The Brooklyn District Attorney’s Office announced yesterday it is teaming up with city and federal authorities to go after doctors, pharmacists and other health care providers who commit Medicaid and Medicare fraud.
The announcement came at a press conference where the office disclosed charges against a Brooklyn doctor and other defendants for allegedly overcharging Medicaid and Medicare some $500,000. District Attorney Charles Hynes described the effort as a "first of its kind" collaboration that will combine efforts of his office, city agencies, the Eastern District U.S. Attorney’s Office and the U.S. Department of Health and Human Services.
Hynes called the collaboration "a creative approach" and "something new" combining the experience of his office with that of other agencies.
Furthermore, Hynes said his office had launched a new Healthcare Fraud Division. The prosecutor had in the past 13 years targeted thieving Medicaid recipients through its Public Assistance Crimes Unit, but the expanded division will now also target health care providers such as doctors, pharmacies and medical suppliers.
Senator Charles Schumer, D-N.Y., helped "secure an agreement" that "expand[s] the cooperation" between the district attorney and U.S. attorney, according to a press release.
But the new collaboration apparently will not include the state Attorney General’s Office, which already has a Medicaid Fraud Control Unit of its own. Attorney General Eric Schneiderman has credited the unit with recovering $335 million last year.
In an interview after the press conference, Jerry Schmetterer, a spokesman for Hynes, said the office shared jurisdiction with the attorney general over health care fraud. He said Hynes would continue to refer cases to the attorney general from the public assistance unit. But he added that the investigation and prosecution of crooked providers was "more aligned with what the federal agencies do."
The case discussed during the press conference arose from Dr. Naveed Ahmad’s alleged overbilling during a three-year period. Under the scheme, Ahmad allegedly got patients through "steerers" who paid Medicaid and Medicare recipients up to $300 for a visit. Ahmad would then conduct "cursory examinations," said a press release, and then prescribe HIV medication though the patients were not HIV positive.
The patients would bill their health plans, fill prescriptions that would ultimately be sold on the black market to HIV patients or the gray market to wholesalers that re-sold the medication back to pharmacies.
Ahmad now faces a 119-count indictment, with top charges including second-degree health care fraud, second-degree grand larceny and fourth-degree conspiracy.
The investigation is ongoing, but the press release noted Ahmad could have fraudulently billed Medicare for another $2 million and another $7 million for prescriptions and $716,000 in procedures to Medicaid.
Ahmad faces a maximum 15-year prison sentence. Another 24 defendants have been charged while a final defendant is being sought.
The city’s Office of the Special Narcotics Prosecutor initiated the case that, at one point, sent two New York City Human Resources Administration undercover investigators to Ahmad’s practice. Ahmed pleaded not guilty at this arraignment.
Lynch said it was "particularly fitting" that the first of this sort of collaboration was occurring in Brooklyn, once home to the world’s largest penicillin manufacturer.
"Today, the threat to patient care and the threat to our health care system overall has a new face, and that is health care fraud," she said, saying that health care fraud claims an estimated $60 billion annually.
Special Narcotics Prosecutor Bridget Brennan said at the press conference that "we are all joined together in a very powerful way to fight an extraordinarily difficult and dangerous problem."
@|Andrew Keshner can be contacted at email@example.com.