PHARMACIST SENTENCED FOR MEDICAID AND MEDICARE FRAUD
BOSTON, Mass...A Roxbury pharmacist was sentenced in federal court for conspiracy to defraud the United States government by submitting false claims to Medicare Part D and Medicaid, which are both federally funded programs, and unlawfully using the identity of a physician to bill for prescription medications.
ALOYSIUS NSONWU, 65, was sentenced yesterday by U.S. District Judge Joseph L. Tauro to nine months time served, to be followed by two years of supervised release and restitution in the amount of $147,799.19. NSONWU pleaded guilty on February 16, 2011 to an Information charging him with two counts of Conspiracy to Defraud the Government.
At the earlier plea hearing, the prosecutor told the Court that had the case proceeded to trial the Government’s evidence would have proven that that, in one conspiracy, NSONWU, a registered pharmacist, and owner of Egleston Square Pharmacy, 3090 Washington Street, Roxbury, paid customers to bring Medicare Part D insurance cards to the pharmacy so that he could submit claims under the names of the beneficiaries to the Medicare Program. NSONWU solicited and used beneficiary cards and information to submit claims for payment to Medicare Part D, which reimburses pharmacies for prescription drugs, for the prescriptions and refills of HIV/AIDS medications, without physically dispensing the medication to the individuals. Many of the individuals whose insurance cards were billed for these HIV/AIDS medications were not, in fact, HIV positive.
On numerous occasions, NSONWU and his co-conspirators, using the identity of a licensed practicing physician, forged prescriptions for HIV/AIDS medications, and submitted the claims to Medicare Part D for reimbursement. NSONWU used the physician’s name and prescribing identity without the knowledge or permission of the physician.
In a second conspiracy, NSONWU obtained legitimate prescriptions from certain Medicaid beneficiaries, particularly individuals who did have HIV/AIDS. When these beneficiaries brought their prescriptions into Egleston Square Pharmacy, NSONWU first confirmed that the prescriptions were approved for payment by Medicaid and then entered the prescriptions into the pharmacy computer and submitted the claims to Medicaid electronically. NSONWU paid the Medicaid beneficiaries a fee in cash without dispensing the medications. Some of these medications fraudulently billed to Medicaid cost hundreds of dollars per one-month supply.
Following his sentencing by Judge Tauro, NSONWU was taken to Suffolk Superior Court where he was sentenced to four years and one day on a state indictment, to which he had previously pleaded guilty, charging him with additional frauds against Medicaid. He was also ordered to repay more than $555,000 in restitution.
United States Attorney Carmen M. Ortiz and Susan J. Waddell, Special Agent in Charge of the U.S. Department of Health and Human Services, Office of Inspector General, Boston Regional Office of Investigations made the announcement today. The case was investigated by the Department of Health and Human Services’ Office of Inspector General and the Medicaid Fraud Division of the Massachusetts Attorney General’s Office. It was prosecuted by Assistant U.S. Attorneys Shelbey Wright and Brian Pérez-Daple of Ortiz’s Health Care Fraud Unit.