adminJames Wildman, 44, of Marmora, New Jersey, who worked as a maintenance employee for the Ocean City School District, pleaded guilty in November 2018 to conspiring to commit health care fraud. Between January 2015 and February 2016, Wildman participated in a scheme that defrauded health insurers by recruiting public employees—including teachers, firefighters, police officers, and state troopers—to obtain expensive, medically unnecessary compounded medications. These medications were prescribed without proper medical evaluations and reimbursed at high rates, leading to significant financial losses.
Scheme Details:
- Recruitment and Compensation: Wildman and his co-conspirators targeted individuals with substantial insurance coverage, offering financial incentives for participation. Wildman personally received $657,040 for his role in the scheme.
- Financial Impact: The Pharmacy Benefits Administrator paid over $50 million for these compounded medications, with approximately $4.8 million associated with Wildman’s activities
Legal Proceedings:
- Sentencing: Wildman faced a maximum sentence of 10 years in prison and a $250,000 fine, or twice the gross gain or loss from the offense. Sentencing was scheduled for February 25, 2019.
- Restitution: As part of his plea agreement, Wildman was required to repay $4.86 million in restitution and forfeit $657,040 in criminal proceeds.
This case is part of a broader investigation into health care fraud involving multiple individuals across various professions, including educators and public servants.
Please note that legal proceedings are ongoing, and details may evolve as new information emerges.
