PLYMOUTH — A Marshfield pharmacy and its owner have been charged in connection with a fraudulent scheme to bill the state’s Medicaid program (MassHealth) and other private and government-funded insurance plans for prescriptions for which they never possessed the inventory to fill.
St. George Pharmacy in Marshfield and its owner, Atef Ayoub, 45, of Marshfield, were indicted Tuesday by a Plymouth County Grand Jury on one count each of Medicaid False Claims, Medicaid Reverse False Claims, False Health Care Claims to Private Insurer, Reverse False Health Care Claims to Private Insurer, Excess Charges to MassHealth members, and two counts of Larceny over $1,200. The defendants are set to be arraigned in Plymouth County Superior Court at a future date.
The AG’s Office alleges that Ayoub billed Medicaid and other insurance plans for prescriptions for a heartburn medication, Zegerid, for which the pharmacy did not have the necessary inventory to fill. In particular, the AG’s Office found that the defendants allegedly billed for nearly 37,000 units of Zegerid even though records indicate that the pharmacy only had approximately 12,000 units on hand. This resulted in the pharmacy receiving approximately $442,000 in inappropriate reimbursement from various insurance plans.
In addition to the lack of inventory, the investigation by the AG’s Office found that the defendants regularly accepted cash payments from Medicaid recipients for prescriptions for controlled substances, in many...
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