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By: Melinda Stevens - Staff Writer
WEST ORANGE – Two pharmacists, who are the former owners of West Orange Pharmacy on Main Street, pleaded guilty to charges of defrauding patients and multiple insurance companies, according to the U.S. Attorney’s District of New Jersey Office.
Twin brothers Robert and William Carlucci, 69, of Florham Park admitted to participating in multiple schemes during the past 15 years that cheated customers and insurance companies out of $1.5 million. They will be sentenced in late November.
According to a press release from the U.S. Department of Justice, the brothers, along with another conspirator identified only as “L.S.” in the charging documents, used a practice called “trade-quick” to underfill prescriptions; substituted generic drugs for brand-name drugs, but then billed the insurance companies for the full amount of the brand-name drugs prescribed by physicians; filled refills on prescriptions without patients’ knowledge and billed the insurance companies for them; purchased prescription drugs back from their customers and used them to refill other patients’ prescriptions; and purchased prescription drugs from nonlicensed wholesalers at a discount to the drugs’ wholesale price, then dispensed the discounted drugs to patients and billed insurers for the full costs associated with the drugs.
The brothers managed to get away with the scheme for years by using the “trade-quick” practice to under-fill prescriptions, according to the release. Each letter in the phrase corresponded to a number, beginning with “T” for “1” through “K” for “0.” The brothers would enter a two-letter code into the West Orange Pharmacy computer system that indicated how much of the prescription they intended to fill.
For example, the code “QK” indicated that a prescription for 90 dosage units would instead be filled with 60 dosage units because the “Q” stood for the number “6” and the “K” stood for the number “0.” The brothers would then bill insurers for the fully filled prescription, according to the release.
Private insurers as well as insurance companies such as Medicaid were defrauded.
The Centers for Medicare and Medicaid Services stated through email correspondence with the Chronicle this week that they “don’t comment on active cases,” but provided the following statement:
“CMS takes seriously all allegations of fraud, abuse and waste in our program benefits and we have in place a series of tools to spot and stop fraud. We believe these tools, including sophisticated data analytics and stronger enrollment and screening requirements for health care providers, made possible by provisions of the Affordable Care Act, help provide protections for our Medicare, Medicaid and CHIP operations and their funding.”
Calls and emails requesting comment from Ricardo Solano, attorney for Robert Carlucci, and Mark Berman, attorney for William Carlucci, were not returned to the Chronicle.
The Carlucci brothers face charges that are punishable by a maximum potential penalty of 10 years in prison and a fine of $250,000 or twice the gross gain or loss from the scheme, according to the release.
The release further states that as part of the brothers’ plea deal, they are agreeing
to pay restitution of $1.5 million.
Additionally, Robert Carlucci is forfeiting $849,568 and William Carlucci is forfeiting $558,717.
In the press release, U.S. Attorney Paul Fishman thanks the West Orange, Elizabeth, Toms River, Clinton and Marlboro police departments for their help.
West Orange Police Chief James Abbott stated that the department brought the case to the Drug Enforcement Agency Task Force after informants prompted an investigation.
“After a robbery occurred at the pharmacy, our detectives cultivated some informants that led to our investigation,” Abbott said in a phone interview this week. “We brought the case to the DEA Task Force once it grew to a level where we could not monitor it anymore.”
“We did participate in the investigation and everyone involved did a great job,” Abbott said.
Fishman further credited special agents of the Drug Enforcement Administration and the Food & Drug Administration’s Office of Criminal Investigations for their assistance. Sentencing for the brothers is scheduled for Nov. 12.