ROCHESTER, N.Y. (Legal Newsline) - New York Attorney General Eric Schneiderman announced on Tuesday that a Rochester-based pharmacy has paid the state nearly $250,000 in restitution to resolve a Medicaid fraud case.
Elizabeth Johnson of Rochester allegedly dispensed prescription medications while working at Tops Market Pharmacy despite having been suspended from practice and excluded from the Medicaid program.
Schneiderman alleged that Johnson, formerly the supervising pharmacist of the Tops Market Pharmacy, was dispensing prescription medications to Medicaid recipients for several months after her license to practice as a pharmacist was suspended and she was excluded from participating as a Medicaid provider by the state. As a result of Johnson's alleged misconduct, Tops and Johnson generated $187,534.10 in billings to the Medicaid program to which they were not entitled. Schneiderman also alleged that Johnson generated fraudulent billings in the amount of $36,699.42 to Medicare and $23,000.41 to Excellus BC/BS.
Johnson pleaded guilty and was sentenced on May 12 for defrauding the Medicaid program out of approximately $187,500. She was ordered to serve eight weekends at Monroe County Jail and five years probation, complete 200 hours of community service and pay $56,929.80 to Tops to cover her wages and salary.
As part of the agreement, Tops has paid restitution in the amount of $247,233.93, which includes the amount billed for prescription medications that were allegedly fraudulently dispensed by Johnson and paid for by the Excellus Blue Cross/Blue Shield and Medicare Medicaid program.
"The message here is simple and the rules of the Medicaid program are very clear," Schneiderman said. "If services were not provided in accordance with state and federal laws, then a reimbursement is owed to the Medicaid program. My office is committed to recouping every taxpayer dollar that is fraudulently obtained through the Medicaid program."
Schneiderman credits Tops Market for taking action in removing Johnson after her status was discovered and for taking corrective measures in reimbursing the money owed.