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TRENTON
Attorney General Jeffrey S. Chiesa announced
that a North Jersey neurologist was charged
in a state grand jury indictment today for
allegedly writing prescriptions while his
license was under suspension by the New
Jersey Board of Medical Examiners.
Magdy
Elamir, 59, of Saddle River, was charged
with second-degree health care claims fraud,
third-degree Medicaid fraud and third-degree
unlicensed practice of medicine.
Elamir,
a neurologist who had a practice in Jersey
City prior to his suspension, was terminated
from the Medicaid Program on Nov. 19, 2009
and his license to practice medicine was
temporarily suspended on December 23, 2009.
The termination from the Medicaid program
and the license suspension came as a result
of a complaint filed against him and a hearing
before the Board of Medical Examiners.
The
state grand jury indictment filed today
alleges that between Dec. 23, 2009 and July
22, 2011, Elamir wrote prescriptions for
Medicaid beneficiaries or otherwise engaged
in the practice of medicine, thereby causing
pharmacies to submit claims for prescriptions
drugs to the Medicaid Program for reimbursement
during the period of time when Elamir’s
license to practice medicine and authority
to write prescriptions was suspended by
the Board of Medical Examiners following
an investigation by the Division of Consumer
Affairs’ Enforcement Bureau.
On
July 15, 2010, Elamir was indicted by a
state grand jury and 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 1000 feet
of school zone, and one count of third degree
distribution of CDS.
The
2010 state grand jury indictment alleged
that between Jan. 1, 2007 and Oct. 20, 2009,
Elamir, 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 alleged 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. Elamir is scheduled to go
to trial on the 2010 charges on September
11, 2012.
Deputy
Attorney General Peter Sepulveda, Lt. Vincent
Gaeta, and Detective Kevin Gannon are assigned
to this matter. Acting Insurance Fraud Prosecutor
Ronald Chillemi thanked the Jersey City
Police Department’s Special Investigation
Unit for their assistance in the investigations.
The
indictments are merely an accusation and
the defendant is presumed innocent until
proven guilty. Second degree carry a maximum
sentence of 10 years in state prison and
a criminal fine of $150,000, while crimes
of the third-degree carry a maximum sentence
of five years in state prison and a criminal
fine of $15,000. The crime of third-degree
Medicaid fraud carries a maximum punishment
of three years State prison and a criminal
fine of up to $10,000.
Acting Insurance Fraud Prosecutor Chillemi
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
at 1 877 55 FRAUD, or visiting
the Web site at www.NJInsurancefraud.org."
State regulations permit a reward to be
paid to an eligible person who provides
information that leads to an arrest, prosecution
and conviction for insurance fraud.
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