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Pharmacist sentenced for fraudulent claims

28 July 2005

Pharmacist sentenced for fraudulent claims

The sentencing of Timaru pharmacist Mark Winefield, who fraudulently claimed close to 900 dispensing payments, brings to a close a lengthy investigation by the Ministry of Health's payment arm HealthPAC.

Winefield was sentenced today in the Timaru District Court to 200 hours community service and ordered to pay reparation of $10,865 to the South Canterbury District Health Board, and $20,000 towards the cost of the investigation. He had pleaded guilty earlier this month to four charges of using a document to obtain a pecuniary advantage and 18 charges of fraud.

HealthPAC Group Manager Jeannie Bathgate said she welcomed the successful outcome of the case.

"The majority of health professionals are highly ethical and honest in their claiming of Government subsidies," she said. "Those who choose to deviate should take heed that the Ministry of Health takes a vigorous approach to anyone found abusing the system and fraudulently claiming taxpayers money."

An anonymous tip-off led HealthPAC to audit Winefield's pharmaceutical claiming at his Marchwiel Pharmacy in September 2004. An intensive investigation was conducted by HealthPac, on behalf of the South Canterbury District Health Board, involving health professionals, patients and both current and former staff of the pharmacy.

It established that Winefield had submitted numerous fraudulent claims over a period of nearly four years. In four representative two-week periods on which the investigation focused, Winefield received more than $10,800 in payments he was not entitled to.

"We identified occasions where the rules relating to dispensing were circumvented as a result of the pharmacist, rather than the doctor prescriber, altering prescriptions from three months dispensing of medications all at once, to allow monthly or even weekly dispensing which in many cases were not justified," said Ms Bathgate.

Ms Bathgate said HealthPAC, as compliance agent to the country's 21 District Health Boards, was currently involved in similar investigations.

Close to $1 billion is paid annually as Government subsidies to pharmacists. The system involves tens of millions of items being claimed each year and relies heavily on the honesty of pharmacists to make accurate returns.

Ms Bathgate said HealthPAC was increasingly using sophisticated computer systems which identify suspicious claiming patterns and would make it easier to detect fraud.


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