Pharmaceutical Sales Rep From Bayville Admits To Health Care Fraud

BAYVILLE, NJ — A Bayville resident and former pharmaceutical sales representative admitted his role in two conspiracies involving health care fraud and criminal HIPAA schemes, Attorney for the United States Vikas Khanna said.

Keith Ritson, 42, pleaded guilty Wednesday to one count of conspiracy to commit health care fraud and one count of conspiring to wrongfully disclose and obtain patients’ individually identifiable health information in violation of the criminal provisions of the Health Insurance Portability and Accountability Act (HIPAA), Khanna said Thursday.

Ritson was a sales rep from 2014 to 2016, promoting compound prescription medications and others, according to officials.

"Compound medications are specialty medications mixed by a pharmacist to meet the specific medical needs of an individual patient," officials said. "Although not approved by the Food and Drug Administration (FDA), they are properly prescribed when a physician determines that an FDA-approved medication does not meet the health needs of a particular patient, such as if a patient is allergic to a dye or other ingredient."

Ritson, along with his conspirators, found that "certain insurance plans with pharmacy benefit management services," which includes plans for state and local government employees and eligible dependents, covered compound medications from Central Rexall Drugs, Inc. (Central Rexall), a Louisiana pharmacy, officials said.

They discovered that certain compound prescriptions would be reimbursed by insurance for thousands of dollars on a monthly basis, according to officials.

"Ritson received a percentage of the amount that Central Rexall received from the pharmacy benefits administrator for the prescriptions he arranged," officials said.

He recruited people with the covered insurance plans to get the medications, even if they were not medically necessary, officials said. Ritson himself also received unnecessary compound prescriptions, officials said.

Ritson earmarked patients with the covered insurance plans at the practices of Dr. Frank Alario, who practiced at locations in Bayville, Marlboro, Whiting, New York City and Florida, according to officials.

Though Ritson was not affiliated with Alario's practices, he illegally had access his medical offices, medical files and patient information as part of a criminal HIPAA scheme, officials said.

"Ritson was present in the office both during and outside normal business hours and had access to areas of the office restricted to staff, including areas with patient files and office computers," officials said.

He would look up patients' information in files and on computers, earmarking those with covered insurance plans so Alario could prescribe those patients compound medications, according to officials.

Ritson was also in the exam room with Alario during appointments, "which gave patients the impression that Ritson was employed by or affiliated with the medical practices," officials said.

"Ritson used patients' confidential information to fill out prescription forms that Alario authorized, and then Ritson received commissions on those prescriptions," officials said.

Alario pleaded guilty on Oct. 7, 2022, to conspiring to wrongfully disclose patients' individually identifiable health information. He is scheduled to be sentenced Feb. 7, 2023.

According to the Attorney's Office, Ritson faces a maximum penalty of 10 years in prison and a $250,000 fine on the health care fraud conspiracy count, and a maximum penalty of one year in prison and a $50,000 fine on the criminal HIPAA conspiracy count. Sentencing is scheduled for Feb. 21, 2023.

Three former executives of Central Rexall, Christopher Kyle Johnston, 43, of Mandeville, Louisiana; Trent Brockmeier, 60, of Pigeon Forge, Tennessee; and Christopher Casseri, 54, of Baton Rouge, Louisiana, were charged on Sept.17, 2020, in a 24-count indictment with health care and wire fraud and other offenses. The charges against them remain pending.

A fourth former pharmacy executive, Hayley Taff, 39, of Hammond, Louisiana, pleaded guilty to health care fraud conspiracy on Aug. 12, 2020, and is scheduled to be sentenced March 13, 2023.

The charges and allegations contained in the indictment against Johnston, Brockmeier and Casseri are merely accusations, and they are presumed innocent unless and until proven guilty.