TRENTON
- Attorney General Anne Milgram and Criminal
Justice Director Deborah L. Gramiccioni announced
that an Atlantic County pharmacist was sentenced
today for using phony prescriptions to distribute
thousands of narcotic pills and fraudulently
bill them to Medicaid and private insurance
companies.
According to Acting Insurance
Fraud Prosecutor Riza Dagli, Paola D’Ottavio,
42, of Pleasantville, was ordered by Superior
Court Judge Albert J. Garofolo in Atlantic
County to serve eight years in state prison
and to pay $19,534 in restitution to Medicaid
and $4,290 in restitution to Caremark/Advance
PCS. D’Ottavio’s sentence was
based on her May 19 conviction on four counts
of health care claims fraud, as well as distribution
of a controlled dangerous substance and Medicaid
fraud. The conviction followed a 10-day jury
trial in front of Judge Garofolo. D’Ottavio’s
pharmacy license was revoked by the New Jersey
Board of Pharmacy on July 8.
Deputy 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 the investigation.
The 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.
The 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,
54, 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
was sentenced in June to one year probation.
Another 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. On May 29, Guld was sentenced
to three years probation.
Acting
Fraud Prosecutor Dagli 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.
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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