Pharmacy (Nestor E. Jaime, owner — Pine Brook, NJ)
Outcome
Pharmacy owner Nestor E. Jaime pleaded guilty to healthcare fraud for billing Medicare for medications that were never dispensed to patients.
Details
Nestor E. Jaime Pharmacy (Pine Brook, NJ) — Medicare Billing for Undispensed Medications
Outcome: Owner Nestor E. Jaime pleaded guilty to one count of healthcare fraud for billing Medicare for prescription medications that were never dispensed to patients.
Nestor E. Jaime (age 37) operated a pharmacy in Pine Brook, New Jersey, through which he submitted fraudulent claims to Medicare for prescription medications that were never actually provided to patients. The scheme involved billing the federal healthcare program for undispensed drugs — creating a paper trail of prescription transactions with no corresponding actual medication delivery.
Jaime entered a guilty plea on November 19, 2025, before U.S. District Judge Katharine S. Hayden in Newark federal court. The case was prosecuted by the U.S. Attorney's Office for the District of New Jersey and announced November 24, 2025.
Primary Source: New Jersey Pharmacy Owner Pleads Guilty to Health Care Fraud Scheme Involving Billing Medicare for Undispensed Medication
How Crucible Prevents This
Crucible's dispense-to-bill reconciliation controls would catch claims for medications with no corresponding dispense record; an inventory-based cross-check comparing purchase orders to claim submissions would surface billing without dispensing within normal billing cycles.
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