A pair of physicians, including a woman who lives on Long Island, are facing charges for allegedly conspiring to operate a pill mill and fraudulently billing Medicaid.
Rockville Centre resident Clarise Clemons and Rego Park resident Ilya Smuglin and have been arrested and charged with criminal sale of a prescription for a controlled substance, health care fraud and conspiracy, New York Attorney General Letitia James announced, following an investigation.
It is alleged that Clemons, 63, Smuglin, 50, and other staff at the Miromedical P.C. and Ferrara Medical Care P.C. clinics created, enabled and fostered an environment that encouraged excessive prescriptions of Suboxone, an opioid. James said that the prescriptions led to “an influx of patients who were the means for (Smuglin and Clemons) to file false Medicaid claims.
James said that the “clinics, located at 903 Sheridan Avenue in the Bronx, and at 2738 Frederick Douglass Boulevard in Manhattan, operated as unauthorized, uncertified providers of substance abuse treatment services.”
According to James, “state law mandates that substance abuse treatment programs be certified by the Office of Alcohol and Substance Abuse Treatment Services in order to treat those suffering from addiction. State and Federal Law further regulates how such treatment is to be conducted in order to heighten the chances of a successful recovery.”
“We will not tolerate attempts to fraudulently use the Medicaid program to take advantage of those suffering from addiction,” she said. “New York is experiencing a serious opioid epidemic, and doctors that prescribe narcotics without proper screening procedures only deepen this crisis. We will continue to take on this crisis from every angle and that includes prosecuting doctors who abuse their duties and our trust.”
It is further alleged that the two doctors and their co-conspirators offered kickbacks and subscriptions to lure Medicaid patients. Once recruited, prosecutors allege that patients encountered the façade of a substance abuse treatment program.
The appropriate and necessary medical histories were not always obtained, physicals and urine toxicology were not regularly performed, and patients were consistently provided with prescriptions for Suboxone at the maximum dose, without any effort to taper or wean the patient off the narcotic in violation of applicable treatment guidelines.
As part of the scheme, the two doctors allegedly gave out pre-signed or blank prescription pads to medical and non-medical staff, allowing them to hand out prescriptions. In total, it is alleged that Medicaid paid pharmacies filling the Suboxone prescriptions $3 million in 2015 and more than $2 million in 2016.
Smuglin and Clemons were arraigned in New York City Criminal Court on Friday, May 6 and ordered to surrender their passports before they were release. The case has been adjourned until June 12. If convicted, each doctor may face a maximum penalty of eight and a third to 25 years in state prison.
"Anyone who takes advantage of vulnerable New Yorkers for their own benefit must be prosecuted to the fullest extent of the law,” Department of Social Service Commissioner Steven Banks stated. “The conduct alleged in this case demonstrates a clear and unconscionable intent to defraud our social safety net as well as an absolute disregard for human dignity – and those who commit such crimes must be held accountable. We remain committed to collaborating with the Attorney General’s Office whenever necessary to prevent, identify, and report suspected fraud and abuse that amount to theft of public benefits.”
Click here to sign up for Daily Voice's free daily emails and news alerts.