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Case Number: 1:21-cr-00681
Judge: Robert B. Kugler
Court: United States District Court for the District of New Jersey (Camden County)
Plaintiff's Attorney: United States Attorney’s Office in Camden
Description: Camden, New Jersey criminal defense lawyer represented Defendant charged with defrauding his employer's health insurance plan out of more than $4 million by submitting fraudulent claims for medically unnecessary compound medications.
Compounded medications are specialty medications mixed by a pharmacist to meet the specific medical needs of an individual patient. Compounded drugs can be 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.
Christopher Gualtieri, age 50, of Franklinville, New Jersey, and others learned that certain compound medication prescriptions were reimbursed by their health insurance plan for up to thousands of dollars for a one-month supply. Gualtieri recruited co-workers who were covered by their employer’s self-funded health insurance plan to agree to receive medically unnecessary compounded medications for themselves and their family members. Gualtieri and others caused the submission of fraudulent prescriptions to compounding pharmacies, which filled the prescriptions and billed the health insurance plan’s pharmacy benefits administrator. The pharmacy benefits administrator paid the compounding pharmacies more than $4 million for compounded medications arranged by Gualtieri and two conspirators for themselves, their dependents, and other family members. Gualtieri received a portion of the amount paid by the pharmacy benefits administrator to the compounding pharmacies. Gualtieri admitted to paying cash to his conspirators for their participation in the scheme. When questioned by special agents of the FBI, Gualtieri falsely denied recruiting others to receive compounded medications and falsely denied paying cash to others for their participation in the scheme.
During the same time period as the conspiracy involving compounded medications, Gualtieri also prepared and caused the filling of fraudulent prescriptions for oxycodone for himself and a family member.
The charge of conspiracy to commit health care and mail fraud is punishable by a maximum potential penalty of 20 years in prison; the charge of obtaining drugs by fraud is punishable by a maximum potential penalty of four years in prison. Both counts are also punishable by a fine of up to $250,000, or twice the gross gain or gross loss from the offense, whichever is greatest. Sentencing is scheduled for Oct. 18, 2023.
Attorney for the United States Khanna credited agents of the FBI, Philadelphia Field Office, Health Care Fraud Task Force, under the direction of Special Agent in Charge Jacqueline Maguire; task force members from the Pennsylvania Attorney General’s Office, Department of Health and Human Services – Office of Inspector General; the Philadelphia Police Department; and diversion investigators of the Drug Enforcement Administration, New Jersey Division, Camden Resident Office, under the direction of Special Agent in Charge Cheryl Ortiz, with the investigation leading to today’s guilty plea. Attorney for the United States Khanna also thanked U.S. Postal Service – Office of Inspector General, for its assistance in the investigation.
The government is represented by Assistant U.S. Attorney Jeffrey Bender of the U.S. Attorney’s Office in Camden.
18:1349 CONSPIRACY TO COMMIT HEALTH CARE FRAUD AND MAIL FRAUD (DOO 1/2015 THRU 3/2021)
18:1341 AND 2 MAIL FRAUD (DOO 3/14/2016 THRU 3/16/2016)
18:1001(a)(2) FALSE STATEMENTS (DOO 3/29/2021)
21:843(a)(3) AND 18:2 ACQUIRING OXYCODONE THROUGH MISREPRESENTATION, FRAUD, AND FORGERY (DOO 6/2015 THRU 3/27/2019)
Outcome: 06/12/2023 37 Minute Entry for proceedings held before Judge Robert B. Kugler: Change of Plea Hearing as to CHRISTOPHER GUALTIERI held on 6/12/2023, Terms of plea agreement read into record. Ordered plea agreement approved. Ordered deft. affirmed; deft. affirmed. Plea entered by CHRISTOPHER GUALTIERI (1) Guilty Counts 1,5. PLEA: GUILTY TO COUNTS 1 AND 5 OF INDICTMENT. Rule 11 form executed and filed. Ordered plea accepted. Ordered Sentencing set for 10/18/2023 @1:30 PM in Camden - Courtroom 4D before Judge Robert B. Kugler. Ordered bail continued as previously set. (Court Reporter: Sharon Ricci (267-249-8780)) (js) (Entered: 06/13/2023)
06/12/2023 38 APPLICATION for permission to enter Plea of guilty as to CHRISTOPHER GUALTIERI. (js) (Entered: 06/13/2023)
06/12/2023 39 PLEA AGREEMENT as to CHRISTOPHER GUALTIERI. (js) (Entered: 06/13/2023)
Defendant pled guilty.