Medicare Compliance & Reimbursement
NJ Provider On Hot Seat In Drug-Fraud Case
Pharmaceutical providers should know that insurance fraud prosecutors are getting really good at rooting out unlicensed pharmacy owners. As a result, submitting claims to Medicaid for prescription medications never dispensed could earn a provider huge fines - and even a trip upstate.
To wit: Essex County, NJ-area Ojah Pharmacy manager Verona Boodram and pharmacy technician Alpha Bangoura face Medicaid fraud charges, state Attorney General Peter C. Harvey announced July 22.
A grand jury indicted Boodram and Bangoura on a second-degree Health Care Claims Fraud charge and two counts of third-degree Medicaid Fraud charges on July 14. Between June 1, 2002 and Oct. 28, 2004, Boodram and Bangoura allegedly billed Medicaid for more than $55,000 worth of prescription drugs they never dispensed.
The pair also purportedly offered Medicaid beneficiaries $10 worth of store merchandise for each prescription they brought to Ojah Pharmacy and an additional $10 to $100 per prescription, based on the medication's value.
An insurance fraud prosecutor's investigation revealed that neither Bangoura nor Boodram was a licensed practitioner, Harvey says.
If convicted, Boodram and Bangoura could each face 16 years in state prison and an $180,000 fine.
Medicare Compliance & Reimbursement
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