OMIG-assisted investigation leads to arrest of Queens pharmacy owner in alleged $31 million Medicaid fraud scheme
A Queens pharmacy owner was arrested and indicted following an OMIG-assisted investigation for allegedly stealing more than $31 million from Medicaid and the AIDS Drug Assistance Program (ADAP) through a scheme involving cash kickbacks and fraudulent claims for HIV medications. The arrest and indictment follows a years-long investigation conducted by the New York State Office of the Attorney General’s Medicaid Fraud Control Unit (MFCU), New York State Office of the Medicaid Inspector General (OMIG), U.S. Department of Health and Human Services, Office of the Inspector General and the U.S. Department of Homeland Security Investigations.
Miguel Baron, 62, of Yonkers, and his companies, Guardiola Pharmacy and Baron Specialty Pharmacy, were indicted by a Queens County grand jury on charges including grand larceny, health care fraud, money laundering and unlawfully paying kickbacks to Medicaid beneficiaries.
“Today’s indictment sends a clear message to those who seek to exploit the Medicaid program for personal gain: you will be held fully accountable,” said Acting Medicaid Inspector General Frank Walsh. “We will continue to work closely with Attorney General James and our other partners to root out fraud, waste, and abuse in the Medicaid program.”
According to prosecutors, from January 2023 through April 2026, Baron and his co-conspirators allegedly paid Medicaid recipients cash kickbacks, often between $150 and $250, to fill prescriptions at his pharmacies. In some instances, the pharmacy allegedly bought back HIV medications from recipients for a few hundred dollars and returned the medications to inventory, allowing pharmacies to bill Medicaid and ADAP multiple times for the same medications.
“Taking advantage of vulnerable New Yorkers to steal tens of millions of dollars from Medicaid is despicable,” said Attorney General James. “Pharmacy owners who exploit patients with medication buyback schemes are putting New Yorkers’ health at serious risk. My office will continue to protect patients, shut down Medicaid fraud schemes, and hold criminals accountable to ensure that our tax dollars are not lining scammers’ pockets.”
Prosecutors also allege that the pharmacies dispensed medications obtained from unlicensed sources while billing Medicaid and ADAP for legitimate HIV medications, potentially putting patients at risk by depriving them of prescribed medications or providing medications without assurances that they had been properly stored and maintained. The alleged scheme resulted in more than $31 million in reimbursements. Prosecutors allege that many of the proceeds were laundered through accounts belonging to shell companies Baron or his associates controlled to disguise the source and ownership of the funds. These shell companies then purchased real estate and funded construction projects with the stolen funds and also converted the money into large sums of cash.
Baron was arrested at LaGuardia Airport as he attempted to board a one-way flight to Toronto, Canada. The Attorney General’s Office also filed a civil asset forfeiture action seeking more than $95 million in damages and targeting assets allegedly purchased with proceeds of the scheme.
Baron faces a maximum sentence of eight and one-third to 25 years in prison if convicted of the top count.
The charges against Baron and his companies are accusations. The defendants are presumed innocent unless and until proven guilty in a court of law.
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