Late last week, U.S. Attorney for New Jersey Philip Sellinger announced that Matthew Puccio, of Randolph, was sentenced to 60 months in prison for his role in a scheme to defraud public health benefits programs by billing for unnecessary compound prescriptions.

Puccio, 41, was convicted last July of conspiracy to commit health care fraud following a trial in Newark federal court before U.S. District Judge John Michael Vazquez, who imposed the sentence June 30, 2023.

Prosecutors had charged that between November 2014 to March 2016, Puccio participated in a conspiracy that involved submitting fraudulent prescriptions for compound medications, which are specialty drugs mixed by a pharmacist to meet the specific medical needs of an individual patient, to public health benefits programs. While not approved by the Food and Drug Administration (FDA), compound medications are properly prescribed when a physician determines that an FDA-approved medication does not meet the health needs of a particular patient.

Marketing companies recruited and paid sales representatives, such as Puccio, to obtain compound medications for themselves and others regardless of medical necessity, targeting health plans that reimbursed for compound medications at high rates, according to prosecutors, who added that Puccio exploited this opportunity through working as a sales representative for several compounding pharmacies.

“He targeted individuals who had health plans that covered compound medications and then convinced those individuals to obtain prescriptions for compound medications, regardless of medical necessity. Puccio and others induced two New Jersey-based physicians to sign medically unnecessary prescriptions for beneficiaries that Puccio and others had recruited,” according to case documents and trial evidence. “Once the prescriptions were written, they were filled by the compounding pharmacies with which Puccio worked. The compounding pharmacies would then receive reimbursement from the health plans and would pay Puccio a percentage of the reimbursement amount. Puccio and his conspirators caused a significant loss to public health benefits programs.”

In addition to the prison term, Puccio was sentenced to three years of supervised release and ordered to pay $2.65 million in restitution.

See also

• Lakewood man admits role in $21.7M fraud scheme
• South Jersey man sentenced for role in health care fraud scheme
• South Jersey man admits laundering COVID fraud money