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Rockville Centre pharmacy bilked Medicaid, state, says comptroller report

An exterior image of David Ethical Pharmacy in

An exterior image of David Ethical Pharmacy in Rockville Centre. (Aug. 13, 2013) Credit: Danielle Finkelstein

A state comptroller's report accuses a Rockville Centre pharmacy of bilking the state and federal government out of at least $235,000 over a four-year period by billing for bogus prescriptions, sometimes on behalf of phony patients.

A 13-page report issued Tuesday by state Comptroller Thomas DiNapoli said Davis Ethical Pharmacy improperly collected money from Medicaid and the New York State Health Insurance Program (NYSHIP) over a four-year period through payments for prescriptions that never made it to patients.

"Davis Ethical Pharmacy and its former owner appear to have been anything but ethical, defrauding the NYSHIP and Medicaid programs of a significant amount of money," DiNapoli said in a news release.

"Davis even went so far as falsifying prescriptions from a deceased physician," he added.

The allegations concern the actions of William Davis, previous owner of the pharmacy, located on North Long Beach Road in Rockville Centre.

Davis, who could not be reached for comment, sold the business in 2011; the audits concern only Davis' tenure.

The audit recommended the state Department of Health and Civil Service work with the Nassau prosecutors and other authorities to recoup money lost through improper payments, evaluate the portion of prescription payments auditors did not survey and review Davis' conduct.

The audit found that between Jan. 1, 2008, and Dec. 13, 2011, Medicaid paid Davis Ethical $776,849 for 7,053 claims, and that $94,460 of that was overpaid for 169 of the 267 selected prescriptions tested.

DiNapoli's office said the state Department of Civil Service paid its prescription drug provider United Healthcare more than $6.2 million for 52,485 claims submitted by Davis Ethical.

Auditors found that United overpaid Davis Ethical $139,796 for 148 of 573 selected prescriptions tested and that "the improper payments included $56,392 for 58 prescriptions where NYSHIP members were not patients of the supposed prescribing physicians."The report said that "improper payments also included $71,462 for 67 other prescriptions that were not authorized by the prescribing physicians, although the members in question were patients of the physicians. Again, the prescriptions were never delivered to any patients. Davis Ethical also billed excessive quantities for 23 other prescriptions, overcharging NYSHIP $11,942 for them."

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