Former Pharmaceutical Employee Admits Role In Scheme To Obtain Medically Unnecessary Compounded Medication
NEWARK, N.J. – A former pharmaceutical company employee today admitted accepting thousands of dollars in exchange for filling medically unnecessary prescriptions for compounded medications for herself and her husband, causing losses of $956,885, U.S. Attorney Paul J. Fishman announced.
Julie Andresen, 39, of Haddonfield, New Jersey, pleaded guilty before U.S. District Judge John Michael Vazquez in Newark federal court to an information charging her with conspiracy to commit health care fraud.
According to documents filed in this case and statements made in court:
Andresen, a former employee of a New Jersey pharmaceutical company, admitted that from September 2014 through September 2015, she received payments from a marketing business – identified in the information as “Company A” – for filling and obtaining medically unnecessary prescription compounded medications for herself and her husband through the pharmaceutical company’s prescription drug benefit plan.
As part of the scheme, Andresen approached a doctor – who was a close friend – at social gatherings that they attended. She would give the doctor pre-printed forms listing compounded medications and ask the doctor to authorize the medications. The doctor did so, as well as authorizing multiple refills. Andresen faxed prescriptions to compounding pharmacies located outside of New Jersey designated by Company A. The compounding pharmacies would fill and bill Andresen’s prescription drug benefit plan. The pharmaceutical company’s prescription drug benefit plan reimbursed the compounding pharmacies $13,572 to $43,689 for each compounded medication Andresen and her husband received.
The compounding pharmacies would pay Company A a percentage of the reimbursement amount, and Company A would pay Andresen a percentage of the amount Company A received from the compounding pharmacies. Andresen received a total of $161,378 from Company A for her role in the conspiracy. The pharmaceutical company lost $956,885 from this scheme.
The conspiracy to commit health care fraud count to which Andresen pleaded guilty carries a maximum penalty of 10 years in prison and a $250,000 fine, or twice the gross gain or loss from the offense. Sentencing is scheduled for June 7, 2017.
On June 29, 2016, Stephanie Naar, 27, of St. Louis, Missouri, who had been an employee of the same pharmaceutical company as Andresen, pleaded guilty before Judge Vazquez and admitted accepting thousands of dollars in exchange for obtaining and filling her own medically unnecessary prescriptions for compounded medications.
On July 19, 2016, Peter Pappas, 44, of Drexel Hill, Pennsylvania, another former employee of the same New Jersey pharmaceutical company as Andresen, also pleaded guilty before Judge Vazquez and admitted to accepting thousands of dollars in exchange for obtaining and filling his own medically unnecessary prescriptions for compounded medications. Pappas also admitted to recruiting others into this scheme.
Naar and Pappas both await sentencing.
U.S. Attorney Fishman credited special agents of the FBI, under the direction of Special Agent in Charge Timothy Gallagher in Newark; and U.S. Department of Defense, Office of the Inspector General, Defense Criminal Investigative Service, under the direction of Special Agent in Charge Craig Rupert, with the ongoing investigation leading to today’s guilty plea.
The government is represented by Assistant U.S. Attorney Erica Liu of the United States Attorney’s Office, Health Care and Government Fraud Unit in Newark.
U.S. Attorney Paul J. Fishman reorganized the health care fraud practice at the New Jersey U.S. Attorney’s Office shortly after taking office, including creating a stand-alone Health Care and Government Fraud Unit to handle both criminal and civil investigations and prosecutions of health care fraud offenses. Since 2010, the office has recovered more than $1.32 billion in health care fraud and government fraud settlements, judgments, fines, restitution and forfeiture under the False Claims Act, the Food, Drug and Cosmetic Act and other statutes.
Defense counsel: Judson Aaron Esq., Philadelphia