Pharmacist Pleads Guilty to Medicare Fraud Scheme
A California man pleaded guilty today to submitting fraudulent claims to Medicare for prescription drugs that were never dispensed to patients.
According to court documents, Paul Mansour, 55, of Sierra Madre, was a pharmacist at a Sierra Madre-based pharmacy, Mansour Partners Inc., doing business as Best Buy Drugs, which he also co-owned. Mansour created fake patient profiles in the pharmacy’s digital filing system and added fraudulent prescription medication entries to these fictitious patient files that duplicated prescriptions for medications provided to real patients of the pharmacy. Mansour then submitted false and fraudulent claims for the drugs added in the fictitious patient files that had never been dispensed, billing Medicare for the fraudulent prescriptions in the names of real patients of the pharmacy. Between January 2017 and June 2022, Mansour caused Medicare to pay the pharmacy between approximately $600,000 and over $1 million as a result of the submission of false and fraudulent claims.
Mansour pleaded guilty to one count of health care fraud. He is scheduled to be sentenced on June 28 and faces a maximum penalty of 10 years in prison. A federal district court judge will determine any sentence after considering the U.S. Sentencing Guidelines and other statutory factors.
Assistant Attorney General Kenneth A. Polite, Jr. of the Justice Department’s Criminal Division, U.S. Attorney Martin Estrada for the Central District of California, Assistant Director Luis Quesada of the FBI’s Criminal Investigative Division, Assistant Director in Charge Donald Alway of the FBI Los Angeles Field Office, and Deputy Inspector General for Investigations Christian J. Schrank of the Department of Health and Human Services Office of Inspector General (HHS-OIG) made the announcement.
The FBI Los Angeles Field Office and HHS-OIG investigated the case.
Trial Attorney Helen H. Lee of the Criminal Division’s Fraud Section is prosecuting the case.
The Fraud Section leads the Criminal Division’s efforts to combat health care fraud through the Health Care Fraud Strike Force Program. Since March 2007, this program, comprised of 15 strike forces operating in 25 federal districts, has charged more than 5,000 defendants who collectively have billed federal health care programs and private insurers more than $24 billion. In addition, the Centers for Medicare & Medicaid Services, working in conjunction with the Office of the Inspector General for the Department of Health and Human Services, are taking steps to hold providers accountable for their involvement in health care fraud schemes. More information can be found at https://www.justice.gov/criminal-fraud/health-care-fraud-unit.