Pharmacist faces fraud charges

Alleged false insurance claims made with United Healthcare Sparta —Desmond Fitzgerald, the 74-year-old owner of the Sparta Pharmacy on Woodport Road, was issued a complaint summons by Sparta Police last Friday, stating that he allegedly falsified at least 23 claims for prescriptions with the United Healthcare Insurance Co. for a customer who says she never requested or received the medications. According to Sparta Police Sergeant Ron Casteel, Fitzgerald was issued the summons and voluntarily went to the police station for questioning. He was processed and released and did not have to post bail, as the summons was not an arrest warrant, Casteel said. The fraud charges came after a nine-month investigation sparked by a 79-year-old Sparta woman who says she discovered claims for such medications as Advair, Celebrex, Lidoderm, and Provental were billed to her insurance company, United Healthcare. She told police she never requested or received these medications, for which her insurance was billed just under $1,000. Detective Douglas Porter of the Sussex County Insurance Fraud Unit confirmed an ongoing investigation into the matter. Asked this week if there was a doctor involved in the alleged fraud, he said he could not discuss specifics of the case, but explained, “In other such cases, we would look for paper records of prescriptions or phone calls to doctors requesting prescriptions, interview the parties, and draw informed conclusions based on the information we obtain.” Porter said the New Jersey Office of the Insurance Fraud Prosecutor was established 12 years ago and is based in Trenton. In 2001, a grant from that office allowed the formation of the Sussex County Insurance Fraud Unit, of which Porter is the sole detective. He said his office investigates a variety of insurance fraud cases, including the most common which include staged auto accidents and arson. The unit has posted a tip line which goes directly to his office for anyone who would like to report suspected insurance fraud. That number is: 973-383-1570, ext. 4403. In the Fitzgerald case, he requests that anyone who has seen billing discrepancies in claims between their insurance companies and Sparta Pharmacy to contact him. To date, Porter said he has received only the one complaint regarding this matter. Fitzgerald, who is scheduled to appear in his first hearing in Sparta Municipal Court today, said he was advised by his attorney not to comment on the charges against him. After the initial hearing, the matter will be sent to Superior Court. Sparta Pharmacy has been a local staple for over 45 years, and has been owned by Fitzgerald since it was established in 1961.The store prides itself on providing “personalized pharmacy services,” according to its Web site. The CVS drug store has been in Sparta’s Theatre Center, just a few doors away from Sparta Pharmacy, since 2003. The small local store has co-existed with the mega-chain by becoming more of a general store. Besides medications and pharmaceutical supplies, the pharmacy sells a variety of year-round gift items, including the collectible “Precious Moments” line of statuettes, seasonal gifts and merchandise, and other items such as toys and costume jewelry. Also available at the store are Lakeland Bus tickets to New York City and Atlantic City.