| TRENTON
- Attorney General Stuart Rabner and Criminal
Justice Director Gregory A. Paw announced
that an Atlantic County pharmacist has been
indicted for her role in a Medicaid and
health insurance scam involving hydrocodone,
the main ingredient in Vicodin.
According
to Insurance Fraud Prosecutor Greta Gooden
Brown, Paola D’Ottavio, 40, of Pleasantville,
was indicted late yesterday by a state grand
jury on charges of second-degree health
care claims fraud, third-degree distribution
of controlled dangerous substances and third-degree
Medicaid fraud.
The
indictment alleges that between Jan. 1,
2004 and June 30, 2005, D’Ottavio,
a pharmacist licensed in the State of New
Jersey, falsified telephone prescriptions
for hydrocodone, and provided thousands
of the pills to at least two purported “customers,”
who would subsequently sell the drugs and
split the profits with D’Ottavio.
It is charged that D’Ottavio submitted
false claims for the drugs to Caremark/Advance
PCS as well as Medicaid. The claims allegedly
stated that the drugs were actually for
legitimate Caremark/Advance PCS and Medicaid
recipients. It was determined that the drugs
had not been prescribed by physicians for
the people named on the prescriptions.
One
of the purported customers, Terry Gatto,
51, of Egg Harbor Township, was previously
prosecuted for picking up prescription drugs
in the names of other patients, then selling
the drugs on the street or black market
and sharing the proceeds of those illegal
sales with D’Ottavio. Gatto pled guilty
to theft by deception on May 12, 2006, and
is scheduled to be sentenced on Feb. 9.
Another
purported customer, Vicki Guld 46,of Galloway,
pleaded guilty before Superior Court James
Isman in Atlantic County to a criminal accusation
which charged her with conspiracy to possess
a controlled dangerous substance. Guld is
scheduled to be sentenced on March 9.
State
Investigator Christine Barclay and Deputy
Attorney General Erik Daab are handling
the case. The U.S. Drug Enforcement Administration
assisted in the investigation.
The
indictment is merely an accusation and the
defendant is presumed innocent until proven
guilty. Under state law, crimes of the second
degree carry a maximum punishment of 10
years in state prison and a criminal fine
of $150,000, while crimes of the third degree
carry a maximum punishment of five years
in state prison and a criminal fine of $15,000.
The matter will also be referred to the
Pharmacy Board for any action it deems appropriate
with regard to D’Ottavio’s pharmacist
license.
Prosecutor
Brown noted that some important cases have
started with anonymous tips. People who
are concerned about insurance cheating and
have information about a fraud can report
it anonymously by calling the toll-free
hotline 1-877-55-FRAUD
or visiting the Web at www.NJInsuranceFraud.org.
State regulations permit an award to be
paid to an eligible person who provides
information that leads to an arrest, prosecution
and conviction for insurance fraud.
The
Office of Insurance Fraud Prosecutor was
established by the Automobile Insurance
Cost Reduction Act of 1998. The office is
the centralized state agency that investigates
and prosecutes both civil and criminal insurance
fraud, as well as Medicaid fraud.
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