Linwood pharmaceutical representative latest to plead guilty in fraud case

A Linwood woman pleaded guilty Wednesday in a far-reaching multimillion-dollar prescription fraud conspiracy. Tara LaMonaca, 43, pleaded guilty before U.S. District Judge Robert B. Kugler in Camden federal court to an information charging her with conspiracy to commit health care fraud. LaMonaca received about $89,855.13 for her role in the scheme, according to the charges. As part of her agreement, she must repay that money plus restitution, which will be determined at her sentencing, which is set for July 19. She could face as long as 10 years in prison. LaMonaca was working as a pharmaceutical representative when from January 2015 to April 2016, she recruited individuals to obtain very expensive and medically unnecessary compounded medications from an out-of-state pharmacy in order to make thousands, according to the charges. The conspirators knew that these medications were covered by an entity referred to in the information's as the “Pharmacy Benefits Administrator.” The Pharmacy Benefits Administrator provided benefit management services for the State Health Benefits Program, which covers qualified state and local government employees, retirees, and eligible dependents, and the School Employees’ Health Benefits Program, which covers qualified local education employees, retirees, and eligible dependents. LaMonaca and others recruited individuals covered by the Pharmacy Benefits Administrator, including public employees, to fraudulently obtain unnecessary compounded medications from the Compounding Pharmacy. LaMonaca obtained insurance information from those individuals and gave it to another conspirator, who completed the prescriptions and had a doctor sign them without examining the individuals. The prescriptions were faxed to the Compounding Pharmacy, which filled the prescriptions and billed the Pharmacy Benefits Administrator. The pharmacy then paid one of their conspirators a percentage of each prescription filled and paid by the Pharmacy Benefits Administrator, which was then distributed to Lamonaca and other members of the conspiracy. According to the information, the Pharmacy Benefits Administrator paid Compounding Pharmacy over $50 million for compounded medications mailed to individuals in New Jersey, including $530,527.01 for prescriptions submitted by LaMonaca and her co-conspirators. Eighteen other conspirators have pleaded guilty and are await sentencing.