Local Pharmacists Bilked Medicare Out Of $3 Million

Two audacious apothecaries bilked the Medicare system out of more than $3 million, filing claims for a whopping 869,698 units of prescription medications that were never doled out.

Sheepshead Bites first reported on the bust this morning, when federal agents raided two pharmacies – Monica’s Pharmacy (1324 Sheepshead Bay Road) and L&A Pharmacy (394 Avenue X) – and arrested the alleged fraudsters.

Authorities charged Luba Balyasny, 46, and Alla Shrayber, 40, with conspiracy to commit health care fraud.  Balyasny and Shrayber are licensed both pharmacists in New York State who co-owned and operated Monica’s Pharmacy and L & A Pharmacy.

Here are the details from the Department of Justice press release:

According to court documents, from January 2007 through December 2009, Balyasny and Shrayber allegedly defrauded the Medicare Part D program by systematically submitting false claims through their pharmacies for certain prescription medications that were not purchased by their businesses and were never dispensed to Medicare beneficiaries.  The complaint alleges that the inventory at both pharmacies for certain prescription medications did not match the pharmacies’ Part D reimbursement claims.  According to court documents, the pharmacies submitted prescription drug claims totaling approximately 869,698 units of prescription medications without any supporting drug purchase invoices.  The shortfall allegedly resulted in approximately $3 million in false and fraudulent claims paid by Medicare Part D, Part D Plans and beneficiaries for prescription drugs that were never purchased or dispensed.

If convicted, Balyasny and Shrayber face a maximum sentence of 10 years in federal prison.  A complaint merely contains allegations and defendants are presumed innocent unless and until proven guilty at trial.