Two men have pleaded guilty in a multimillion health care fraud scheme using doctors to prescribe expensive compounds and then recruiting public employees to join in the illegal venture.
Matthew Tedesco, 42, a pharmaceutical representative from Linwood, made more than $11 million leading the conspiracy. He pleaded guilty in Camden federal court, becoming the first conviction in a long, wide-spread investigation that included federal subpoenas for Margate, Ventnor and Atlantic City.
Robert Bessey, 43, of Philadelphia, made more than $485,000 recruiting “patients” for endeavor.
Both have to forfeit the money they made, along with paying restitution: Tedesco must pay back more than $28.7 million. Bessey nearly $2.7 million.
In 2015 and 2016, Pharmacy Benefits Administrator paid more than $50 million for compounded medications mailed to people in New Jersey, according to the federal complaint.
Compounded drugs are where a licensed pharmacist combines, mixes or alters ingredients of one or more drugs to make a tailor-made medication that fits the needs of a patient, the charges explain.
But those compounds were not prescribed through medical need but for want of money, the complaint says.
The complaint explains the scam as follows:
Tedesco and others paid doctors with money and benefits to sign pre-printed prescription forms requesting 12 months of refills to get the highest reimbursement possible. The doctors would not see the patients to evaluate them and to see whether the compounds would work or if a non-compounded prescription or over-the-counter medication would be an option.
Instead, Tedesco and not-yet-named conspirators would recruit firefighters, police officers, teachers and others with public health benefits to be “patients” on these forms.
They would then fax the forms to Pharmacy Benefits Administrator directly, without the “patient” getting the subscription that could be filled through their local pharmacy.
Tedesco is the first to plead in the investigation, which included search warrants served to at least two local doctor’s offices, sources have told BreakingAC.
One practice is still open. The other was Dr. James Kauffman, who is now jailed on weapons offense, after he pulled a gun when law enforcement came to serve a search warrant at his Egg Harbor Township office.
More pleas are scheduled for Friday.
