MEDI-CAL: Pharmacy Ring Defrauds Program Of More Than $5 Million
A group of pharmacies and medical clinics from the San Diego area were involved in a Medi-Cal fraud ring that may have cost the state well over $5 million, the San Diego Union-Tribune reports. According to a six-year investigation, three families of Southeast Asian immigrants are guilty of "one of the biggest pharmacy racketeering scams in the state, if not the nation." The pharmacy ring "generated a blitz of fraudulent prescriptions that were charged to Medi- Cal" by "[u]sing a system of shuttle drivers, kickbacks to patients, medical clinics and physicians."
The Crooked Plan
The Union-Tribune reports that a "review of federal and state court records shows how the fraudulent Medi-Cal payments were generated." Drivers brought Southeast Asians with Medi-Cal cards to clinics and were paid "$8 per person delivered." Clinic personnel -- "a number of which were not licensed -- then issued prescriptions, often on pads stamped with physicians' signatures," that "could be filled only at designated pharmacies." According to the Union- Tribune, pharmacies did not always fill the full prescription "but billed Medi-Cal the full amount anyway," and a few dollars cash "would be put in the bag with the medications." This week, the three Vietnamese refugees reported to be leaders of the ring await sentencing by federal Judge Judith Keep. So far, 18 people, "including two physicians and two pharmacists, have been convicted of fraud-related felonies and misdemeanors in state and federal courts" and "[a]t least 10 have been sent to prison. Some $450,000 has been recovered" (Dalton, 5/18).