Pharmacy Owner and Operations Manager Convicted of $2.3M Ohio Medicaid Fraud

 

A federal jury convicted an Ohio pharmacist and his operations manager, a pharmacy technician, for conspiring to defraud Ohio’s Medicaid program.

According to court documents and evidence presented at trial, Nathanael Thompson, 45, of Westerville, owned four pharmacies in Columbus, Ohio. Sanam Ahmad, 34, of Galena, managed the pharmacies. Thompson and Ahmad conspired to charge Medicaid for a particular manufacturer’s omeprazole, a type of proton pump inhibitor, which was reimbursable at a significantly higher rate than most omeprazole. In reality, the dispensed medication was generic omeprazole purchased at big-box warehouse retail stores. In addition, to maximize profits, Thompson’s pharmacies put in place certain protocols to dispense omeprazole as though a doctor had prescribed the drug even when there was no prescription.

The jury convicted Thompson and Ahmad of one count of conspiracy to commit health care fraud and two counts of defrauding Medicaid. They face a maximum penalty of 10 years in prison on the conspiracy charge and each health care fraud charge. A sentencing date has not yet been set. A federal district court judge will determine any sentence after considering the U.S. Sentencing Guidelines and other statutory factors.

Acting Assistant Attorney General Nicole M. Argentieri of the Justice Department’s Criminal Division, U.S. Attorney Kenneth L. Parker for the Southern District of Ohio, Special Agent in Charge Orville O. Greene of the Drug Enforcement Administration (DEA) Detroit Division, Acting Special Agent in Charge Cheryl Mimura of the FBI Cincinnati Field Office, Special Agent in Charge Mario M. Pinto of the Department of Health and Human Services Office of Inspector General (HHS-OIG) Chicago Region, Special Agent in Charge Jeff Krafels of the U.S. Postal Service Office of Inspector General (USPS-OIG) Mid-Atlantic Area Field Office, Ohio Attorney General Dave Yost, and Director Steven W. Schierholt of the State of Ohio Board of Pharmacy Executive made the announcement.

The DEA, FBI, HHS-OIG, USPS-OIG, Ohio Medicaid Fraud Control Unit, and the State of Ohio Board of Pharmacy investigated the case.

Trial Attorneys Kathryn Furtado and Leslie Fisher of the Criminal Division’s Fraud Section are prosecuting the case.

The Fraud Section leads the Criminal Division’s efforts to combat health care fraud through the Health Care Fraud Strike Force Program. Since March 2007, this program, currently comprised of nine strike forces operating in 27 federal districts, has charged more than 5,400 defendants who collectively have billed federal health care programs and private insurers more than $27 billion. In addition, the Centers for Medicare & Medicaid Services, working in conjunction with HHS-OIG, are taking steps to hold providers accountable for their involvement in health care fraud schemes. More information can be found at www.justice.gov/criminal-fraud/health-care-fraud-unit.