Federal Jury Declares Woman Guilty for Conspiring a $65 Million Pharmaceutical “Coupon” Fraud

A U.S. Attorney Dawn N. Ison announced that a federal jury convicted a woman from Dearborn on Friday on charges of conspiracy to commit Wire Fraud and Health Care Fraud for her engagement in a multi-year scheme obtaining more than $65 million from multiple pharmaceutical co-pay assistance programs.

Suzan Berro, 23, from Dearborn, Michigan, participated in a conspiracy to submit fraudulent reimbursement claims to multiple pharmaceutical manufacturer’s co-pay assistance programs. These “coupons” that are sponsored by manufacturers are made to help real patients purchase high-cost prescription drugs often from name brands. According to the evidence, Berro, who engaged in the scheme for almost a year, worked as a biller for multiple pharmacies.

Using her job, she faked “prescriptions” for fake “patients” by using addresses from real estate lists, making up names and birth dates, selecting expensive name brands, and then partnering them up with names and credentials of real doctors. The evidence also revealed that Berro made sure that the addresses of the real doctor, the fake pharmacy, and the made-up patient were in close geometric proximity to make the plot more believable.

In addition, a witness attests that the majority of the pharmacies involved by Berro in the scheme never existed physically–nor ordered inventory– and were only existent on paper. All in all, Berro and the other schemers involved in the plot committed fraud on behalf of more than 40 pharmacies, wherein the sum amounted to over $65 million dollars.

Berro is facing a maximum of 20 years in prison for each count and her sentencing hearing is scheduled on May 1, 2023. “This was a complicated scheme that abused dozens of programs established to help those who are legitimately unable to afford their medications,” said U.S. Attorney Ison. “Our office will continue to investigate and unravel these schemes, and will vigorously pursue those who are responsible.”

Along with Ison in the announcement was James A. Tarasca, Special Agent in Charge of the Detroit Field Division of the Federal Bureau of Investigation. “The jury’s verdict confirms an alarming and unacceptable trend of individuals attempting to exploit segments of the health care system designed to help those who legitimately need prescription assistance,” said Tarasca. “The FBI will continue to work with our federal partners to identify fraudsters like this defendant and hold them accountable for their crimes.”