CAMDEN — An Ocean City school maintenance worker pleaded guilty Tuesday in federal court to defrauding the state health benefits plan of nearly $5 million, part of an ongoing federal investigation.
James Wildman, 44, of Marmora, became the 22nd person from South Jersey to admit to taking part in the multimillion-dollar health benefits fraud scheme between 2015 and 2016. The first plea agreement was announced in August 2017.
Wildman’s attorney, Mark Roddy, of Pleasantville, was not immediately available for comment.
Four of the 21 defendants in a multimillion-dollar state health benefits fraud case still ha…
According to state records, Wildman earned an annual salary of $42,284 at Ocean City. The Board of Education accepted his resignation at its Oct. 15 meeting, according to the agenda posted on the district website.
Ocean City School District spokeswoman Aimee Schultz of JASM Consulting confirmed Wildman was no longer employed by the district. She said his resignation was effective Oct. 11 and declined to comment further.
In his plea Tuesday, Wildman admitted serving as a recruiter in the conspiracy, persuading individuals, especially those on the state health benefits plan, to obtain medically unnecessary compounded prescriptions in exchange for money. Wildman said he received $657,040 for his role in the scheme.
Court documents state Wildman and his co-conspirators took advantage of the generous compensations the state health benefits plans provide to pharmacies for fulfillment of compounded medications. Compounded medications are specialty medications mixed by a pharmacist to meet the specific medical needs of an individual patient.
CAMDEN — A former pharmaceutical representative from Ocean County became the 21st person to …
The U.S. Attorney’s Office has yet to name the out-of-state compounding pharmacy involved in the scheme or the “pharmacy benefits administrator” that provided the pharmacy benefits management services for the State Health Benefits Program and the School Employees Health Benefits Program. The pharmacy benefits administrator would pay prescription drug claims and then bill the state for the amounts paid.
The scheme worked by collecting the insurance information from the public employees and passing that information on to a co-conspirator, who had paid a doctor to sign off on the prescriptions without examining the employees as patients. Working like a pyramid scheme, the compounding pharmacy would pay a percentage of its payout from the health insurance to the conspirators, who would pass on cash rewards to the recruits.
Wildman also admitted filling prescriptions for compounded medications he did not need to financially benefit a conspirator.
According to the U.S. Attorney’s Office, the unnamed compounding pharmacy was paid more than $50 million for prescriptions mailed to New Jersey residents, including $4.9 million for prescriptions filled by Wildman and his co-conspirators.
Wildman faces 10 years in prison and a $250,000 fine. Sentencing is scheduled for Feb. 25, 2019.