By: Richard L. Smith
Friday, a Philadelphia resident received a 15-month prison sentence for participating in a scheme that defrauded New Jersey state health benefit programs and various insurance providers of $2.69 million.
The fraudulent activity involved the submission of false claims for medically unnecessary prescriptions. Vikas Khanna, the Attorney representing the United States, made this announcement.
Federal officials said Robert Bessey, 49, of Philadelphia, previously pleaded guilty before U.S. District Judge Robert B. Kugler to an information charging him with conspiracy to commit health care fraud. Judge Kugler imposed the sentence today in Camden federal court.
According to documents filed in this case and statements made in court:
From January 2015 through April 2016, Bessey, a recruiter in the conspiracy, and others persuaded individuals in New Jersey to obtain costly and medically unnecessary compounded medications from an out-of-state pharmacy.
The conspirators learned that a pharmacy benefits administrator would reimburse pharmacies thousands of dollars for a one-month supply of certain prescription compounded medications, including pain, scar, antifungal, and libido creams, as well as over $10,000 per month for certain vitamin combinations.
The pharmacy benefits administrator managed the prescription drug benefit plan for some New Jersey state and local government and education employees, including teachers, firefighters, municipal police officers, and state troopers.
The conspirators 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 addition to the prison term, Judge Kugler sentenced Bessey to two years of supervised release. Bessey was ordered to forfeit $485,540 and pay restitution of $2.69 million.
