The owner of a pharmacy in the heart of Edmonton’s Chinatown has been handed the maximum penalty of $50,000 in fines for making “falsified” insurance claims and dispensing unauthorized prescriptions.
Shereen Elbayomy, owner of Metro Pharmacy at 10608 97th Street, has been sanctioned by the Alberta College of Pharmacy.
Elbayomy’s pharmacy registration has been cancelled and she has been barred from operating or being the proprietor of a pharmacy for a period of 10 years, the college announced in a news release Thursday. Elbayomy has also been ordered to cover the $29,000 cost of the investigation and hearing.
“Due to the seriousness of the misconduct,” the college said it sent a copy of its decision to the minister of justice and solicitor general for review.
“Elbayomy was accused by a third-party insurer of submitting claims that were later determined to have been falsified, dishonest, incomplete, without authorization, and/or without supporting purchase records,” the Alberta College of Pharmacy said in an emailed statement.
“Elbayomy failed to co-operate with ACP throughout the investigation and hearing processes.”
$388,000 in false claims
The infractions took place between Jan. 30, 2015, and Feb. 28, 2017, and account for more than $388,000 in false claims, a college tribunal found. The investigation was triggered by a complaint from Alberta Blue Cross.
A hearing tribunal determined that Elbayomy submitted about $299,659 worth of false claims for three drugs — the asthma medications Advair and Symbicort and a type of insulin called Levemir, — and five nutritional supplements to the insurance company without being able to provide the required supporting invoices.
Elbayomy also created false dispensing records when claims were submitted, and the pharmacy did not have the corresponding stock for the drugs to have been dispensed in the first place. Elbayomy received substantial monetary benefit from submitting claims she was not entitled to, the college said, and her actions seriously undermined the integrity of the profession.
“There is no question that the conduct in this case on all allegations is far beyond the range of permitted conduct,” the tribunal decision said.
“There is a repeated pattern of dishonest interactions with an insurer, the creation of false dispensing records and the failure to comply with an investigation.
“Elbayomy’s conduct demonstrates an unwillingness to comply with the fundamental duties of a pharmacist and licensee as well as a complete disregard for the ethical duties and standards that apply to pharmacists and licensees.”
The tribunal found no evidence that patients had been impacted by the misconduct but said Elbayomy’s actions were potentially dangerous.
“Inaccurate medical records have the potential to harm patients because health professionals rely on those records when treating a patient. If a patient’s record is incorrect, they may not receive proper treatment.”
Elbayomy did not attend the hearing.
Despite repeated attempts to make contact with her through phone calls and registered mail, investigators were not able to make contact with her before the hearing, the college said. She has been given 90 days to pay her fines and penalties.