Lakewood Pharmacy To Repay Medicaid $878K On Prescription Claims

LAKEWOOD, NJ — A Lakewood pharmacy and its owner have agreed to repay more than $878,000 to Medicaid for claims that were paid but for which the pharmacy could not provide invoices, state officials said Thursday.

Madison Avenue Pharmacy of Lakewood and its owner, David Segal, will repay $878,083 under the settlement announced by state Comptroller Philip James Degnan.

The news release from Degnan's office did not say when the investigation occurred or what time period the investigation encompassed. The pharmacy received its NPI number, which certifies it as a health provider, in 2012, according to online records.

The unsubstantiated claims were uncovered during what Degnan said was a routine inventory analysis investigation of the pharmacy conducted by the comptroller's office Medicaid Fraud Division.

"Our investigators verify that submitted claims are supported by proper documentation," Degnan said. "When the pharmacy cannot provide sufficient documentation, we will act aggressively to pursue a recovery on behalf of the Medicaid program."

The settlement between Madison Avenue Pharmacy and the Medicaid Fraud Division resolves all allegations resulting from this investigation, but does not amount to an admission of liability by the pharmacy, Degnan said.

Under the agreement, Segal and the pharmacy had to repay $440,083.38 immediately and the remainer is to be repaid over the course of several months.

Suspected Medicaid waste, fraud or abuse can be reported to the MFD by calling its toll-free hotline at 888-937-2835 or by submitting a complaint form (click here).

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