An Indian-American woman has been charged with defrauding federal insurance programmes of approximately USD 9 million, using two pharmacies in the US.
Sunita Kumar, 54, was arrested yesterday and presented in Manhattan federal court before Magistrate Judge Andrew Peck, Acting US Attorney for the Southern District of New York Joon Kim said.
She was charged with operating a health care fraud scheme utilizing two pharmacies in Brooklyn here through which she submitted approximately USD nine million in fraudulent claims to Medicaid and Medicare.
The charges carry a maximum sentence of 15 years in jail.
Kim said Kumar defrauded Medicare and Medicaid, public programmes to assist the indigent and the elderly, by submitting USD 9 million in fraudulent claims. She allegedly did so by inducing people to surrender their own prescriptions and forego their medications in exchange for kickbacks.
"Medicare and Medicaid provide critical health care for some of our most vulnerable citizens. Together with our law enforcement partners, we will aggressively pursue those who allegedly use public programmes as a vehicle for illegal personal profit," he said.
According to the allegations contained in the complaint, Kumar while owning one pharmacy herself and operating a second pharmacy conducted a multimillion-dollar scheme to defraud Medicare and Medicaid programs by fraudulently seeking reimbursements for prescription drugs.
Specifically, she engaged in a scheme to obtain prescriptions for medications, for which her pharmacies billed and received reimbursement from Medicare and Medicaid, but which she did not actually dispense to customers.
From in or about January 2015 through December 2016, Kumar obtained approximately USD 9 million in reimbursements from Medicare and Medicaid for prescription drugs that her pharmacies never actually dispensed.
She defrauded Medicare and Medicaid into providing her pharmacies with these reimbursements by obtaining prescriptions from other individuals, who were willing to forego delivery of the medications in exchange for a share of the reimbursed proceeds, in the form of kickbacks paid by Kumar.
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