- Attorney General Anne Milgram and Criminal
Justice Director Deborah L. Gramiccioni announced
that an Atlantic County pharmacist was convicted
today of using phony prescriptions to distribute
thousands of narcotic pills and fraudulently
bill them to Medicaid and private insurance
to Insurance Fraud Prosecutor Greta Gooden
Brown, Paola D’Ottavio, 42, of Pleasantville,
was convicted by an Atlantic County jury of
four counts of second-degree health care claims
fraud, as well as third-degree distribution
of a controlled dangerous substance and third-degree
Medicaid fraud. The conviction followed a
10-day trial in front of Superior Court Judge
Albert J. Garofolo. Sentencing is scheduled
for July 31.
Attorneys General Erik Daab and Linda Rinaldi
prosecuted the case and represented the Office
of Insurance Fraud Prosecutor at trial. Detective
Christine Barclay led the investigation, and
Mona Patel, a paralegal in the Medicaid Fraud
Control Unit, assisted at trial. The U.S.
Drug Enforcement Administration assisted in
crimes carry a maximum sentence of 10 years
in state prison and a criminal fine of $150,000,
while third-degree crimes carry a maximum
sentence of five years in state prison, and
a fine of $15,000. The Medicaid fraud charge
carries a maximum sentence of three years
in state prison and a $10,000 fine. The matter
will be sent to the New Jersey Board of Pharmacy
for review regarding D’Ottavio’s
Atlantic County jury found that between Jan.
1, 2004 and June 30, 2005, D’Ottavio,
a pharmacist licensed in the State of New
Jersey, created false telephone prescriptions
for hydrocodone and provided thousands of
the pills to at least two purported customers.
The customers were actually friends of D’Ottavio,
who sold the drugs, splitting the profits
with D’Ottavio. Hydrocodone is the main
ingredient in the painkiller Vicodin.
jury found that D’Ottavio submitted
false claims for the drugs to Caremark/Advance
PCS and Medicaid, as well as to private pay
prescription insurance companies and pharmacy
benefit managers. The claims stated the drugs
were for legitimate private pay prescription
insurance patients and Medicaid patients.
It was determined that the drugs had not been
legitimately prescribed by physicians for
the people named on the prescriptions.
One of the purported customers, Terry Gatto,
53, 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 pleaded guilty
to theft by deception on May 12, 2006. Gatto
is scheduled to be sentenced on June 5.
purported customer, Vicki Guld, 48, of Galloway,
pleaded guilty before Superior Court Judge
James Isman in Atlantic County to a criminal
accusation which charged her with conspiracy
to possess a controlled dangerous substance.
She is also awaiting sentencing.
is particularly disturbing when licensed professionals
defraud the Medicaid program,” said
Insurance Fraud Prosecutor Brown. “This
defendant not only stole tax dollars, she
stole from a program designed to assist persons
who cannot afford health insurance or health
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 site 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.
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.