Pharmacist sentenced in claims fraud case - Minist
October 13, 2006
Pharmacist sentenced in claims fraud case - Ministry
A South Auckland pharmacist was today sentenced in Manukau District Court to 18 months imprisonment, with leave to apply for home detention, for making fraudulent claims.
Andrew Douglas Pellowe, owner and operator of Dawson Road Pharmacy in Flat Bush, in August pleaded guilty to 47 charges of using a document for pecuniary advantage.
The Ministry of Health's business unit HealthPAC brought the charges after a lengthy investigation found the pharmacy sent in 8390 fraudulent claims worth $219.366.66 between October 2003 and September 2005, said HealthPAC Group Manager Quentin Wilson.
Pellowe has repaid the $219,366.66 and also paid $50,000 towards the cost of the investigation.
Dawson Road Pharmacy gained substantial income from claiming subsidies from Counties Manukau District Health Board for dispensing and supplying pharmaceuticals.
Certain repeat medications were processed through the pharmacy's computer as if they had been dispensed, although they had not been.
Many repeats processed this way were either not collected by patients, or not collected within the 90 days expiry period.
In these cases, both the dispensing fees and the cost of the non-supplied medicine was fraudulently obtained from Counties Manukau DHB through claims processed by HealthPAC.
Each charge relates to a separate claim period during which the pharmacy submitted an electronic claim for its costs and services. The total claim amount was electronically paid into bank account of Andrew Pellowe Pharmacy Limited.
HealthPAC accepts some patients requested their repeat prescriptions after the expiry date so estimates the defendant gained about $175,000 from the offending.
"Pellowe has co-operated with us and gave a full and candid interview about how the false claims were made and the extent of the offending," said Mr Wilson.