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TRENTON
- Attorney General Paula T. Dow and Criminal
Justice Director Stephen J. Taylor announced
that a North Jersey neurologist was charged
in a state grand jury indictment today for
his alleged role in a pharmaceutical narcotics
trafficking and Medicaid fraud scam.
According
to Acting Insurance Fraud Prosecutor Riza
Dagli, Dr. Magdy Elamir, 57, of Saddle River,
was charged with second-degree conspiracy,
second-degree distribution of a controlled
dangerous substance (CDS) and two counts
each of second-degree health care claims
fraud and second-degree distribution of
CDS within 500 feet of certain public property,
as well as three counts of third-degree
Medicaid fraud, two counts of third-degree
distribution of CDS within 1,000 feet of
school zone, and one count of third-degree
distribution of CDS.
Deputy
Attorney Debra A. Conrad presented the case
to the state grand jury.
The
state grand jury indictment alleges that
between Jan. 1, 2007 and Oct. 20, 2009,
Elamir, a neurologist who has a practice
in Jersey City, conspired with others to
submit fraudulent claims to the Medicaid
program for reimbursement and received payments
for medical examinations that had not been
provided. It is also alleged that Elamir
conspired to write medically unnecessary
prescriptions for Medicaid beneficiaries,
thereby causing pharmacies to submit claims
to Medicaid for the medically unnecessary
drugs.
The
indictment further alleges that Elamir distributed
CDS by providing medically unnecessary prescriptions
for Xanex and Percocet in exchange for cash
payments within 500 feet of the Jersey City
Public Library, a public building, and within
1,000 feet of St. Joseph’s School
which is owned or leased by the Archdiocese
of Jersey City.
Today’s
indictment stemmed from Operation MedScam,
an ongoing investigation by the Office of
the Insurance Fraud Prosecutor’s Medicaid
Fraud Control Unit and the Jersey City Police
Department’s Special Investigation
Unit. Since October, more than 32 people,
including doctors and pharmacists, have
been arrested in the joint investigation,
which uncovered a criminal narcotics network
based in Hudson County that distributed
black market prescription pain pills
such
as OxyContin and Percocet. The network was
obtaining fraudulent narcotics prescriptions
and filling them at various pharmacies.
At the same time, Medicaid was being billed
for phony doctor visits and prescription
medicines that were never dispensed.
The
network allegedly distributed the prescription
pain pills throughout Hudson County and
other parts of the state, including Bergen,
Ocean, Morris and Monmouth counties. A single
30 milligram OxyContin pill, known as a
“blue,” typically sells for
$10 to $20 on the street, while a 10 milligram
Percocet pill sells for $5 to $8.
Detective
Kevin Gannon, Sgt. Frederick Weidman and
Deputy Attorneys General Erik Daab, who
is the Chief of the Medicaid Fraud Control
Unit, Cynthia Vazquez and Conrad were assigned
to the investigation.
They
were assisted by Medicaid Fraud Control
Unit Analyst Mitzi Gross and Anne Howell,
RN., as well as the following members of
the Jersey City Police Department’s
Special Investigation Unit under the supervision
of Chief Thomas Comey: Capt. Gary Lallo,
Sgt. Anthony Musante, Sgt. Wally Wolf, Detective
Wael Shahid, Detective Jeff Guilfoyle, Detective
Vincent Disbrow, Detective Hector Marrero,
Police Officer Alex Torres, Police Officer
Chris Dolan, and Police Officer Erik Infantes.
“As
this indictment demonstrates, we are moving
forward expeditiously to bring the members
of this criminal network to justice for
distributing dangerous narcotics in our
communities,” said Acting Insurance
Fraud Prosecutor Dagli. “We have also
charged other doctors and pharmacists with
participating in this ring and falsely billing
Medicaid.”
The
indictment is merely an accusation and the
defendant is presumed innocent until proven
guilty. Second-degree crimes carry a maximum
sentence of 10 years in state prison and
a criminal fine of up to $150,000. Third-degree
crimes carry a maximum sentence of five
years in state prison and a criminal fine
of up to $15,000, while the crime of third
degree Medicaid Fraud carries a maximum
sentence of three years in state prison
and a criminal fine of up to $10,000.
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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