Posted on: Friday, March 16, 2001

Settlement expected in Medicaid fraud case

By William Cole
Advertiser Courts Writer

A $2.1 million Medicaid fraud settlement is expected to be announced today, representing a record recovery in Hawai'i involving an individual physician.

Law enforcement officials said the O'ahu doctor who was not identified yesterday illegally allowed a clerk to dispense medication out of his office, and overbilled Medicaid and other coverage providers for hundreds of thousands of pills.

The investigation was a joint effort involving the FBI, U.S. Attorney's Office and state attorney general's office.

The settlement is expected to be announced this afternoon. Authorities say the illegal activity occurred over a number of years.

By law, only doctors can dispense medication from an office, but a clerk was instructed to do so in this case, officials said. The investigation also showed the doctor billed extensively for expensive medication, but records indicated he purchased very little of those drugs, according to officials.

Authorities said Medicaid and the clerk, who came forward and cooperated with authorities, will share in the expected settlement as the result of a "qui tam" lawsuit involving individuals who submit false claims to the government.

Under the Hawai'i False Claims Act passed last year, whistle blowers are allowed to share in the recovery.