Joint State & Federal Investigation Uncovers Physician Illegally Distributed Vaccines; Defendant will Reimburse State for $179,000
ALBION - Attorney General Eric T. Schneiderman today announced the conviction of an Orleans County physician who fraudulently obtained vaccines from a state program that makes vaccines available free of charge for eligible patients and then sold the free vaccines to patients who were ineligible to receive them under the program.
Ghulam Mustafa, M.D., 48, was arraigned today in Orleans County Court on charges of Grand Larceny in the Fourth Degree, a class “E” felony, and Offering a False Instrument for Filing in the First Degree, a class “E” felony. He pleaded guilty to Grand Larceny in the Fourth Degree. Mustafa, who is employed by the Hassan Medical Group, P.L.L.C., doing business as “Extended Hours Medical Care” at 210 South Main Street in Albion and 1038 Gwinn Street in Medina, also agreed to pay New York State $179,000 for the fraudulently obtained vaccines.
“This office will leave no stone unturned in the quest to save money for taxpayers by rooting out waste, fraud, and corruption wherever we find it,” said Attorney General Schneiderman. “In this case, New York State taxpayers were being short-changed by a physician fraudulently reporting the number of Medicaid patients he served and illegally dispensing vaccines to those that were ineligible. This is unacceptable, and we will work every day to ensure that those who cheat the taxpayers are caught and forced to pay for their crimes.”
The New York State Department of Health, through the New York State Vaccines for Children (VFC) and “Child Health Plus B” programs, makes vaccines available at no cost to participating providers for administration exclusively and free of charge to patients who receive Medicaid, Medicaid Managed Care, or Child Health Plus B benefits, as well to those who are without insurance that pays for vaccines, or are of Native American or Alaskan American descent. Participating providers enroll annually in the programs, at which time they report the number of patients in their practice who are eligible to receive the free vaccines, and also report on a monthly basis the number of vaccines administered to program eligible patients.
In court documents filed by the Attorney General’s Medicaid Fraud Control Unit (MFCU), it was alleged that during the period of January 2003 through December 2007, Mustafa directed program vaccines to be used on ineligible patients and caused monthly reports to be submitted to the Department of Health which overstated the number of vaccines that had actually been administered to program eligible patients.
The conviction and settlement resolve the state portion of the case against Mustafa, which was jointly investigated by state and federal law enforcement personnel through the Western New York Health Care Task Force, whose members also include representatives from private health insurance companies in Western New York.
Mustafa faces a maximum penalty of four years in prison. He will be sentenced on June 13, 2011. Today's proceedings took place before the Hon. James P. Punch in Orleans County Court.
The state charges were investigated and prosecuted by Special Assistant Attorney General Gary A. Baldauf, Regional Director of the Attorney General’s Medicaid Fraud Control Unit’s Buffalo office, under the direction of Deputy Attorney General for MFCU Monica J. Hickey-Martin. Supervising Special Investigator Kathleen Donahue and Associate Special Auditor/Investigator Christopher Magin contributed to the investigation.
Attorney General Schneiderman thanked the United States Attorney’s Office in Buffalo, the Federal Bureau of Investigation, the Department of Health and Human Services, and the Food and Drug Administration’s Office of Criminal Investigations, as well as Blue Cross of Western New York, Independent Health, and Univera, for their cooperation and assistance in the investigation.
Ghulam Mustafa, M.D., 48, was arraigned today in Orleans County Court on charges of Grand Larceny in the Fourth Degree, a class “E” felony, and Offering a False Instrument for Filing in the First Degree, a class “E” felony. He pleaded guilty to Grand Larceny in the Fourth Degree. Mustafa, who is employed by the Hassan Medical Group, P.L.L.C., doing business as “Extended Hours Medical Care” at 210 South Main Street in Albion and 1038 Gwinn Street in Medina, also agreed to pay New York State $179,000 for the fraudulently obtained vaccines.
“This office will leave no stone unturned in the quest to save money for taxpayers by rooting out waste, fraud, and corruption wherever we find it,” said Attorney General Schneiderman. “In this case, New York State taxpayers were being short-changed by a physician fraudulently reporting the number of Medicaid patients he served and illegally dispensing vaccines to those that were ineligible. This is unacceptable, and we will work every day to ensure that those who cheat the taxpayers are caught and forced to pay for their crimes.”
The New York State Department of Health, through the New York State Vaccines for Children (VFC) and “Child Health Plus B” programs, makes vaccines available at no cost to participating providers for administration exclusively and free of charge to patients who receive Medicaid, Medicaid Managed Care, or Child Health Plus B benefits, as well to those who are without insurance that pays for vaccines, or are of Native American or Alaskan American descent. Participating providers enroll annually in the programs, at which time they report the number of patients in their practice who are eligible to receive the free vaccines, and also report on a monthly basis the number of vaccines administered to program eligible patients.
In court documents filed by the Attorney General’s Medicaid Fraud Control Unit (MFCU), it was alleged that during the period of January 2003 through December 2007, Mustafa directed program vaccines to be used on ineligible patients and caused monthly reports to be submitted to the Department of Health which overstated the number of vaccines that had actually been administered to program eligible patients.
The conviction and settlement resolve the state portion of the case against Mustafa, which was jointly investigated by state and federal law enforcement personnel through the Western New York Health Care Task Force, whose members also include representatives from private health insurance companies in Western New York.
Mustafa faces a maximum penalty of four years in prison. He will be sentenced on June 13, 2011. Today's proceedings took place before the Hon. James P. Punch in Orleans County Court.
The state charges were investigated and prosecuted by Special Assistant Attorney General Gary A. Baldauf, Regional Director of the Attorney General’s Medicaid Fraud Control Unit’s Buffalo office, under the direction of Deputy Attorney General for MFCU Monica J. Hickey-Martin. Supervising Special Investigator Kathleen Donahue and Associate Special Auditor/Investigator Christopher Magin contributed to the investigation.
Attorney General Schneiderman thanked the United States Attorney’s Office in Buffalo, the Federal Bureau of Investigation, the Department of Health and Human Services, and the Food and Drug Administration’s Office of Criminal Investigations, as well as Blue Cross of Western New York, Independent Health, and Univera, for their cooperation and assistance in the investigation.
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