tci Medicare Compliance & Reimbursement - 2005 Issue 29

ENFORCEMENT WATCH: Want Civil And Crimianl Fines? Commit Rx Drug Fraud

How an undercover MFCU investigator can expose a pharmacy fraud scheme.Providers that bill Medicaid for medications never dispensed can make Medicaid Fraud Control Unit investigators suspicious.Postiglione Pharmacy Inc. owner John Postiglione, of Port Chester, NY, admitted to defrauding Medicaid of more than $600,000, state Attorney General Eliot Spitzer announced June 27. Between Jan. 1, 1997 and Nov. 3, 2003, Postiglione allegedly submitted claims to Medicaid for expensive medications he never provided. Bogus list dooms defendant: The medical providers listed on Postiglione's Medicaid claims either never prescribed the medications, or prescribed the medications in lesser amounts...

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