A Lakewood pharmacy has reached a settlement the state comptroller’s office to pay back only a portion of Medicaid claims that had no purchase invoices.
The Comptroller’s Medicaid Fraud Division found that Madison Avenue Pharmacy,400 Madison Ave., submitted 13,214 Medicare claims between Jan.1, 2013 and Feb. 29, 2016 that were not supported by wholesaler invoices. In all, the pharmacy, owned by David Segal, was overpaid $1,414,985.01 and $1,842.47 for prescription discrepancies.
The settlement gives a “credit” of $538,744.10, leaving Madison Avenue Pharmacy to pay back $878,083.38.
The first payment of $440,083.38 was due at the signing of the agreement. Monthly payments of $73,000 will made over six months, the first of which was due Nov. 15.
Jersey Shore Online reached out to the Comptroller’s office to ask why the more than half-a-million “credit” was given to the pharmacy. Jeff Lamm of the Comptroller’s office told Jersey Shore Online Thursday afternoon that the pharmacy was eventually able to provide documentation of claims for that amount credited to them.
“The pharmacy inventory investigations that we routinely conduct ensure that Medicaid funds are being spent appropriately,” State Comptroller Philip James Degnan said. “Through this process, our investigators verify that submitted claims are supported by proper documentation. When the pharmacy cannot provide sufficient documentation, we will act aggressively to pursue a recovery on behalf of the Medicaid program.”
A press release issued Nov. 16 from the MFD said the settlement resolves any allegations resulting from the investigation, but the pharmacy does not admit to any liability.