Acting Manhattan U.S. Attorney Announces Settlement Of Lawsuit Against Pharmacist For Fraudulent Billing Practices
Defendant Ramesh Taduvai Makes Admissions and Agrees to Pay a Total of $600,000
Audrey Strauss, the Acting United States Attorney for the Southern District of New York, and Scott J. Lampert, Special Agent in Charge of the New York Regional Office of the U.S. Department of Health and Human Services, Office of the Inspector General (“HHS-OIG”), announced today that the United States has settled a civil healthcare fraud lawsuit against RAMESH TADUVAI (“TADUVAI”), the former part-owner and Pharmacist-in-Charge of Manav II, Inc., d/b/a Good Health Pharmacy (“Good Health Pharmacy”) in Manhattan. The settlement resolves claims that, from February 2013 through February 2014, TADUVAI submitted false claims for payment to Medicare and Medicaid for prescriptions that Good Health Pharmacy never dispensed to patients, and received reimbursements to which the pharmacy was not entitled, in violation of the False Claims Act. Under the settlement approved yesterday by U.S. District Judge P. Kevin Castel, TADUVAI will pay $600,000 to the United States to resolve the fraudulent billing claims. TADUVAI also made admissions regarding his conduct as further described below.
Acting U.S. Attorney Audrey Strauss said: “For more than a year, pharmacist Ramesh Taduvai knowingly billed the Medicare and Medicaid programs for prescriptions that his pharmacy never dispensed to patients. This Office will continue to hold accountable those who engage in fraudulent billing schemes to personally profit at the expense of federally funded healthcare programs.”
HHS-OIG Special Agent in Charge Scott J. Lampert said: “Health care professionals must be held to a high standard of ethical behavior. HHS-OIG will continue to ensure that those individuals and entities that bill federal health care programs do so in an honest manner.”
According to the Complaint filed in Manhattan federal court:
TADUVAI has been a licensed pharmacist since 1999 and was a 50% owner of Good Health Pharmacy, a retail pharmacy in New York, New York, from late 2005 until October 2014. From February 2013 through February 2014, TADUVAI, on behalf of Good Health Pharmacy, knowingly billed Medicare and Medicaid for prescription drugs that were never actually dispensed to patients. After Pharmacy Benefit Manager CVS/Caremark (“CVS”) determined that Good Health Pharmacy had submitted claims for medications that were not supported by records showing that it had purchased the medications, TADUVAI presented checks that he had issued, purportedly to independent pharmaceutical wholesalers, and falsely claimed they were proof of the purchases. However, Good Health Pharmacy had in fact not purchased these drugs and the checks were instead deposited into bank accounts controlled by TADUVAI. In March 2017, TADUVAI, Good Health Pharmacy, and others were indicted by the Manhattan District Attorney’s Office for crimes related to underreporting income, some of which related to the issuance of these checks. In November 2018, TADUVAI pled guilty to three counts of criminal tax fraud in the second degree.
As part of the settlement, TADUVAI admits, acknowledges, and accepts responsibility for the following conduct:
- At all times during the relevant time period, TADUVAI was Good Health Pharmacy’s Pharmacist-in-Charge and was responsible for the pharmacy’s operations and the management of its staff.
- Good Health Pharmacy, under the management of TADUVAI, as Pharmacist-in-Charge, submitted false claims for payment to Medicare and Medicaid for prescriptions that were never dispensed to patients and received reimbursements on these prescriptions to which it was not entitled.
- TADUVAI issued checks, purportedly to independent pharmaceutical wholesalers, and claimed that these checks were proof that Good Health Pharmacy had ordered and paid for drugs for which the pharmacy billed CVS and federal healthcare programs, but the medications were not actually purchased and the checks were instead deposited into bank accounts controlled by TADUVAI and others.
Ms. Strauss thanked HHS-OIG for its assistance with the case.
The case is being handled by the Office’s Civil Frauds Unit. Assistant U.S. Attorney Jennifer Jude is in charge of the case.