Former Madison County Pharmacy Owner Sentenced for Health Card Fraud

 SYRACUSE, NEW YORK - Jennifer Caloia, age 57, a licensed pharmacist who owned and operated Dougherty Pharmacy in Morrisville, New York, from 1998 to 2015, was sentenced today in federal court in Utica to serve a two-year term of probation, perform 80 hours of community service, a fine in the amount of $10,000.00, a special assessment of $100 after previously pleading guilty to one felony count of health care fraud.

The announcement was made by Acting United States Attorney Antoinette T. Bacon; Janeen DiGuiseppi, Special Agent in Charge of the Albany Field Office of the Federal Bureau of Investigation (FBI); Scott J. Lampert, Special Agent in Charge of the New York Regional Office of the U.S. Department of Health and Human Services, Office of Inspector General (HHS OIG); Ralph D. Tortora III, Regional Director, New York Attorney General’s Medicaid Fraud Control Unit, Syracuse Office; Carol S. Hamilton, Regional Director, U.S. Department of Labor Employee Benefits Security Administration (DOL EBSA); and Shirin Emami, Acting Superintendent, New York State Department of Financial Services.

In pleading guilty previously, Jennifer Caloia admitted that between 2011 and 2015 she defrauded public and private health insurance programs by submitting false and fraudulent claims for prescription drugs that the pharmacy did not dispense. Caloia also admitted that customers submitting prescriptions for medications had their health insurance providers billed for more expensive drugs than those prescribed. To facilitate this scheme, Caloia changed the names of some of the prescription drugs in the software she used to communicate with insurance companies and to print drug labels, which allowed her to submit her fraudulent claims while providing the customer with the appropriate labels and instructions. Evidence presented to the court in support of Caloia’s guilty plea also revealed that in at least a few instances she dispensed a drug different than what a customer’s doctor had prescribed as part of her scheme to defraud. Caloia no longer owns or operates Dougherty Pharmacy.

In sentencing Caloia, United States District Judge David N. Hurd also ordered her to pay restitution in the amount of $110,431.02 to the public and private insurers affected by her fraud scheme.

In separately negotiated civil settlements with the Civil Division of the United States Attorney’s Office for the Northern District of New York and the New York State Attorney General’s Office, Caloia and her company agreed to pay $92,308.76 related to her submission of false claims to public insurers such as Medicare and Medicaid. The civil settlement resolves a whistleblower lawsuit filed under the qui tam provisions of the federal and New York False Claims Acts, which allow private persons, knowns as “relators,” to file civil actions on behalf of the government and share in any recovery.  The relator in this case will receive $18,461.75 of the settlement proceeds. The federal civil case is docketed with the United States District Court for the Northern District of New York under number 6:17-cv-92 (BKS/ATB).

This case was investigated by the Federal Bureau of Investigation (FBI); the U.S. Department of Health and Human Services, Office of Inspector General (HHS OIG); the U.S. Drug Enforcement Administration (DEA), the U.S. Department of Labor-Employee Benefits Security Administration (DOL EBSA), New York Attorney General’s Medicaid Fraud Control Unit; and the New York State Department of Financial Services, and it is being prosecuted by Assistant U.S. Attorney Michael F. Perry. The civil investigation is being handled by Assistant United States Attorney John Hoggan and New York Attorney General’s Medicaid Fraud Control Unit, Syracuse Office Regional Director Ralph D. Tortora III.