Pharma Pusher

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Pills spilling out of a prescription bottle on 100 dollar paper currency

Defrauding a lifeline program like Medicaid or Medicare is immoral. Doing so while dispensing controlled substances that carry high risk of addiction and the potential to be lethal is beyond evil. (But oh, so alluring to fraudsters, because the repeat business is so lucrative.)

The fraud scheme perpetrated by Harris Hussnain, a New York pharmacy owner, was particularly insidious, because he dispensed more than 10,000 Oxycodone pills (a semi-synthetic opioid)—without even being a pharmacist. The harm he may have caused patients is incalculable, but it is certain that he billed and was reimbursed by Medicaid and Medicare for about $3 million in fraudulent pharmacy claims. He transferred much of the money to personal accounts in his and family members names. (Of course, since the pharmacy was less a business than a front for his scheme.) 

Between July 2016 and December 2019, Hussnain claimed to be the pharmacist at New Moon Pharmacy. Despite not being licensed, he operated the pharmacy daily and dispensed medications with no medical oversight. He paid kickbacks to a co-conspirator, Nisha Diler, a licensed pharmacist, to try to cover his tracks. Diler pretended to be the full-time pharmacist, though she seldom even visited the pharmacy. Both Hussnain and Diler filed falsified paperwork to make fraudulent pharmacy claims. Diler also under-reported her income from the kickbacks. (Please tell us she loses her license for this, forever.)

In September 2020 Diler pleaded guilty to defrauding Medicare and Medicaid and submitting a false tax return. Hussnain pleaded guilty to healthcare fraud conspiracy, distribution of Oxycodone, and illegal financial transactions or, as the Acting U.S. Attorney put it, “Hussnain masqueraded as a health care professional when, in reality, he is a drug-dealing criminal who abused the trust of the Medicare and Medicaid systems, put New Moon Pharmacy’s customers in harm’s way and introduced thousands of Oxycodone pills into the community during an opioid epidemic”. (I couldn’t have said it any better myself.)

Today’s Fraud of the Day comes from a Shore News Network article, “Queens Pharmacy Owner Sentenced to 36 Months in Prison for Health Care Fraud and Narcotics Distribution,” dated May 27, 2021.

Earlier today, in federal court in Brooklyn, Harris Hussnain, the owner of a pharmacy in Queens, was sentenced by United States District Court Judge Rachel P. Kovner to 36 months in prison for his participation in a health care fraud conspiracy, distribution of Oxycodone and illegal financial transactions. Hussnain pleaded guilty to the charges in September 2020.

Mark J. Lesko, Acting United States Attorney for the Eastern District of New York; Scott Lampert, Special Agent-in- Charge, U.S. Department of Health and Human Services – Office of Inspector General, Office of Investigations, New York Regional Office (HHS-OIG); Ray Donovan, Special Agent-in-Charge, Drug Enforcement Administration, New York Division (DEA), Jonathan D. Larsen, Special Agent-in-Charge, Internal Revenue Service-Criminal Investigation, New York (IRS-CI); Frank Walsh, Acting Medicaid Inspector General, New York State Office of the Medicaid Inspector General (OMIG); and Dermot F. Shea, Commissioner, New York City Police Department (NYPD), announced the sentence.

Additional information comes from a Hicksville, NY Patch article, “Nassau Pharmacist Accused of Health Care Fraud in Crackdown,” dated October 1, 2020.

 

 

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Larry Benson
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.