Philadelphia Man Sentenced For Role in $2.69M NJ Healthcare Fraud Conspiracy
A man from Philadelphia has been sentenced to 15 months in prison for his role in defrauding New Jersey state health benefits programs and other insurers out of $2.69 million by submitting fraudulent claims for medically unnecessary prescriptions.
49-year-old Robert Bessey previously pleaded guilty to a charge of conspiracy to commit health care fraud.
Federal authorities say from January 2015 through April 2016, Bessey, a recruiter in the conspiracy, and others persuaded individuals in New Jersey to obtain very expensive 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, Bessey was also sentenced to two years of supervised release, he was ordered to forfeit $485,540, and pay restitution of $2.69 million.