NEWARK, NJ – A former sales rep for multiple pharmacy and marketing companies today announced his role in a $ 7.89 million public and private health program scam for billing medically unnecessary compound prescriptions, the reigning U.S. Public Prosecutor Rachael A. Honig with.
Christopher Cuffari, 55, of Little Falls, New Jersey, videoconference pleaded guilty to US District Judge John Michael Vazquez over information accusing him of conspiracy to commit healthcare fraud.
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 compound drugs are 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 particular patient’s health needs, such as dye or other ingredient in the prescription.
Between November 2014 and September 2017, Cuffari participated in a conspiracy that resulted in fraudulent prescriptions for compound drugs being submitted to public and private health insurers. At the heart of the program was the discovery that certain insurance plans paid for prescription compound drugs – including scar creams, wound creams, and metabolic supplements / vitamins – at exorbitant reimbursement rates.
Cuffari took this opportunity by working as a sales rep for several compounding pharmacies. To benefit as a sales rep, Cuffari targeted individuals who had compound drug insurance plans and then persuaded those individuals to obtain prescriptions for compound drugs, often with cash payments, regardless of the medical need to obtain prescriptions for compound drugs. In order to obtain prescriptions for compound drugs for some of the recruits, Cuffari arranged payments to a New Jersey-based doctor.
Once the prescriptions were written, they were bottled by the compound pharmacies that Cuffari worked with. The compound pharmacies would then receive a reimbursement from the insurance plans and would pay Cuffari a percentage of the reimbursement amount.
As part of his plea agreement, Cuffari must forfeit $ 995,328 in criminal proceeds received for his role on the program and pay a refund of at least $ 7.89 million. He faces a maximum legal sentence of 10 years in prison and a fine of $ 250,000 or double the gross profit or loss from the offense. The conviction is scheduled for November 9, 2021.
Acting US Attorney Honey attributed the investigations that led to today’s admission of guilt to FBI special agents, headed by special agent George M. Crouch Jr. in Newark.
The government is represented by Assistant Attorney General Sean M. Sherman of the US Attorney’s Office, Newark Opioid Abuse Prevention and Enforcement Division.