News
Release
February 28, 2007
Contact: Erin Mulvey
212 337-2906
U.S.
Arrests Owner and Two Employees of Manhattan Pharmacy
For Stealing Over $1.2 Million From the Medicaid Program
FEB 28 --
(New York) JOHN P. GILBRIDE, the Special Agent-in-Charge of the New
York Office of the United States Drug Enforcement Administration ("DEA"),
MICHAEL J. GARCIA, the United States Attorney for the Southern District
of New York, MARK J. MERSHON, the Assistant Director-in-Charge of the
New York Office of the Federal Bureau of Investigation ("FBI"),
RAYMOND W. KELLY, the Police Commissioner of the City of New York,
Commissioner ROBERT DOAR of New York City Human Resource Administrations’ Bureau
of Fraud Investigation, and the New York State Department of Health
Office of Medicaid Management, announced that DINESH DAYABHAI SHAH,
a licensed pharmacist and owner of the MLK Pharmacy in Manhattan, was
arrested today on charges that he systematically defrauded the Medicaid
Program of at least $1.2 million over the past four years by buying
drug prescriptions from Medicaid beneficiaries in exchange for cash
and merchandise. In addition, two employees of MLK Pharmacy -- NILESH
RAJANIKANT SHAH (DINESH DAYABHAI SHAH’s nephew) and IQBAL MIRZA
-- were also arrested in connection with the charges. Simultaneous
with the arrests, law enforcement agents executed a search of MLK Pharmacy’s
premises and two rooms in an adjacent building where the defendants
stored expired medications that they frequently used to fill prescriptions.
According to the
Complaint filed in Manhattan federal court: Between June 2002 and the
present, DINESH DAYABHAI SHAH, NILESH RAJANIKANT SHAH, and IQBAL MIRZA,
(the "defendants") engaged in a scheme at MLK Pharmacy to
defraud the Medicaid Program of reimbursement costs for prescription
drugs which they never dispensed. While operating and working at MLK
Pharmacy, the defendants purchased drug prescriptions from Medicaid
beneficiaries in exchange for cash payments and/or other goods.
The defendants paid
the Medicaid beneficiaries a fraction of the total reimbursement value
of the prescriptions that the Medicaid Program would pay to MLK Pharmacy.
The defendants then submitted reimbursement claims to the Medicaid
Program for the prescription drugs which they falsely claimed had been
provided to the beneficiaries, but which in fact MLK Pharmacy had not
dispensed to the Medicaid beneficiaries or even sufficiently stocked.
Through this scheme, the defendants obtained the full value of the
Medicaid reimbursement for the drug prescriptions, and pocketed the
difference between the reimbursement and the cash that the defendants
paid to the beneficiaries.
During the investigation,
an undercover New York City Police officer posing as a Medicaid beneficiary
sold prescriptions to both DINESH DAYABHAI SHAH and NILESH RAJANIKANT
SHAH on multiple occasions. Medicaid records confirm that, after the
SHAHs purchased the prescriptions, MLK Pharmacy then billed the Medicaid
Program for the full reimbursement value despite the fact that the
medications were never dispensed. Each of the defendants is charged
with conspiracy to commit health care fraud, and health care fraud.
If convicted, the defendants face a maximum sentence of 10 years’ imprisonment
and a maximum fine of the greatest of $250,000, or twice the pecuniary
loss or gain derived from the offense.
U.S. Attorney GARCIA
praised the efforts of the FBI, the DEA, the New York City Police Department,
the New York City Bureau of Fraud Investigation, and the New York State
Department of Health Office of Medicaid Management.
Assistant United
States Attorney WILLIAM STELLMACH is in charge of this prosecution
and Assistant United States Attorney CHRISTINA BISCHOFF is in charge
of the criminal forfeiture proceedings.
The charges in the
Complaint are merely accusations, and the defendants are presumed innocent
unless and until proven guilty.
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