New York State Office of the

Medicaid Inspector General


Fighting Fraud. Improving Integrity and Quality. Saving Taxpayer Dollars.


Undercover Investigation Reveals Unacceptable Practices

Manor Pharmacy Inc. in Sullivan County applied for enrollment as a provider with Medicaid. After discrepancies were found in the application, OMIG conducted an undercover investigation at the pharmacy. Investigators discovered that Manor filled a prescription later billed to Medicaid through another provider, Sullivan Pharmacy. Based on this unacceptable practice, OMIG denied enrollment to Manor Pharmacy under 18 NYCRR §504.5(a) (13). OMIG sent an educational letter to the billing pharmacy to instruct them that they may not bill for prescriptions that are not filled at their store.