CAMDEN, N.J. – Two former New Jersey state public education system employees were sentenced today to prison terms for defrauding New Jersey state health benefits programs by submitting fraudulent claims for medically unnecessary compounded prescriptions, U.S. Attorney Craig Carpenito announced.

Richard McAllister, 45, a former schoolteacher, and James Wildman, 46, a former maintenance worker for the public school system, both of Marmora, New Jersey, were sentenced to 37 months and 46 months in prison, respectively. Both McAllister and Wildman previously pleaded guilty before U.S. District Judge Robert B. Kugler to separate criminal informations charging them with conspiring to commit health care fraud. Judge Kugler imposed the sentences today in Camden federal court.

According to documents filed in this case and statements made in court:

Compounded medications are specialty medications mixed by a pharmacist to meet the specific medical needs of an individual patient. Although compounded drugs are 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.

In 2015 and 2016, McAllister and Wildman served as recruiters in the conspiracy and persuaded individuals in New Jersey to obtain very expensive and medically unnecessary compounded medications from a Louisiana pharmacy, Central Rexall Drugs Inc. (Central Rexall). The chief executive officer of Central Rexall, Hayley Taff, pleaded guilty on Aug. 12, 2020, to health care fraud conspiracy, and Central Rexall executives Christopher Kyle Johnston, Trent Brockmeier, and Christopher Casseri were indicted on Sept. 16, 2020 for conspiracy to commit health care and wire fraud, conspiracy to commit identity theft, and money laundering charges.

The members of the conspiracy, including McAllister and Wildman, learned that certain compound medication prescriptions – including pain, scar, antifungal, and libido creams, as well as vitamin combinations – were reimbursed for up to thousands of dollars for a one-month supply. 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 compound medications. An entity referred to in the information 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.

McAllister, Wildman, and their conspirators recruited public employees and other individuals covered by the Pharmacy Benefits Administrator to fraudulently obtain compounded medications from Central Rexall without regard as to their medical necessity. Given that McAllister and Wildman were employees of the State’s public education system, they had access to and recruited others in the public education system to participate in the scheme. The prescriptions were faxed to Central Rexall, which filled the prescriptions and billed the Pharmacy Benefits Administrator. 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. 

The conspiracy resulted in over $50 million in fraudulent insurance claims for compounded medications that were not medically necessary, including over $3.4 million for prescriptions submitted by McAllister and his cohorts and over $4.8 million for prescriptions submitted by Wildman and his cohorts. McAllister received over $450,000 and Wildman received over $650,000 in illicit profits from the scheme. 

In addition to the prison terms, Judge Kugler sentenced McAllister to three years of supervised release and ordered him to pay $3.4 million in restitution and to forfeit $456,806. Judge Kugler also sentenced Wildman to three years of supervised release and ordered him to pay $4.86 million in restitution and to forfeit $657,040.

U.S. Attorney Carpenito credited agents of the FBI’s Atlantic City Resident Agency, under the direction of Special Agent in Charge George M. Crouch Jr. in Newark; IRS – Criminal Investigation, under the direction of Special Agent in Charge Michael Montanez in Newark, and the U.S. Department of Labor, Office of Inspector General, New York Region, under the direction of Special Agent in Charge Michael C. Mikulka. He also thanked the Division of Pensions and Financial Transactions in the State Attorney General’s Office, under the direction of Attorney General Gurbir S. Grewal and Division Chief Aimee Nason, for its assistance in the investigation.

The government is represented by Assistant U.S. Attorneys R. David Walk Jr. and Christina O. Hud of the U.S. Attorney’s Office in Camden.

CAMDEN, N.J. – Three former executives of a Louisiana compounding pharmacy are charged in a 24-count indictment with using the pharmacy to defraud New Jersey and military health benefits programs, U.S. Attorney Craig Carpenito announced today. 

Christopher Kyle Johnston, 41, of Mandeville, Louisiana; Trent Brockmeier, 58, of Pigeon Forge, Tennessee; and Christopher Casseri, 52, of Baton Rouge, Louisiana, were charged with conspiracy to commit health care fraud and wire fraud and a second conspiracy to commit identity theft by using individuals’ personal identifying information without their consent.  Casseri was also charged with repeatedly lying to federal agents when interviewed. Johnston and Brockmeier face additional charges of conspiring to commit money laundering and substantive counts of money laundering for transactions involving more than $43 million in illicit profits they realized from the scheme.

The defendants are expected to appear today before U.S. Magistrate Judge Ann Marie Donio by videoconference. The case is assigned to U.S. District Judge Robert B. Kugler in Camden. 

According to the indictment:

Central Rexall Drugs was a retail pharmacy in Louisiana that prepared compounded medications, which are specialty medications mixed by a pharmacist to meet the specific medical needs of an individual patient. In 2013, Johnston and Brockmeier entered into an agreement with Central Rexall’s chief executive officer, Hayley Taff – who pleaded guilty on Aug. 12, 2020, to conspiracy to commit health care fraud – to take over the management of the pharmacy and expand the compounding business in exchange for 90 percent of the profits. Brockmeier became chief operating officer of Central Rexall and Johnston became general counsel. They hired Casseri as vice president of sales to manage Central Rexall’s outside sales force.

Johnston, Brockmeier, and Casseri learned that certain insurance plans administered by an entity referred to in the indictment as the “Pharmacy Benefits Administrator” would reimburse thousands of dollars for a one-month supply of certain compounded medications – including pain, scar, and antifungal creams, as well as vitamin combinations. The health plans for New Jersey state and local government and education employees, including teachers, firefighters, municipal police officers, and state troopers, had this insurance coverage, as did TRICARE, which insures current and former members of the armed forces and their families. 

The three conspirators designed compounded medications and manipulated the ingredients in the medications in order to obtain high insurance reimbursements rather than serve the medical needs of patients. To determine which ingredients and combinations resulted in the highest insurance reimbursements, Johnston, Brockmeier, and Casseri had Central Rexall employees send the Pharmacy Benefits Administrator false prescription claims to test out different combinations of ingredients, but the prescriptions did not exist. By trial and error use of these false claims, Johnston, Brockmeier, and Casseri designed compounded medications with combinations of ingredients that were chosen solely based on the amount of money that insurance would pay rather than on the medications’ ability to serve the medical needs of patients. At their direction, Central Rexall sent compounded medications to patients based solely on financial gain, without any research or testing showing that the combination of ingredients was effective. 

When the Pharmacy Benefits Administrator stopped covering one combination, the conspirators would develop a compounded medication with a different combination of ingredients based solely on the insurance reimbursement and without considering the medical necessity or effectiveness of the new combination. Central Rexall then would send that new compounded medication to patients, even though the new combination of ingredients was not medically equivalent to the combination originally prescribed for the patients and without telling the patients or their doctor about the differences.

The outside sales force retained and directed by Johnston, Brockmeier, and Casseri used various methods to get doctors to prescribe these medications and patients to accept them, including having prescriptions signed without the patient seeing a doctor or knowing about the medications, having medications or refills ordered with the patients’ knowledge, and paying patients to accept the medications and paying doctors to prescribe them.

Johnston, Brockmeier, and Casseri and their conspirators caused over $50 million in fraudulent insurance claims for compounded medications that were not medically necessary.  Johnston received over $34 million and Brockmeier received over $5 million in illicit profits, and Casseri received $200,000 in bonuses. 

The indictment also charges Johnston, Brockmeier, and Casseri with a second scheme to commit identity theft. The conspirators took the patients’ names, dates of birth, and identifying information (including insurance information) without their consent from pre-existing Central Rexall prescriptions and used the information to make the false test claims to the Pharmacy Benefits Administrator.

The health care fraud and wire fraud conspiracy count carries a maximum potential penalty of 20 years in prison and a $250,000 fine, or twice the gain or loss from the offense. The false statement count and the conspiracy to commit identity theft count each carry a maximum penalty of five years in prison and a $250,000 fine, or twice the gross gain or loss from the offense. The money laundering charges carry a maximum term of imprisonment of 10 years and a fine of $250,000 or twice the gross gain or loss from the offense or not more than twice the amount of the criminally derived property involved in the transactions.

U.S. Attorney Carpenito credited special agents of the FBI’s Atlantic City Resident Agency, under the direction of Special Agent in Charge George M. Crouch Jr. in Newark; IRS – Criminal Investigation, under the direction of Special Agent in Charge Michael Montanez in Newark: the U.S. Department of Labor, Office of Inspector General, New York Region, under the direction of Special Agent in Charge Michael C. Mikulka; and the Defense Criminal Investigative Service, under the direction of Special Agent in Charge Cyndy Bruce, Southeast Field Office, with the investigation leading to the indictment. He also thanked the Division of Pensions and Financial Transactions in the State Attorney General’s Office, under the direction of Attorney General Gurbir S. Grewal and Division Chief Aimee Nason, for its assistance in the investigation.

The government is represented by Assistant U.S. Attorneys R. David Walk, Jr. and Christina O. Hud of the U.S. Attorney’s Office in Camden.

The charges and allegations contained in the indictment are merely accusations, and the defendants are presumed innocent unless and until proven guilty.