Prescription Drug Fraud
Two owners of a South Florida treatment center for infectious diseases, a physician at the center and a nurse who served as its administrator, were arrested for their roles in a costly Medicaid fraud scheme, according to an October 1, 2004 press release from the Florida Attorney General. The scheme involved billing for prescriptions for medications that were never dispensed and the creation of false medical records to conceal the doctor’s absence from patient treatment and office supervision. Medicaid investigators seized over $1.6 million in illegally purchased assets, including a 40-foot boat, an ocean-view condominium, and a Cadillac SUV.
Operation Free Shot is tracking down doctors who charge Medicaid for immunizations that were paid for by the Vaccines for Children (VFC) program. VFC is an immunization program funded jointly by state and federal government. The Department of Public Health distributes vaccines to doctors and clinics for free. In May 2004, Jorge Elias, a Norwalk, CT doctor, pleaded guilty to healthcare fraud. He had charged Medicaid and other insurers for these free vaccines. In all he collected over $220,000 for vaccines that were already paid for by the government. Elias has agreed to pay $222,920 to the government, as well as $108,000 to private insurers. He could face jail time as well.
Florida authorities have arrested participants in an alleged $10 million prescription drug fraud ring. Carlos Luis, Adalberto Hernandez, Edward Safille, Eddie Mor and Javier Rodriguez allegedly sold counterfeit Serostim to undercover authorities. The Florida Attorney General reports that Lupron and Serostim were diverted from Medicaid and other sources through multiple corportations owned by the defendents.
Serostim is a prescription growth hormone used to treat wasting disease associated with AIDS. Body builders use the drug illegally. A typical prescription is $7,000 to $8,000 for a one-month supply. After Medicaid or private insurance pays for the drugs, dealers often sell them on the street. There have been cases of this all across the country, including New Jersey and California.