New Jersey Division of Criminal Justice Director Vaughn McKoy announced that a Monmouth County pharmacist has been sentenced to state prison and ordered to pay more than $450,000 in fines and restitution after pleading guilty to using “runners” and paying kickbacks to medical providers as part of a scam to defraud Medicaid.
According to Insurance Fraud Prosecutor Greta Gooden-Brown, Rammohan Pabbathi, 58, of Howell, was sentenced by Monmouth County Superior Court Judge Bette Uhrmacher to three years in state prison and ordered to pay $450,000 in restitution and fines to the Medicaid Program. Pabbathi paid the $450,000 prior to sentencing.
Brown noted that Pabbathi pled guilty to a criminal Accusation filed by the Division of Criminal Justice – Office of Insurance Fraud Prosecutor on March 23. The Accusation charged Pabbathi with Health Care Claims Fraud.
In pleading guilty, Pabbathi, the owner/operator of GLV Parke Warner Pharmacy in Neptune, Monmouth County, reportedly admitted that he fraudulently billed Medicaid for prescriptions that the pharmacy did not dispense. An undercover investigation by the Division of Criminal Justice – Office of Insurance Fraud Prosecutor determined that Pabbathi paid “kickbacks” to patients for prescriptions that were then submitted to Medicaid.
In one instance, an undercover investigator posed as a Medicaid recipient and presented a prescription for an expensive HIV medicine. The Medicaid recipient did not pick up the medication, yet Pabbathi reportedly billed Medicaid as if the drug had been dispensed. The Medicaid Program paid $1,130 for that one prescription medication.
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