TWO PHARMACISTS CHARGED IN MEDICARE PART D BILLINGS FRAUD

Department of Justice
Office of Public Affairs
The case below is an excerpt from the Department of Justice website:

"Tuesday, July 26, 2011
WASHINGTON – Two defendants who co-owned and operated two Brooklyn,N.Y.,-area pharmacies were arrested today on health care fraud charges for their alleged participation in a scheme to defraud Medicare Part D that resulted in more than $3 million in fraudulent billings, announced the Department of Justice, FBI and the Department of Health and Human Services (HHS) and its Office of Inspector General (OIG).



Luba Balyasny, 46, and Alla Shrayber, 40, are each charged with conspiracy to commit health care fraud in a criminal complaint unsealed today in the Eastern District of New York. Balyasny and Shrayber, both of Brooklyn, are licensed pharmacists in New York State who co-owned and operated Monica’s Pharmacy and L & A Pharmacy.



According to court documents, from January 2007 through December 2009, Balyasny and Shrayber allegedly defrauded the Medicare Part D program by systematically submitting false claims through their pharmacies for certain prescription medications that were not purchased by their businesses and were never dispensed to Medicare beneficiaries. The complaint alleges that the inventory at both pharmacies for certain prescription medications did not match the pharmacies’ Part D reimbursement claims. According to court documents, the pharmacies submitted prescription drug claims totaling approximately 869,698 units of prescription medications without any supporting drug purchase invoices. The shortfall allegedly resulted in approximately $3 million in false and fraudulent claims paid by Medicare Part D, Part D Plans and beneficiaries for prescription drugs that were never purchased or dispensed.



If convicted, Balyasny and Shrayber face a maximum sentence of 10 years in federal prison. A complaint merely contains allegations and defendants are presumed innocent unless and until proven guilty at trial.



Today’s charges were announced by Assistant Attorney General Lanny A. Breuer of the Criminal Division, U.S. Attorney Loretta E. Lynch of the Eastern District of New York, Assistant Director-in-Charge Janice K. Fedarcyk of the FBI’s New York field office and Special Agent-in-Charge Thomas O’Donnell of the HHS-OIG.



The case is being prosecuted by Trial Attorney James Hayes of the Criminal Division’s Fraud Section. HHS-OIG and FBI conducted the investigation.



Since their inception in March 2007, Strike Force operations in nine locations have charged more than 1,000 defendants who collectively have falsely billed the Medicare program for more than $2.3 billion. In addition, the HHS Centers for Medicare and Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.