Brooklyn psychiatrist nabbed for prescription fraud

February 7, 2013 New York State Attorney General's Office

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After an undercover investigation, NYS Attorney General Eric T. Schneiderman yesterday announced the arrest of Dr. Jean Elie, a Brooklyn psychiatrist, on grand larceny charges for billing the state’s Medicaid program $230,000 for services he did not provide.

Dr. Elie, 59, of Elmont, wrote prescriptions for Seroquel valued at over a million dollars over a three-year period to a revolving door of clients. Dr. Elie, who worked out of the Family Practice offices at 1155 Broadway in Bushwick, faces up to 15 years in prison.

Schneiderman said, “This doctor’s office was basically a pill mill. The systemic abuse of prescriptions drugs is an epidemic in this country and in this state. It must stop. Our office will do everything in its power to ensure that it does.”

According to a complaint filed in Brooklyn Criminal Court, Elie billed over $232,000 for therapy sessions which he falsely claimed lasted a minimum of 45 minutes. Instead, the sessions routinely lasted less than 10 minutes. By law, physicians are required to submit claims for payment using billing codes which accurately reflect the services they provided.

As described in the court papers, undercover investigators from the Attorney General’s office, posing as patients, signed up for seven sessions with Elie. None of these sessions lasted for more than six minutes.

Even so, the doctor billed Medicaid using a code, known as the “hour code,” which requires, in addition to a medical evaluation, 45 to 50 minutes of face-to-face therapy with a patient, according to the complaint.

Between 2009 and 2012, Elie wrote prescriptions for Seroquel valued at over a million dollars, making him one of the top prescribers of Seroquel in the state.

The anti-psychotic medication is frequently abused and has a street value among addicts. Elie’s prescribing patterns and the observations made by MFCU investigators during the course of the investigation appear to indicate that some of Elie’s patients sought prescriptions for medications they could sell on the street.

At his arraignment, prosecutors charged that Elie worked at the Family Practice offices for only four hours a day but routinely billed Medicaid for therapy sessions that, if legitimate, would have taken longer than the 24-hour period he claimed they occurred in. On one date, Elie billed the hour code 30 times; and on 94 separate dates he billed it 20 or more times.