January 22, 10

NEWS / Two Essex County Pharmacy Technicians Plead Guilty to Medicaid Fraud

Medicaid program billed for expensive HIV/AIDS prescriptions never dispensed

TRENTON - Acting Attorney General Paula T. Dow announced that two Essex County pharmacy technicians have pleaded guilty to participating in a scheme in which pharmacy owners and employees allegedly bought completed prescription forms for HIV/AIDS drugs from indigent patients so Medicaid could be billed for drugs that were never actually dispensed.

According to Acting Insurance Fraud Prosecutor Riza Dagli, Jannah Rasheedah Amatul Muid, 26, of East Orange, and Alicia Stephens, 29, of Newark, each pleaded guilty yesterday afternoon to third-degree Medicaid fraud before Superior Court Judge Michael A. Petrolle in Essex County. The charge was contained in a state grand jury indictment obtained by the Office of Insurance Fraud Prosecutor’s Medicaid Fraud Control Unit on Oct. 26, 2009.

At the guilty plea hearing, the defendants, both technicians at Pharmacy of America in East Orange, admitted that between May 11, 2006 and October 15, 2008, they paid Medicaid beneficiaries for prescriptions and subsequently billed the Medicaid Program for prescription drugs that were never dispensed to the Medicaid beneficiaries.

Deputy Attorney General Sherry Wilson took the guilty pleas for the Office of Insurance Fraud Prosecutor.

The crime of third-degree Medicaid fraud carries a maximum sentence of three years in state prison and a criminal fine of $10,000. Judge Petrolle scheduled sentencing for Muid and Stephens for March 8.

The defendants were charged as a result of Operation PharmScam, an ongoing investigation targeting Medicaid fraud that began in 2008 and has been conducted by the Office of Insurance Fraud Prosecutor’s Medicaid Fraud Control Unit, the Jersey City Police Department and the U.S. Food and Drug Administration’s Office of Criminal Investigations.

On Oct. 26, 2009, a total of 10 defendants, including Muid and Stephens, were indicted as a result of the investigation into Pharmacy of America and other pharmacies that were buying prescriptions from patients and billing the Medicaid Program for medicines that were never dispensed. A full list of defendants charged is in the Oct. 26, 2009 press release.

The investigation has been conducted for the Medicaid Fraud Control Unit by Detective Danielle Han, Detective Joseph Jaruszewski, Detective Jacqueline Latty, Detective Kevin Gannon, Sgt. Fred Weidman and Sgt. James Wrightson. Deputy Attorneys General Sherry Wilson and Debra Conrad are leading the prosecutions, with assistance from Deputy Attorneys General Erik Daab, William Hoyman, Cynthia Vazquez, Linda Rinaldi and Carol Stanton Meier.

The Medicaid Program, which is funded by the state and federal governments, provides health care services and prescription drugs to persons who may not otherwise be able to afford such services and medicines. The State of New Jersey administers the Medicaid Program through the Division of Medical Assistance and Health Services and through the Office of the Insurance Fraud Prosecutor’s Medicaid Fraud Control Unit, which investigates both criminal and civil Medicaid fraud and abuse in that program.

Acting Insurance Fraud Prosecutor Dagli noted that some important cases have started with anonymous tips. People who are concerned about insurance cheating and have information about suspected fraud can report it anonymously by calling the toll-free hotline 1-877-55-FRAUD. State regulations permit a reward to be paid to an eligible person who provides information that leads to an arrest, prosecution and conviction for insurance fraud.

http://www.nj.gov/oag/newsreleases10/pr20100120b.html


Tags: criminal investigation,