Manahawkin Woman Imprisoned For Prescription Fraud Scheme

CAMDEN, NJ — A Stafford woman was sentenced to two years in prison for her role in a conspiracy to provide medically unnecessary prescriptions, officials announced Tuesday. Kristie Masucci pleaded guilty in October to serving as recruiter for a scheme that defrauded New Jersey state medical benefit programs.

The conspiracy had public employees file claims for expensive and medically unnecessary prescriptions filled through another state. Masucci, 37, persuaded individuals in New Jersey to receive these medications, according to the U.S. Attorney's Office.

These prescriptions were compounded medications — specialty medications that a pharmacist is supposed to mix to meet a patient's specific needs. Although the Food and Drug Administration don't approve of them, they are properly prescribed when a physician determines that an FDA-approved medication doesn't meet a particular patient's health needs.

Masucci and conspirators convinced individuals to get compounded medications from an out-of-state pharmacy identified as the "Compounding Pharmacy." She became the 21st person to enter a plea deal in this scheme in October. Read more: Stafford Woman Admits Fraud With Prescription Scheme

Masucci served as a recruiter for the conspiracy from January 2015 through February 2016, according to the USAO. The conspirators learned that certain compound-medication prescriptions — including pain, scar, anti-fungal, libido creams and vitamin combinations — were reimbursed for thousands of dollars for a one-month supply.

Conspirators also learned that New Jersey state and local government and education employees had insurance coverage for these particular compound medications. Employees included teachers, firefighters, municipal cops and state troopers.

An entity referred to as the "Pharmacy Benefits Administrator" provided pharmacy benefit management services for the State Health Benefits Program. The program covers qualified state and local government employees, retirees and eligible dependents. The Pharmacy Benefits Administrator would pay prescription drug claims and then bill the State of New Jersey for the amounts paid.

Masucci and conspirators recruited public employees and other individuals covered by the Pharmacy Benefits Administrator to fraudulently obtain compounded medications from the Compounded Pharmacy without evaluation from a medical professional.

The Pharmacy Benefits Administrator paid the Compounding Pharmacy more than $50 million for medications mailed to people in New Jersey, including $1.8 million for prescriptions submitted by Masucci and her cohorts, the USAO said.

Along with prison, Masucci was sentenced to three years of supervised release and must pay $1.8 million in restitution.

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