A New Jersey pharmaceutical sales representative pleaded guilty to conspiracy to commit healthcare fraud and conspiring to disclose patients' personal health information, the Justice Department said Oct. 20.
Keith Ritson, 42, pleaded guilty Oct. 19 for his role in a scheme to defraud New Jersey health plans by prescribing compound medications to patients, regardless of their need for these medications.
Mr. Ritson worked as a pharmaceutical representative promoting compound medications from 2014 to 2016, according to the Justice Department. Mr. Ritson and others indicted in the scheme discovered certain health plans would reimburse thousands of dollars for these medications from Central Rexall Drugs, a Louisiana-based pharmacy.
Mr. Ritson recruited individuals with health plans that would cover the drugs to receive compound medications, regardless of their actual medical need for the drugs, the Justice Department said. He also received these medications himself. Central Rexall paid Mr. Ritson a percentage of the reimbursements it received from insurance plans for the prescriptions he arranged.
According to the Justice Department, Mr. Ritson would earmark patients with health plans that would reimburse compound medications at the practice of Frank Alario, MD, who allowed Mr. Ritson to access patient records. As a sales representative not employed by the practice, this constituted a violation of patient privacy laws.
Dr. Alario pleaded guilty to conspiring to wrongly disclose patient information for his role in the scheme Oct. 7, the Justice Department said.
Three executives for Central Rexall Drugs were indicted for conspiracy to commit healthcare fraud and other charges related to the scheme in September 2020. The Justice Department alleges the executives and conspirators prompted more than $50 million in fraudulent billing claims for the compound medications.
A fourth Central Rexall company executive, Hayley Taff, pleaded guilty to healthcare fraud conspiracy in August 2020.