Federal charges have been filed against a Blanchester pharmacist, alleging he fraudulently billed Medicaid for an amount totaling more than $300,000.
The indictment against Brian L. Martin, R.Ph., who co-owns Main Street Pharmacy in Blanchester, describes Martin’s alleged conduct as a “fraud scheme” that occurred between March 2004 through Sept. 14, 2005. The pharmacy was temporarily closed Sept. 15, 2005, when a multi-agency team of investigators executed a search warrant, looking for potential evidence of alleged Medicaid fraud.
As part of the scheme, Martin “routinely entered and submitted, or directed pharmacy technicians to routinely enter and submit, ‘dummy’ prescriptions for Zyprexa, Zofran, Imitrex and others into the Medicaid electronic billing system knowing that the ‘dummy’ prescriptions were never prescribed by physicians or being dispensed by Main Street,” according to a copy of the indictment from the U.S. District Court for the Southern District of Ohio.
Further, the 37-count indictment alleges Martin forged prescriptions.
Martin’s attorney, Deborah Lydon of the Cincinnati law firm of Dinsmore & Shohl, said the federal district court’s rules relating to publicity and public disclosures “discourage comment” by the attorneys and the defendant in a case before the court.
Similarly, Ohio Attorney General Deputy Director of Communications Ted Hart said in an e-mail it’s his understanding the prosecuting attorneys involved in the Martin case are not interested in commenting beyond what is included in the indictment filed with the clerk of courts.
Martin co-owns Main Street Pharmacy with pharmacist Kris Gundler. Nothing in the eight-page indictment implicates Gundler or suggests that Gundler is under suspicion.
In fact, the indictment says, “Defendant Martin and the other pharmacist were responsible for filling prescriptions at Main Street and generally alternated days working as the on-site pharmacist.”
On Thursday evening, Gundler said, “The indictment makes it clear that Brian Martin is the only one being charged with a crime, not Main Street Pharmacy nor myself. The government’s case involves a billing area reimbursement issue, not a quality of care issue. We’ll be open for business as usual, providing the highest quality of care for our customers that they’ve always received.”
Martin is scheduled to be arraigned in court to answer the charges on April 10. Currently, the arraignment is scheduled to be held at a federal courtroom in Columbus. Lydon however has filed a request for a change of venue to a federal court in Cincinnati.
Federal and state of Ohio tax dollars jointly pay for the Ohio Medicaid program. The Medicaid program provides financial assistance to indigent people for medical care.
Prescription drugs, such as Zyprexa, Zofran and Imitrex, are among the reimbursable medical benefits covered by Medicaid.
The drug Zyprexa is an antipsychotic medication generally used to treat schizophrenia and bipolar disorder. Zofran is a drug generally used for preventing nausea and vomiting due to cancer chemotherapy or surgery. Imitrex is a drug generally used to treat migraine headaches.
According to the indictment, Martin “or the pharmacy technicians under the direction of defendant Brian L. Martin,” typically billed Medicaid from $1,000 to $1,200 for 60 Zyprexa tablets of 20 mg, from $900 to $1,000 for 30 Zofran tablets of 8 mg, and from $120 to $200 for nine Imitrex tablets of 100 mg.
Other drug strengths and other drugs also were included in the scheme, alleges the indictment.
The 37-count indictment is the result of a joint investigation by the Ohio Attorney General’s Health Care Fraud Section and the U.S. Attorney’s Office, said Hart. The Greater Warren County Drug Task Force was involved in the probe, too.
The Ohio Board of Pharmacy, which regulates pharmacies and pharmacists, assisted in the matter.