adminIn December 2021, Andrew Gerstel, 43, a former pharmaceutical sales representative from Galloway, New Jersey, was sentenced to 12 months and one day in prison for his role in a health care fraud conspiracy targeting New Jersey state health benefits programs.
Details of the Scheme:
- Recruitment of Public Employees: From January 2015 to April 2016, Gerstel and his co-conspirators recruited New Jersey public employees—including teachers, firefighters, police officers, and state troopers—to obtain expensive, medically unnecessary compounded medications from an out-of-state pharmacy.
- Financial Incentives: In exchange for their participation, recruiters and individuals with insurance coverage were compensated, and a percentage of each prescription filled was distributed among the conspirators.
- Financial Impact: The Pharmacy Benefits Administrator paid the Compounding Pharmacy over $50 million for these compounded medications mailed to individuals in New Jersey.
Sentencing Details:
- Prison Term: Gerstel was sentenced to 12 months and one day in prison.
- Financial Penalties: As part of his plea agreement, Gerstel forfeited $184,389 in criminal proceeds and was ordered to pay restitution of $483,946.
This case underscores the importance of vigilance in preventing health care fraud within public programs.
