Shore Area Woman Gets 2 Years For $50 Million Insurance Conspiracy

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  CAMDEN – An Ocean County woman was sentenced to two years in prison for submitting claims for “medically unnecessary prescriptions,” according to the U.S. Attorney’s office. The conspiracy of public employees submitting false claims added up to more than $50 million.

  Kristie Masucci, 37, of the Cedar Run section of Stafford, pleaded guilty to the charge of conspiracy to commit health care fraud.

  According to the charges, Masucci and her conspirators recruited public employees. These employees would get prescriptions for medicines they didn’t need. The state would pay the pharmacy for the drugs. The pharmacy would pay the employees a share. Everyone in the chain would get paid for their work.

  The medications in question were considered compounded medications, which means they are mixed by a pharmacist to meet the specific needs of that patient, according to the release. They are not approved by the Food and Drug Administration. Rather, they are made when a patient can’t take the usual medicine because of an allergy.

  The charges state that from January 2015 through February 2016, Masucci served as a recruiter in the conspiracy and persuaded individuals to obtain the medicine from an out-of-state pharmacy. These people were reimbursed for thousands of dollars for a one-month supply of medicines to treat pain, scars, fungi, as well as libido creams and vitamin combinations.

  The state of New Jersey would be billed for the prescriptions through the health insurance policies provided to teachers, firefighters, municipal police officers, and state troopers.

  The pharmacy paid one of Masucci’s conspirators a percentage of each prescription filled. This money was then doled out.

  More than $50 million was mailed to people in the state, including $1.8 million for prescriptions submitted by Masucci and her cohorts. Masucci received $388,608 for her role in the scheme.

  U.S. District Judge Robert B. Kugler imposed the sentence in Camden federal court. In addition to the prison term, Judge Kugler sentenced Masucci to three years of supervised release and ordered her to pay $1.8 million in restitution.