Ex-pharmacy owner sentenced in $11.5 million Medicare fraud case
Aftab Hussain and his associates were found to have paid illegal kickbacks to patients to ensure they would use certain pharmacies.
Photo: Blanchi Costela/Getty Images
Former pharmacy owner Aftab Hussain has been sentenced to two to six years in prison for allegedly stealing more than $11.5 million dollars through a Medicaid fraud scheme that targeted low-income HIV patients who needed life-saving medications, according to New York Attorney General Letitia James.
Hussain and his associates were found to have paid illegal kickbacks to patients to ensure they would use over 20 pharmacies owned by Hussein and his cohorts across New York City and Westchester County. They then filled their prescriptions with unsafe medications illegally purchased from the black market or other pharmacy patients, said James.
Hussain was the last defendant to be sentenced in an investigation that included the arrest and conviction of five others, along with two pharmacies located throughout New York.
WHAT'S THE IMPACT?
The investigation was conducted by the Office of the Attorney General's (OAG) Medicaid Fraud Control Unit (MFCU), which found that Hussain owned, operated or controlled more than 20 pharmacies in Manhattan, the Bronx and Westchester County during that time, frequently moving his businesses to new locations.
From 2015 to 2019, said James, he and several of his employees and coconspirators paid or directed others to pay illegal kickbacks to Medicaid recipients diagnosed with HIV. This was apparently an attempt to entice those recipients to have their prescriptions for HIV medication filled at the Hussain-controlled pharmacies. These kickbacks were typically between $25 and $100.
Hussain and his coconspirators would often offer to buy back the HIV medication from the Medicaid recipients for cash at the time of delivery, usually offering $100 to $200 per bottle, even though the wholesale price of the medications was usually between $2,000 and $3,000 per bottle. As a result, the AG said, many vulnerable patients went without their medication, putting them at severe risk of developing life-threatening complications from HIV.
The coconspirators also allegedly purchased large quantities of HIV medications through black market channels – often drugs obtained through other illegal kickbacks – and dispensed those prescription medications to unsuspecting recipients. They then submitted claims for reimbursement to the Medicaid program as if the medications they were disbursing had been purchased honestly and distributed safely.
The other coconspirators who have been sentenced include Josmary Cardenas, Victor Streety, Blanca Vanessa Alvarado and Felix Lopez, who all pleaded guilty to their respective charges.
THE LARGER TREND
Four corporations operating as pharmacies owned or controlled by Hussain or his coconspirators were also charged: Harlem Super Pharmacy, Health Smart Pharmacy, Broadway RX Enterprises and E-Green Pharmacy, d/b/a WinHealth Pharmacy. RX Enterprises and E-Green Pharmacy both pleaded guilty and were sentenced on October 16. As part of the sentences, the corporations must dissolve.
Jeff Lagasse is editor of Healthcare Finance News.
Email: jlagasse@himss.org
Healthcare Finance News is a HIMSS Media publication.
