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A massive Medicaid fraud ring is busted, which allegedly involved buying back HIV meds from impoverished patients and reselling them.
On Monday, New York Attorney General Letitia James filed a civil lawsuit against a Long Island pharmacy king who has been allegedly running a multi-million dollar Medicaid scam and taking advantage of impoverished people living with HIV, as reported in the Daily News.
As part of his scheme, Aftab Hussain — who ran pharmacies in Manhattan, the Bronx, and Westchester County — would allegedly convince poor poz patients to sell back their life-saving medication for nearly nothing. Hussain then laundered the millions he stole from Medicaid through shell corporations, real estate companies, and multiple bank accounts, according to charges filed in the suit.
Investigators discovered that Hussain’s operation would open a new pharmacy, purchase a limited amount of drugs from legitimate wholesalers, get more medication from unauthorized sources, get reimbursement from Medicaid, then change the pharmacy’s name or ownership on paper — or sell it outright, James alleges.
Part of his scam involved getting paid kickbacks to Medicaid recipients so that they’d fill their prescriptions at his stores, the AG alleges. Investigators sent undercover operatives into the pharmacies to fill a prescription for Atripl, an HIV antiretroviral, and at least one of the operatives got kickbacks, according to the lawsuit.
The court filings allege that at least one of his stores, the Harlem Super Pharmacy on Seventh Ave., urged indigent patients to sell their HIV meds back to the pharmacy — after Medicaid reimbursed the store for filling the expensive prescriptions. The pharmacy would then put the drugs back on its shelves for sale.
“These pharmacies… dispense diverted medications, for which the origin and quality cannot be verified, to unsuspecting patients,” read a statement from James’s office. “Various insurers, including government-funded healthcare programs such as Medicaid, will pay for the same bottle of medication twice.”
These medications can cost more than $2,000 a bottle, but Hussain and his lackeys would pay patients just $25 to $100 per prescription, the AG alleges. And even worse than the unfair financial burden of the scam, these people were now without their life-saving medications — which not only puts their health at risk, but also increases their chances of transmitting HIV to others if their viral load rebounds.
“Failure to take medications as prescribed can result in the HIV virus replicating in the body and becoming resistant to treatment,” the AG’s office wrote in the statement. “Thus, by taking advantage of an indigent patient population living with HIV or AIDS, Hussain’s criminal enterprise is robbing these individuals of life-saving treatments.”
A raid at a vacant property last month in Mount Vernon, that used to house one of his pharmacies, turned up 280 boxes of “diverted, expired and/or adulterated medications,” the lawsuit alleges.
Medicaid paid more than $28 million to the pharmacies to cover medications between Jan. 1, 2015, and Oct. 31, 2018, but Hussain’s stores only paid out roughly $17 million to the state’s pharmaceutical wholesalers during that time, the AG alleges.
The pharmacies named in James’ lawsuit include Harlem Super Pharmacy; E-Green Pharmacy, which is also goes by WinHealth Pharmacy, in Hamilton Heights; Broadway Rx, also in Hamilton Heights; A&Z Dug Store, also named Ankerson Pharmacy, in Mount Vernon; and Health Smart Pharmacy in the Bronx, which was later renamed Health Smart Rx.
Hussain was careful to keep his name off the licenses of most of his pharmacies, but he was often listed as the signatory on their bank accounts, the AG alleges. Hussain’s wife, daughter, girlfriend and son-in-law all had their names on a variety of businesses connected to the scheme, the AG’s office alleges.
Hussain was arrested March 1 and separately charged with orchestrating a criminal scheme to defraud patients. He’s being held at the Manhattan Detention Complex on $2 million bail. James wants to seize more than $26 million from Hussain and several alleged accomplices.
