NEWARK, NJ – A former pharmaceutical sales rep was charged today for his role in a plot to defraud a telecommunications company’s health plan by charging for medically unnecessary compound prescriptions, U.S. Attorney Rachael A. Honig said.
Carmine A. Mattia Jr., 60, of Cedar Grove, New Jersey, has been charged with health fraud conspiracy in one case and health fraud in three cases. He has his first appearance on a date to be determined.
According to documents filed in this case and statements made in court:
Compound drugs are specialty drugs that are mixed by a pharmacist to meet the specific medical needs of an individual patient. Although not approved by the Food and Drug Administration (FDA), they are properly prescribed when a doctor determines that an FDA-approved drug does not meet a specific patient’s health needs, such as ingredients in the prescription.
The program focused on Mattia’s work as a sales rep for a marketing company and various pharmacies for which he sold compound medications, including pain creams, scar creams, wound creams, and metabolic supplements / vitamins. Mattia was also a full-time employee of the telecommunications company and a union representative for the company’s employees.
Between April 2016 and July 2016, Mattia participated in a conspiracy to submit fraudulent prescriptions for compound drugs to the telecommunications company’s health plan. The compound pharmacies paid Mattia a commission for each compound medication prescription that Mattia had to charge to the company’s health plan.
In order to fraudulently grow his profits as a sales rep, Mattia recruited Individual-1 to obtain medically unnecessary compound drugs. Mattia paid Individual-1 to get Individual-1 to receive these drugs. Mattia also secured the signature of a New Jersey doctor, Robert Agresti, on the prescription forms for Individual-1. Agresti and Individual-1 did not have a doctor-patient relationship, Agresti did not determine whether Individual-1 required the selected compound drugs, and he did not study Individual-1. Agresti pleaded guilty to the healthcare fraud conspiracy on June 26, 2018 and is awaiting conviction.
Mattia’s participation in the program caused a loss in the telecommunications company’s health plan of approximately $ 100,000.
Conspiracy and Major Health Fraud charges each have a legal limit of 10 years in prison and a fine of $ 250,000 or double the gross profit or loss of the offense, whichever is greater.
Acting US Attorney Honey attributed the investigations that led to today’s indictment to FBI special agents, headed by special agent George M. Crouch Jr. in Newark.
The government is represented by U.S. Assistant Attorneys Emma Spiro and Sean M. Sherman of the U.S. Attorney’s Office for the Opioid Abuse Prevention and Enforcement Division in Newark.
The allegations and allegations contained in the indictment are merely allegations and the defendant is presumed innocent until proven guilty.