Connecticut is suing a Florida compounding pharmacy and at least 13 current or former state workers who participated in a pharmacy-benefit billing kickback scheme that state prosecutors claim cost taxpayers some $11 million in drug overcharges.
Attorney General George P. Jepsen announced Tuesday his office is suing the co-defendants under the state's False Claims Act for three times the $10.9 million in losses it claims to have suffered from the fraud.
"The fraud we are alleging in this lawsuit is simply egregious," Jepsen said, adding the state's overarching benefit-fraud investigation is ongoing.
This latest action stems from a request from state Comptroller Kevin Lembo, whose office administers the state Pharmacy Benefit Plan and who has publicly complained about irregularities and abuses he claims contribute to escalating costs to the state and participants.
This is the second lawsuit relating to compound drug billing fraud that was initiated as a result of the state's investigation. The state's probe into compounded pharmaceutical manufacturers and pharmacy providers is ongoing.
In Feb., Jepsen sued a Fairfield County physician and her husband, who was employed at UConn staffer, to recover $1 million in alleged overbillings to the state's pharmacy benefit plan. The pair also face criminal charges related to that scheme, authorities say.
"Today's action," Lembo said in the same statement, "should send a clear-cut message: When you defraud the state's health plan, you will get caught and you will face consequences."
According to Jepsen, Assured Rx, of Clearwater, Fla., has a nonresident Connecticut license to operate in the state. Assured Rx, he said, conspired with Nicholas Maulucci, of Simsbury, a retired state corrections department staffer, and Maulucci's ex-wife, Lisette Martinez, of Springfield, to perpetrate the fraud.
Compounded pharmaceuticals differ from mass-made drugs in that they typically are made-to-order, based on doctors' prescripted dosing and patients' medical histories. Compound drugs are not approved by the U.S. Food and Drug Administration and, thus, tend to cost "significantly more than FDA-approved brand name and generic drugs,'' Jepsen said in a statement.
State investigators allege that Assured Rx paid the Mauluccis kickbacks for their own compound drug prescriptions and those enrolled in the state's pharmacy benefit plan whom they recruited into the scheme. In turn, they said, these other individuals paid the Mauluccis in the manner of a classic pyramid scheme.
The kickbacks were allegedly paid out of reimbursements Assured Rx received from the state for dispensing the compound drug products.
The Mauluccis formed NLM LLC, a Florida limited liability company, for the alleged purpose of funneling the kickback payments, investigators said.
The state alleges the pharmacy benefit plan fraudulently paid $394,403 for prescriptions for Nicholas Maulucci, and $442,477 for prescriptions for Lisette Martinez. The Mauluccis and NLM allegedly received $2.7 million in compensation for their role in the scheme. The Mauluccis in turn used a portion of those funds to pay kickbacks to the other individuals they recruited into the scheme.
The additional defendants, all but one retired corrections-department staffers, are: