Former Pharmaceutical Employee Sentenced to 15 Months in Prison for Role in Scheme to Obtain Medically Unnecessary Prescription Compounded Medication
NEWARK, N.J. – A former pharmaceutical employee was sentenced today to 15 months in prison for 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 Craig Carpenito announced.
Julie Andresen, 40, of Haddonfield, New Jersey, previously pleaded guilty before U.S. District Judge John Michael Vazquez to an information charging her with conspiracy to commit health care fraud. Judge Vazquez imposed the sentence today in Newark federal court.
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 would receive payments from a marketing business identified in the information as “Company A” in return for filling and obtaining medically unnecessary prescription compounded medications for herself and her husband through the New Jersey pharmaceutical company’s prescription drug benefit plan.
Andresen approached a physician identified in the information as “Physician-1,” who was Andresen’s close friend, at social gatherings. Andresen would provide Physician-1 with preprinted prescription forms listing various compounded medications. Andresen requested that Physician-1 authorize certain compounded medications for her and her husband, such as scar creams and metabolic supplements. Physician-1 did authorize the prescriptions and multiple refills.
Andresen faxed prescriptions for the compounded scar creams and metabolic supplements authorized by Physician-1 to various compounding pharmacies designated by Company A that were located outside of New Jersey. The compounding pharmacies would fill and bill Andresen’s prescription drug benefit plan for the compounded prescriptions. The New Jersey pharmaceutical company’s prescription drug benefit plan reimbursed the compounding pharmacies anywhere between $13,572 and $43,689 for each compounded medication Andresen and her husband received.
The compounding pharmacies would then pay Company A an agreed upon percentage of the reimbursement amount. Company A would pay Andresen an agreed upon percentage of the amount Company A received from the compounding pharmacies. Andresen also requested multiple refills of her and her husband’s prescriptions, and received monetary payment for the refills as well. Altogether, Andresen received $161,378 from Company A for her role in the conspiracy. The New Jersey pharmaceutical company lost $956,885 from this scheme.
In addition to the prison term, Judge Vazquez sentenced Andresen to three years of supervised release, ordered her to pay restitution of $956,885 and to forfeit $161,378.
On June 29, 2016, Stephanie Naar, 28, of St. Louis, Missouri, who had been an employee of the same New Jersey pharmaceutical company as Andresen, pleaded guilty before Judge Vazquez and admitted to accepting thousands of dollars in exchange for obtaining and filling her own medically unnecessary prescriptions for compounded medications.
On July 19, 2016, Peter Pappas, 45, 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 to defraud.
Naar and Pappas are awaiting sentencing.
U.S. Attorney Carpenito 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 Leigh-Alistair Barzey, with the ongoing investigation leading to today’s sentencing.
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.
The New Jersey U.S. Attorney’s Office reorganized its health care fraud practice in 2010 and created a stand-alone Health Care and Government Fraud Unit to handle both criminal and civil investigations and prosecutions of health care fraud offenses. Since that time, the office has recovered more than $1.38 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.