Corporate Compliance

Pharmacy owner defrauds Medicaid of $3 million

Compliance Monitor, September 30, 2009

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.

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