Medicaid Fraud Charges Against Pharmacy Owner Reveal Investigation Methods

The owner of Patient’s Pharmacy & Infusion has been arrested for allegedly defrauding Medicaid of almost $600,000.  The owner is accused of submitting false claims to Medicaid for prescription medicines that were never dispensed.

The pharmacy owner is charged with one count of first degree Medicaid fraud.  If convicted, she faces up to 30 years in prison and more than $2.9 million in fines.

The arrest came after an investigation by the state Medicaid Fraud Control Unit (MFCU).

It appears that the pharmacy owner was caught in a classic investigation technique.  According to the government, the volume of medicines allegedly dispensed did not match up with invoices for the amount of medicines actually purchased.

Comparing dispensing data with purchasing data has become an important tool for Medicaid fraud investigators throughout the country, especially in investigations into pharmacists, pharmacies, and durable medical equipment (DME) supply companies.

MFCU investigators often obtain purchasing data from wholesalers and other suppliers before the pharmacists know they are under investigation.  They then compare the amount of drugs purchased with the amount of drugs allegedly dispensed to determine if the pharmacy is seeking reimbursement for more drugs than it purchased.

If you are under investigation for Medicaid fraud or have been charged with a crime, you should know that the government has tremendous resources on its side.  You should consult with an experienced Medicare and Medicaid fraud defense attorney immediately to protect your rights.

To arrange a free and confidential initial consultation, call John Howley, Esq. at (212) 601-2728 or click here to reach our law offices via email.

John Howley, Esq.

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