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A New York man has pleaded guilty to participating in a sweeping, multimillion-dollar insurance scam in which state health insurance plans were defrauded using phony prescriptions.
Christopher Frusci, 33, a bus driver with the Metropolitan Transportation Authority, pleaded guilty in Newark, N.J., federal court to charges of conspiracy to commit healthcare fraud. Frusci admitted that he conspired to defraud health plans, including MTA’s plan, using fraudulent claims for various compounded medications marketed by a company referred to as “Company A” in court documents.
According to the US Attorney’s Office, Company A recruited Frusci as a sales representatives and instructed him to target people with certain health plans that covered compounded medications. Frusci convinced multiple MTA employees to get medically unnecessary prescriptions by paying them monthly cash bribed between $100 and $1,500.
As part of his plea agreement, Frusci will forfeit $724,448 in proceeds he received from the scam. He’s also been ordered to pay restitution of at least $5 million. He faces up to 10 years in prison and a fine of up to $250,000.
“In an era when many Americans worry about securing health insurance for their families, we’ve seen far too many instances where both private and publicly funded insurance providers are being raided for millions in phony reimbursements on compounded medications,” US Attorney Craig Carpenito said. “Frusci admitted that he and others sought to defraud the MTA health plan and other insurers by recruiting the very people who enjoy that coverage, offering them cash bribes to get medications they didn’t need.”
