Double-dealing Scammers

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Shot of two doctors working together on a digital tablet in a hospital

While many honest pharmacy owners would see operating several pharmacies as a way to earn a living while serving the community, Mohamed Abdalla, the New Jersey owner of several Virginia pharmacies, saw his businesses as vehicles for lucrative fraud. He concocted and carried out two schemes to bilk Medicare and TRICARE, raking in more than $8 million.

From January 2014 through at least the end of 2018, Abdalla paid kickbacks to providers who referred prescriptions to his pharmacies for expensive compound medications and naloxone auto-injectors to treat opioid emergencies. That scheme brought in more than $2 million from Medicare and TRICARE. (But in classic fraudster style, it wasn’t nearly enough for the greedy Abdalla.)

In the second scheme (as if one were not enough), Abdalla and his employees billed for prescriptions in their own names, and in the names of family members and other pharmacy employees. (A lot of sick people, indeed.) They also billed for customer prescriptions that were never filled. All those fake prescriptions added up to $6,216,434.39 in fraudulent billings to federal, state, and private health care benefit programs. (Did these people have any time left to fill legitimate prescriptions?)

Fortunately, Abdalla and many of his co-conspirators will soon enjoy a lengthy break from their strenuous healthcare fraud responsibilities. On March 19, 2021, Abdalla was sentenced to four years in federal prison for his healthcare scams.

Onkur Lai, who participated in the schemes as a pharmacy tech, pharmacy intern, and pharmacist, was sentenced in March to three years in prison. Mohammad Tariq Amin, a pharmacy tech and general manager, got two years in prison; while Daniel Tyle White, a pharmaceutical salesman, got 15 months; and Michael Beatty, a pharmacist, got one year and one day in prison. (Aw, they’re going to be “pen pals” – but not the kind that write letters.)

Today’s Fraud of the Day comes from an Inside NOVA article, “Northern Virginia pharmacy owner, employees sentenced in fraud scheme,” dated April 20, 2021.

The last of six defendants was sentenced Monday for multiple health care fraud conspiracies involving kickbacks and fake billings that resulted in nearly $8 million in losses to health-care benefit programs.

According to court documents, Mohamed Abdalla, 48, of Allendale, New Jersey, owned multiple pharmacies in Northern Virginia, including Medex Health Pharmacy in Falls Church and Royal Care Pharmacy in Fairfax. As the owner, Abdalla oversaw and executed two related schemes to defraud health care benefit programs, the U.S. District Attorney’s Office for Easter Virginia said in a news release.

 

 

 

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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.