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TRENTON
– Attorney General Paula T. Dow and
Acting Insurance Fraud Prosecutor Ronald
Chillemi announced that a North Jersey neurologist,
who previously was arrested in connection
with a major Medicaid fraud and narcotics
trafficking investigation, was re-arrested
today for engaging in the practice of medicine
knowing that his license is suspended and
causing fraudulent prescription claims to
be submitted to Medicaid.
According to Acting Insurance Fraud Prosecutor
Chillemi, Dr. Madgy Elamir, 58, of Saddle
River, was charged with health care claims
fraud (2nd degree), Medicaid fraud (3rd
degree) and the practice of medicine by
an unlicensed person (3rd degree). Bail
was set at $1 million cash or bond by Superior
Court Judge Kevin G. Callahan in Hudson
County.
The
New Jersey Board of Medical Examiners suspended
Elamir’s license to practice medicine
in New Jersey effective December 23, 2009.
Despite the suspension, which remains in
effect, he allegedly has been writing prescriptions.
Regulations allow Medicaid to pay for prescriptions
only if they are issued by a properly licensed
doctor and necessary for treatment of a
beneficiary. It is alleged in the new charges
that Elamir defrauded Medicaid by writing
prescriptions without a medical license
that were paid for by Medicaid.
Elamir
is scheduled to go on trial in September
in connection with a July 15, 2010 indictment
charging him for his alleged role in a major
network that engaged in narcotics trafficking
and Medicaid fraud. The indictment alleges
that between 2007 and 2009, Elamir, who
has a practice in Jersey City, conspired
with others to submit fraudulent claims
to Medicaid and received Medicaid 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 unlawfully
distributed controlled dangerous substances
by providing medically unnecessary prescriptions
for Xanex and Percocet in return for cash.
The indictment stemmed from Operation MedScam,
an investigation by the Office of the Insurance
Fraud Prosecutor’s Medicaid Fraud
Control Unit and the Jersey City Police
Department’s Special Investigation
Unit which already has led to 35 guilty
pleas, including pleas from another doctor,
three pharmacists and numerous street-level
drug dealers.
The
narcotics network allegedly distributed
prescription pain pills throughout Hudson
County and other parts of the state, including
Bergen, Ocean, Morris and Monmouth counties.
Detective
Kevin Gannon, and Deputy Attorneys General
Cynthia Vazquez and Conrad were assigned
to the investigation for OIFP’s Medicaid
Fraud Control Unit and were assisted by
John Krayniak, who is the acting Deputy
Chief of the Medicaid Fraud Control Unit.
They
were assisted by Medicaid Fraud Control
Unit Analyst Mitzi Gross, 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.
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