patients.

The alleged ringleader, still at large

The person prosecutors identify as the organization's leader, Brian Sutton, a Los Angeles born U.S. citizen, has not been tried. The U.S. Attorney's Office in Brooklyn describes him as at large, and a felony case tied to the scheme remains active. Nothing about Sutton in this article has been established at trial; the government's characterization of his role is an allegation unless and until it is proven in court.

In an investigation published on July 29, 2026, OCCRP reported that Sutton is living freely in Russia and has built a conspicuous lifestyle there, including elite real estate near Moscow, a fleet of luxury vehicles, and a minority stake in a mixed martial arts club linked to a member of the Russian parliament. OCCRP also reported that Sutton obtained Israeli citizenship in 2017 and a Russian passport in 2022. OCCRP said Sutton and his family did not respond to its requests for comment, and that U.S. and Russian authorities did not respond either.

Why extradition is considered unlikely

OCCRP quoted Ilya Shumanov, a former director of Transparency International's Russia chapter, who said the chance of Sutton's extradition to the United States is effectively zero because the two countries have no extradition treaty. That assessment is an outside expert's opinion, not a court ruling, but it explains why an indicted defendant can remain beyond the reach of a U.S. prosecution even after co-defendants are sentenced.

What this means for telehealth patients

Cases like this are prosecuted as fraud against insurers, not as evidence that telehealth itself is illegitimate. Legitimate telehealth starts with a patient seeking care, involves a real clinical evaluation, and produces prescriptions or orders tied to that evaluation. The conduct described by prosecutors here started with a sales pitch and ended with a signature disconnected from any genuine patient encounter. For readers, the practical distinction is between care you initiate with a provider you chose and an unsolicited offer that arrives by phone, text, or ad.

How to recognize a telefraud pitch

This is general information, not legal or medical advice, but federal agencies have repeatedly flagged a few common markers of these schemes:

• An unsolicited call, text, or ad offering free or no cost medication, tests, or equipment, especially if it asks for your insurance details.
• Prescriptions or orders you did not request and your own clinician did not recommend.
• A doctor you never actually spoke with signing off on treatment in your name.
• Pressure that stresses the item is free or fully covered so there is no reason to say no.