LANSING - Attorney
General Mike Cox today announced charges filed against a Mattawan pharmacist
accused of operating a fraudulent Medicaid billing scheme. Edward Nantais, a
licensed pharmacist, is the owner and operator of Mattawan Pharmacy, which is
also charged in the case. Under the scheme, Nantais and Mattawan Pharmacy
billed Michigan Medicaid for expensive prescriptions that were never actually
dispensed to Medicaid patients.
families struggle to earn every dollar they send to Lansing, we must be diligent
in our efforts to root out fraud and waste in government," said Cox. "Fighting
Medicaid fraud ensures taxpayer dollars are used efficiently, and most
importantly, ensures Michigan residents receive needed medical services."
investigation by Attorney General Mike Cox's Health Care Fraud Division found
that Nantais filed
over $35,000 in fraudulent Medicaid billings from 2006 through 2009. The drugs
in question are Valcyte, Zyvox, and Abilify. In one instance, Nantais billed
Medicaid $7,217.87 for one prescription of Valcyte (180 tablets) that the
Medicaid recipient never received. Not only did the patients never receive the
drugs, but their physicians never prescribed them. In some cases, the pharmacy
never even purchased from its wholesaler the drugs it allegedly dispensed.
The Michigan Medicaid
program was not the only victim in this scheme. CVS Caremark, a pharmacy
benefits manager, conducted an audit on behalf of its clients and determined
that Nantais fraudulently billed private insurers, as well as the federal
Medicare Program in excess of $1,750,000 over the same time period.
Agents from the Attorney
General's office worked with federal and local authorities to execute a search
warrant on June 9, 2010 at Nantais' home and business.
Mattawan Pharmacy are each charged with 16 counts of felony Medicaid Fraud, four
years and/or $50,000 each. Nantais will be arraigned at the 54B District Court
in East Lansing today at 1:00 PM.
"I would like to thank the
U.S. Department Health & Human Services - Office of Inspector General, the U.S.
Attorney's Office for the Western District, Mattawan Village Police Department,
St. Joseph County Sheriff's Department, and the Michigan Department of Community
Health for their assistance and cooperation in this investigation," said Cox.
Cox's Medicaid Fraud Control Unit have recovered a record $173 million since he
took office, more than nine times the amount collected by Michigan's previous
two attorneys general.
charge is merely an accusation and defendants are presumed innocent unless
proven guilty beyond a reasonable doubt.
- 30 -