OMIG Assists in Investigation that Leads to Arrests of NYC Pharmacy Owner, Managers for Roles in Alleged $10 Million Medicaid Scheme
A New York City pharmacy owner and three of her managers were arrested July 19 following an OMIG-assisted investigation for their alleged participation in a multi-million-dollar Medicaid fraud scheme involving kickbacks and HIV prescription drugs.
Irina Pichkhadze, 34, of Queens, NY, the Owner of First Choice Pharmacy in Harlem, NY, and three of her managers, Raymond Dieffenbacher, 46, of Queens, NY, Yana Dubrinskaya, 31, of Brooklyn, NY, and Tarlan Pinkhasov, 40, of Queens, NY were charged by prosecutors in State Supreme court with two counts of Grand Larceny in the First Degree, two counts of Health Care Fraud in the First Degree, and Scheme to Defraud in the First Degree for defrauding Medicaid out of more than $10 million in an alleged kickback and HIV prescription drug diversion scheme.
According to prosecutors with the state Attorney General's Medicaid Fraud Control Unit (MFCU), the defendants directed employees to pay cash kickbacks to Medicaid recipients, in return for each patient's agreement to fill their HIV prescriptions at Pichkhadze's First Choice Pharmacy, which generated hundreds of thousands of dollars from Medicaid.
Prosecutors further allege that between 2013 and 2016, Pichkhadze's First Choice Pharmacy filed thousands of false claims for reimbursement from Medicaid and Medicaid Managed Care Organizations (MCOs) in refills that were not dispensed, as evidenced by its not purchasing enough medication from licensed New York State drug wholesalers to justify the quantities of medication it claimed.
Pichkhadze, Dieffenbacher, and Dubrinskaya were also charged, along with two additional companies - Express Audit and OTC - with various counts of money laundering in the first and second degree in connection with the scheme; Pichkhadze was also charged with two counts of Criminal Possession of a Forged Instrument in the Second Degree. Grand Larceny in the First Degree, Health Care Fraud in the First Degree, and Money Laundering in the First Degree are all class "B" felonies for which the maximum state prison sentence is 25 years. Money Laundering in the Second Degree, Criminal Possession of a Forged Instrument in the Second Degree, and Scheme to Defraud in the First Degree are, respectively, class "C", "D", and "E" felonies carrying maximum prison terms of 15, 7 and four years.
OMIG pharmacy consultants and investigators assisted in the investigation, along with officials from the New York State Department of Health and United States Department of Health and Human Services, Office of the Inspector General (HHS-OIG).
The charges and allegations contained in an indictment are merely accusations. The defendants are presumed innocent unless and until proven guilty.
New York State Office of the Medicaid Inspector General
Our mission is to enhance the integrity of the New York State Medicaid program by preventing and detecting fraudulent, abusive, and wasteful practices within the Medicaid program and recovering improperly expended Medicaid funds while promoting high-quality patient care.
Help us fight fraud, waste and abuse: OMIG Fraud Hotline: 1-(877) 87-FRAUD/1-(877) 873-7283
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