A Vaccination for Fraud

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It’s hard to find anyone that actually likes receiving shots. But apparently a San Juan, Puerto Rico pharmacy owner really likes to give them, even when illegal. Liz Ann Banchs, owner and president of Farmacia Gabriela, Inc., pleaded guilty to health care fraud for providing Pfizer-BioNTech COVID-19 vaccines to minors between the ages of 7 and 11. (That age group was not authorized to receive the vaccination.)

Banchs had a little help from her employees at her pharmacy. They knowingly and willfully gave the Pfizer-BioNTech COVID-19 vaccine to 24 kids 11 years-old or younger and submitted their Medicaid claims to MC-21, a pharmacy benefits administrator in Puerto Rico. (And they gave the vaccine at full dosage. Children should not receive an adult dose.)

Even though Farmacia Gabriela, Inc. was eligible to participate in the Centers for Disease Control and Prevention (CDC) COVID-19 Vaccination Program, they did not comply with all of the requirements, including the Emergency Use Authorization (EUA) which allowed the Pfizer-BioNTech COVID-19 vaccine to be given to children over the age of 12. The pharmacy was also not allowed to submit claims to MC-21, obviously because it was for children that were too young at the time. 

Fortunately, the pharmacy owner’s illegal activity was detected and shut down by the Puerto Rico Department of Health. (So much for being part of one of the most trusted professionals. I guess her greed was stronger than her ethics.)

Luckily, no serious medical conditions have been detected in the children who received the COVID-19 shots. (You also have to ponder why any parent would allow their child to receive a vaccination that was not approved yet. Sounds like a big risk to me.)

Banchs has since paid back the money received from the illegal Medicaid billings and agreed to being excluded as a provider for Medicare, Medicaid, and all federal health care programs for five years. (How about forever? Does she really deserve a “do-over”?)

When sentenced, the Puerto Rican pharmacist is facing a maximum of five years in prison, a fine up to $250,000, plus three years of supervised release. (Someone needs to come up with a vaccination against fraud. Now that would be a miracle cure for sure.)

Today’s Fraud of the Day comes from a Department of Justice press release, “Pharmacy Owner Pleads Guilty to Federal Charge Involving the Vaccination of Minors Under 12 with the Pfizer-BioNTech Covid-19 Vaccine,” dated September 27, 2021.

SAN JUAN, Puerto Rico – Liz Ann Banchs, the owner and president of Farmacia Gabriela, Inc. was charged and pleaded guilty on September  24, 2021 to participating in a felony conspiracy to convert government property and to commit health care fraud in connection with the illegal vaccination of minors between the ages of 7 to 11 with the Pfizer-BioNTech COVID-19 vaccine. The announcement was made by W. Stephen Muldrow, United States Attorney for the District of Puerto Rico and Scott Lampert, Special Agent in Charge for the United States Department of Health and Human Services, Office of Inspector General (HHS-OIG), New York Regional Office.

From approximately May 28, 2021 through June 22, 2021, Liz Ann Banchs and employees of Farmacia Gabriela, Inc.’s pharmacy in Juana Díaz, Puerto Rico, conspired to knowingly and willfully administer the Pfizer-BioNTech COVID-19 vaccine to children 11 years old or younger and to submit corresponding Medicaid claims to MC-21. A total of twenty-four children aged 7-11 were administered the Pfizer-BioNTech COVID-19 vaccine, at full dosage, without lawful authority as a part of the conspiracy.

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Larry Benson is currently the Director of Strategic Alliances for Revenue Discovery and Recovery at LexisNexis Risk Solutions. In this role, Benson is responsible for developing partnerships for the tax and revenue and child support enforcement verticals. He focuses on embedded companies that have a need for third-party analytics to enhance their current offerings.