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Post date: February 7 2013

A.G. Schneiderman Announces Arrest Of NYC Psychiatrist Who Stole More Than $230k From Medicaid

Dr. Jean Elie Saw Patients For Less Than 10 Minutes And Handed Out Prescriptions Valued At More Than A Million Dollars For The Frequently Abused Prescription Drug Seroquel

Schneiderman: Crooked Doctors Who Steal From Taxpayers And Feed Rx Drug Abuse Will Be Prosecuted

NEW YORK – Following an undercover investigation, Attorney General Eric T. Schneiderman today announced the arrest of Dr. Jean Elie, a Brooklyn psychiatrist on grand larceny charges for billing the state’s Medicaid program $230,000 for services he did not provide. Dr. Elie, 59, of Elmont, wrote prescriptions for Seroquel valued at over a million dollars over a three-year period to a revolving door of clients. Dr. Elie, who worked out of the Family Practice offices at 1155 Broadway, in Brooklyn, faces up to 15 years in prison.

“Crooked doctors who abuse their position and their privileges do tremendous harm to their patients, to the communities they claim to serve and to their profession. In this case, Dr. Elie also ripped off New York State taxpayers by billing Medicaid for services he failed to provide, pocketing critical resources at the expense of the most vulnerable among us,” Attorney General Schneiderman said. “This doctor’s office was basically a pill mill. The systemic abuse of prescriptions drugs is an epidemic in this country and in this state. It must stop. Our office will do everything in its power to ensure that it does.”

According to a complaint filed in Brooklyn Criminal Court today, Elie billed over $232,000 for therapy sessions which he falsely claimed lasted a minimum of 45 minutes. Instead, the sessions routinely lasted less than ten minutes. By law, physicians are required to submit claims for payment using billing codes which accurately reflect the services they provided.  

As described in the court papers, undercover investigators from the Attorney General’s office, posing as patients, signed up for seven sessions with Elie. None of these sessions lasted for more than six minutes. Even so, the doctor billed Medicaid using a code, known as the “hour code,” which requires, in addition to a medical evaluation, 45 to 50 minutes of face-to-face therapy with a patient.

Between 2009 and 2012, Elie wrote prescriptions for Seroquel valued at over a million dollars, making him one of the top prescribers of Seroquel in the State. The anti-psychotic medication is frequently abused and has a street value among addicts. Elie’s prescribing patterns and the observations made by MFCU investigators during the course of the investigation appear to indicate that some of Elie’s patients sought prescriptions for medications they could sell on the street.  

Today’s arraignment follows a successful effort by Attorney General Schneiderman to overhaul the state’s prescription drug monitoring system in order to prevent overprescribing by doctors. In June 2012, the legislature unanimously passed the Internet System for Tracking Over-Prescribing Act, or I-STOP.  First introduced by Attorney General Schneiderman, I-STOP requires doctors to review a patient’s prescription drug history and update it in real time when writing prescriptions for certain controlled substances. Had such a system been in place at the time Elie committed his crimes, authorities could have detected it more quickly.

At his arraignment, prosecutors charged that Elie worked at the Family Practice offices for only four hours a day but routinely billed Medicaid for therapy sessions that, if legitimate, would have taken longer than the 24-hour period he claimed they occurred in. On one date, Elie billed the hour code 30 times; and on 94 separate dates he billed it 20 or more times.    

Elie is charged with Grand Larceny in the Second Degree, which carries a maximum prison term of 5 to 15 years. He also faces multiple counts of Offering a False Instrument for Filing, which carry a maximum term 1 and 1/3 to 4 years behind bars. The charges against Elie are accusations and he is presumed innocent until and unless proven guilty.

The prosecution is being handled by the Medicaid Fraud Control Unit’s New York City Regional Office by Special Assistant Attorney General Mark P. Cannon, under the supervision of Deputy Regional Director Christopher Shaw. The investigation was conducted by Special Investigators Thomas Dowd and Steven Broomer and Senior Special Auditor Investigator Shoma Howard, under the supervision of Principal Special Auditor Investigator Paul Erhardt and New York City Chief Audit Investigator Thomasina Smith. The Medicaid Fraud Control Unit is directed by Special Deputy Attorney General Monica Hickey-Martin under the supervision of Executive Deputy Attorney General for Criminal Justice Kelly Donovan.

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