Source: Asbury Park Press
Kristie Masucci, 35, has admitted in U.S. District Court in Camden that she took part in a conspiracy to defraud New Jersey’s health care benefits programs by submitting bogus claims for expensive, custom-made drugs from a compound pharmacist.
Compounding pharmacies make drugs prescribed by doctors for specific patients with needs that can’t be met by commercially available drugs — for instance, when a child needs medication that only comes in adult doses, or a patient who is allergic to ingredients in a commercially prepared drug.
Authorities said Masucci recruited people — teachers, firefighters, police officers and other public employees — to obtain pain, scar, anti-fungal and libido creams costing thousands of dollars a month from an out-of-state pharmacy.
The unnamed out-of-state compounding pharmacy made more than $50 million in New Jersey, $1.88 million of it from Masucci and her recruits, authorities said. Masucci pocketed $388,608 from the scheme, according to the U.S. Attorney’s Office.
In exchange for obtaining unnecessary prescriptions from doctors who did not perform evaluations, Masucci’s recruits were then paid a percentage of those medications, authorities said.
A health benefits administrator accepted the claims and paid them on behalf of the New Jersey State Health Benefits Program and the School Employees’ Health Benefits Program and billed New Jersey, authorities said.
It was part of a broader scheme to defraud the state’s health benefits programs, and ran from January 2015 to February 2016, authorities said.
Masucci, of the Cedar Run section of Stafford, entered her guilty plea on this week, and is scheduled to be sentenced on next Feb. 5. She faces up to 10 years in prison and a maximum fine of $250,000 for the single charge of conspiracy to commit health care fraud, according to the U.S. Attorney’s Office.
In August 2017, Matthew Tedesco, 43, a pharmaceutical sales representative from Linwood, and Robert Bessey, 44, of Philadelphia, pleaded guilty to conspiracy to commit health care fraud. Authorities said they were involved in a $25 million effort to bilk the benefits programs.