Ocean County pharmaceutical rep latest to plead in health care fraud case

An Ocean County pharmaceutical representantive is the latest to plead guilty in a multimillion dollar scheme to defraud health benefits.
Kristie Abbott Masucci, 36, of Cedar Run, admitted to conspiracy to commit health care fraud Monday.
Firefighters, teachers and a doctor are among the 20 who already pleaded guilty in the scheme that took advantage of benefits afforded state and local government and education employees. Thousands of dollars were made in reimbursements for monthly supplies of compound medications that were prescribed for profit rather than necessity.
As a recruiter in the conspiracy from January 2015 through February 2016, Masucci made $388,608, U.S. Attorney Craig Carpenito said.
She and those working under her recruited public employees and other individuals covered by the Pharmacy Benefits Administrator to fraudulently obtain compounded medications from the Compounding Pharmacy without any evaluation by a medical professional that they were medically necessary. In return, the pharmacy paid one of Masucci’s conspirators a percentage of each prescription filled and paid by the Pharmacy Benefits Administrator, which was then distributed to Masucci and other members of the conspiracy.
Masucci’s conspirators would then cause the prescriptions to be signed by a doctor who never evaluated whether the patients had a medical necessity for the compounded medication. The prescriptions were then faxed to the Compounding Pharmacy, which filled the prescriptions and billed the Pharmacy Benefits Administrator.
According to the information, the Pharmacy Benefits Administrator paid the Compounding Pharmacy more than $50 million for compounded medications mailed to individuals in New Jersey, including $1.88 million for prescriptions submitted by Masucci and her cohorts.
Masucci faces a maximum as long as 10 years in prison and a $250,000 fine, or twice the gross gain or loss from the offense. Sentencing is scheduled for Feb. 5.
As part of her plea agreement, Masucci must forfeit her criminal proceeds and pay restitution in an amount to be determined at sentencing.

Others who have pleaded

Dr. John Gaffney, 55, of Linwood: Margate doctor must forfeit $25,000. Cost: $24.9 million

Michael Sher, 40, of Northfield: Margate firefighter must forfeit $1.7 million. Cost: tbd at sentencing

Mike Pepper, 45, of Northfield: Atlantic City firefighter must forfeit $113,627.54. Cost: $719,000

Richard Erick McAllister, 42, of Ocean City: Pleasantville High School English teacher must forfeit $456,806.23. Cost: $3.4 million

Shawn Sypherd, 46, of Marmora: Middle Township Middle School social studies teacher must forfeit $354,264.06. Cost: $2.4 million

Michael Pilate, 39, of Williamstown: Pleasantville schools counselor must forfeit $392,684.20. Cost: $3.5 million

Matthew Tedesco, 42, of Linwood: Pharmaceutical representative must forfeit $11.1 million. Cost: $28.7 million

Nicholas Tedesco, 44, of Linwood: local candy retailer must forfeit $782,766.56. Cost: $2 million

Tara LaMonaca, 43, of Linwood: Pharmaceutical representative must forfeit $89,855.13. Cost: $530,527

William Hunter, 43, of Sewell: Salesman must forfeit $245,020.08. Cost: $1.3 million

Michael Neopolitan, 49, of Willow Grove, Pa.: Pharmaceutical representative must forfeit $198,617.14. Cost: $762,519

Judd Holt, 42, of Marlton: Pharmaceutical representative must forfeit $95,574.49. Cost: $769,762

George Gavras, 36, of Moorestown: Pharmaceutical representative must forfeit $204,002.02. Cost: $679,368.53

Steven Urbanski, 37, of Marlton: Pharmaceutical representative must forfeit $113,600. Cost: $250,000

Thomas Hodnett, 41, of Voorhees: Pharmaceutical representative must forfeit $270,000. Cost: $1.5 million

Robert Bessey, 43, of Philadelphia: Pharmaceutical representative must forfeit $485,540.09. Cost: $2.7 million

Richard Zappala, 45, of Northfield: Pharmaceutical representative must forfeit $1.5 million. Cost: $4.3 million

Andrew Gerstel, 39, of Galloway Township: Pharmaceutical representative must forfeit $184,389.05. Cost: $483,946

Timothy Frazier, 42, of Galloway Township: Commercial construction estimator must forfeit $145,425. Cost: $801,119

Robert Madonna, 36, of Florida: Former Margate mortgage consultant must forfeit $179,370. Cost: $2.1 million.

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