Jeffrey Andrews, worked as Chief Financial Officer and Adam Brosius worked as Director of Business Development, for Main Avenue Pharmacy, a mail-order pharmacy with a storefront in Clifton, New Jersey. Brosius actually worked his way up the ladder to President. But when the end game is stealing from the U.S. taxpayer, titles are almost a parody. Andrews and Brosius were both Chief Fraud Officers by running an illegal kickback scheme involving compounded drugs. A scheme which fraudulently received approximately $33 million in Tricare and Medicare health care benefits.
Main Avenue Pharmacy would first identify lucrative formulas for compound prescriptions such as scar creams, pain creams, and migraine medications. The prescriptions didn’t need to be effective or even in demand. Only lucrative. They would then create large prescription pads with those formulas on it and distribute the pads to marketers across the country with whom it had contractual relationships. These marketing companies would in turn distribute the prescription pad to telemedicine companies and doctors with whom they had financial arrangements. A supply chain to fraud.
Main Avenue Pharmacy would fill the prescription and then submit reimbursement claims to Medicare, Tricare, and other commercial payers in New Jersey and elsewhere. After Main Avenue obtained reimbursement, Main Avenue paid kickbacks to marketers who had generated the prescriptions. Main Avenue signed contracts with many of the marketers which detailed the illicit kickback arrangement. Details which called for Main Avenue to pay each marketer money based on the volume of referrals of compounded prescriptions and the reimbursement amount that Main Avenue received.
When there are contracts, responsibilities are clear. And it was clear that Andrews and Brosius were fraudsters. On September 26, 2024, both pled guilty to fraud.
Great job by the FBI and the Department of Health and Human Services in this case.
Today’s Fraud of The Day is based on article “N.J. pharmacy officials admit roles in $33M kickback scheme” published by NJ.Com on September 26, 2024.
Two high-ranking officials with a pharmacy in New Jersey pleaded guilty to their roles in a $33 million kickback scheme, U.S. Attorney Philip R. Sellinger announced Wednesday.
Jeffrey Andrews, 73, of Bryn Mawr, Pennsylvania and Adam Brosius, 55, of Langhorne, Pennsylvania pleaded guilty to separate charges. The two ran a pharmacy in Clifton that was accused of providing prescription pads to marketers that included formulas for compound medications that would provide large reimbursements from health insurers.
