The conspirators also learned that some New Jersey state and local government and education employees, including teachers, firefighters and state troopers, had insurance coverage for these particular medications, Carpenito said.
An entity referred to in court documents as the “Pharmacy Benefits Administrator” provided pharmacy benefit management services for the State Health Benefits Program, which covers qualified state and local government employees, retirees and eligible dependents, and the School Employees’ Health Benefits Program, which covers qualified local education employees, retirees and eligible dependents, Carpenito said.
Given that McAllister and Wildman were employees of the state’s public education system, they had access to and recruited others in the system to participate in the scheme, Carpenito said.
CAMDEN — A status conference for the five South Jersey co-defendants who have pleaded not gu…
The prescriptions were faxed to Central Rexall, which filled the prescriptions and billed the Pharmacy Benefits Administrator, Carpenito said.
In return for the obtaining the prescriptions, the pharmacy paid certain conspirators a percentage of each prescription filled and paid by the Pharmacy Benefits Administrator, which was then distributed to McAllister, Wildman and other members of the conspiracy, Carpenito said.
The conspiracy resulted in more than $50 million in fraudulent insurance claims for compounded medications that were not medically necessary, including more than $3.4 million for prescriptions submitted by McAllister and his cohorts and more than $4.8 million for prescriptions submitted by Wildman and his cohorts, Carpenito said.