A.G. Schneiderman Announces Recovery Of $250,000 From Rochester Pharmacy To Pay Back State In Medicaid Fraud Case
AG Resolves Rochester Medicaid Fraud Case Involving Suspended Pharmacist Who Continued To Practice
Schneiderman: My Office Is Committed To Recouping Every Dollar Stolen From Taxpayers
ROCHESTER– Attorney General Eric T. Schneiderman today announced that Tops Market Pharmacy, with corporate headquarters in Williamsville, Erie County, has paid the state nearly $250,000 in restitution to resolve a Medicaid fraud case involving the misdeeds of a former pharmacist in one of their Rochester stores. Elizabeth Johnson, 49, of Rochester, was suspended from practice and excluded from the Medicaid program, but continued to dispense prescription medications while working at Tops Market Pharmacy.
Johnson ultimately pleaded guilty and was sentenced on May 12 for defrauding the Medicaid program out of approximately $187,500. She was ordered to serve eight weekends at the Monroe County Jail, complete 200 hours of community service, and five years probation. Johnson must also pay $56,929.80 to Tops to cover her wages and salary.
As part of the agreement, Tops has paid restitution in the amount of $247,233.93. This includes the amount billed for prescription medications that were fraudulently dispensed by Johnson and paid for by the Medicaid program, Medicare and Excellus Blue Cross/Blue Shield.
"The message here is simple and the rules of the Medicaid program are very clear. If services were not provided in accordance with state and federal laws, then a reimbursement is owed to the Medicaid program," said Attorney General Schneiderman. "My office is committed to recouping every taxpayer dollar that is fraudulently obtained through the Medicaid program."
The Attorney General credits Tops Market for taking action in the removal of Ms. Johnson after her status was discovered and for taking corrective measures in reimbursing the money owed.
In 2007, the Attorney General’s investigation revealed that Johnson, formerly the Supervising Pharmacist of the Tops Market Pharmacy, located at 710 Lake Avenue in the City of Rochester, was dispensing prescription medications to Medicaid recipients for several months after her license to practice as a pharmacist was suspended and she was excluded from participating as a Medicaid provider by the State. As a result of Johnson's conduct, Tops and Johnson generated $187,534.10 in billings to the Medicaid program to which they were not entitled. The investigation also revealed that Johnson generated fraudulent billings in the amount of $36,669.42 to Medicare and $23,000.41 Excellus BC/BS.
The prosecution was handled by Jerry Solomon, Rochester Regional Director of the Attorney General’s Medicaid Fraud Control Unit under the supervision of Deputy Attorney General for the Medicaid Fraud Control Unit, Monica J. Hickey-Martin. The investigation was conducted by Senior Special Investigator Douglas Hinchey and Associate Auditor/Investigator Michael Warfield. The case was referred to the Attorney General's Medicaid Fraud Control Unit by the Office of the Medicaid Inspector General.