Pharmacy owner defrauds Medicaid of $3 million
Compliance Monitor, September 30, 2009
Want to receive articles like this one in your inbox? Subscribe to Compliance Monitor!
A New York U.S District Judge sentenced Yefry Burgos, 33, to 78 months in prison for illegally billing Medicaid for medications, according to a Department of Justice (DOJ) release.
Burgos, former owner of the now defunct Coral Pharmacy, fraudulently billed Medicaid for over $3 million in prescriptions that were never dispensed to Medicaid beneficiaries. Burgos, and Coral Pharmacy’s manager, Lourdes Bastardo, purchased prescriptions from Medicaid beneficiaries for a fraction of the amount Medicaid Program would reimburse the pharmacy.
Burgos withdrew thousands of dollars from Coral Pharmacy’s accounts and provided a substantial portion to Bastardo to buy the prescriptions from beneficiaries, according to the DOJ. The pharmacy then submitted full value reimbursement claims to Medicaid and pocketed the difference between Medicaid reimbursements and the money paid to the beneficiaries.
Bastardo, 55, pleaded guilty to healthcare fraud and awaits sentencing.
Want to receive articles like this one in your inbox? Subscribe to Compliance Monitor!
Related Products
-
Strategies for Health Care Compliance
News and real-life examples to increase the effectiveness of your compliance program. Strategies for Health Care Compliance...
-
Compliance Monitor
This HTML e-mail newsletter delivers news on Medicare and Medicaid fraud and abuse, as well as recent documents and targets...
-
Medicare Weekly Update
Each issue of Medicare Weekly Update includes the latest CMS proposed and final rules, CMS manual revisions, and...
-
Medicare Update for Physician Services
Medicare Update for Physician Services is a free, monthly e-zine that delivers news and information to help physician...
Most Popular
- Articles
-
- HIPAA Q&A: HIPAA-compliant phone messages
- HealthDataInsights posts new issues for medical necessity claims
- Physician referral patterns ripe for scrutiny
- Dealing with data breaches
- Sneak Peek: Planning for homecare can reduce avoidable readmissions
- Ask the expert: Should medical staff bylaws address employment contracts and exclusive contracts?
- New FAQ posted on storing laryngoscope blades
- Nurse pleads guilty to Medicare fraud
- Q/A: New device pass-through categories
- Featured webcast: Assessing the competence of low- and no-volume practitioners
- E-mailed
-
- HIPAA Q&A: HIPAA-compliant phone messages
- Ask the expert: Should medical staff bylaws address employment contracts and exclusive contracts?
- Sneak Peek: Planning for homecare can reduce avoidable readmissions
- What does case-mix index mean to you?
- 2012 CPT code changes for ASCs: Shoulder and knee scopes and pain management
- Featured webcast: Assessing the competence of low- and no-volume practitioners
- To sign or not to sign
- Bill and charge for supplies correctly to reduce risk and minimize lost revenue
- Blanket Warmers, What Is Safe?
- Featured blog post: Nurses face felony charges after reporting physician to the Texas Medical Board
- Searched