$10.9 Million Bilked From State Pharmacy Benefit Plan In 'Kickback Scheme,' AG's Suit Says

Jon Lender
Contact Reporterjlender@courant.com

State Attorney General George Jepsen’s office said Tuesday that it is suing a Florida-based pharmacy and a dozen current and retired state government employees — claiming they engaged in a "kickback pyramid scheme" in 2014 and 2015 to defraud the state's taxpayer-funded Pharmacy Benefit Plan out of $10.9 million by filing “false claims” for extremely expensive mixtures of drugs known as "compounded medicines."

The suit alleges that Assured Rx, which produces and distributes such compounded medicines on a large scale, received $10,911,051 from the state’s prescription coverage plan for prescriptions of its medications that were obtained by participants in the alleged scheme.

Assured Rx paid $2,655,958 of that sum in kickbacks to a retired state Department of Correction employee and his former wife, along with a Florida limited liability company that they formed — called NLM LLC — through which they allegedly funneled part of what they received from Assured Rx to other state employees or retirees, whom they recruited into the scheme, the lawsuit says.

Assured Rx had no immediate comment.

The couple at the center of the alleged scheme was identified in the suit as correction department retiree Nicholas Maulucci of Simsbury and his ex-wife, Lisette Maulucci, now of Springfield, who the AG’s office said also is known as Lisette Martinez. They divorced in Florida in 2015, according to the lawsuit. In addition to Lisette Maulucci’s involvement with NLM LLC, she also was an employee of Assured Rx from June to December of 2014, and was paid at least $72,449, including a $35,000 bonus, the AG’s suit says.

The Mauluccis' names surfaced a decade ago in connection with a swingers' sex party at a hotel bar in Windsor Locks in 2008, when each was arrested on public indecency and obscenity charges that were later dropped. At the time Nicholas Maulucci was a manager of Hot Couples Parties LLC in Simsbury, which sponsored the event, and was a correction officer in the MacDougall-Walker Correctional Institution in Suffield.

On Tuesday, the AG’s office issued a news release saying: "The state alleges that Assured Rx paid the Mauluccis kickbacks for their own compound drug prescriptions and those of other Pharmacy Benefit Plan members they recruited into the scheme. In turn, these other individuals — several of whom are named as defendants — received payments from the Mauluccis in the manner of a classic pyramid scheme."

“The state contends that the Pharmacy Benefit Plan would not have approved or paid for the prescriptions had it known that these plan beneficiaries were being paid kickbacks by Assured Rx in exchange for arranging for the prescriptions for the compound drugs,” the AG’s office said.

Costly Combination

A compounded medicine is a mixture of drugs — typically in the form of a topical cream to fight pain or treat scarring — that often is produced by large, out-of-state "compounding pharmacies" and has not been tested and approved by the U.S. Food and Drug Administration. Such drugs are often much more costly than FDA-approved brand name and generic drugs.

The drugs became controversial in 2015 when state Comptroller Kevin Lembo, who runs the state employees' health plan, cited a three-year explosion in the state’s annual costs for such drugs from $800,000 to $24 million.

Lembo said then that a one-month supply of compounded medicine could cost thousands of dollars even though they’re often “essentially just combinations of affordable over-the-counter drugs like ibuprofen and Pepcid AC or Aleve and Nexium.” He later imposed a "prior authorization" requirement under which a doctor must certify that it's medically necessary for a patient to receive a compounded medicine before the plan will pay for it.

That has stemmed the cost explosion in Connecticut (it happened in other states and also hit the U.S. military’s pharmaceutical plan), but Lembo asked Jepsen to embark on his investigation — which already has resulted in one civil lawsuit by the AG’s office against a physician and her husband over an alleged fraud scheme. Federal prosecutors brought charges against them in June that are now pending.

It’s unknown whether criminal authorities will pick up on Tuesday’s lawsuit and launch a probe of their own.

Details Of Suit

According to the AG’s new Hartford Superior Court lawsuit, which was in the process of being served Tuesday:

  • Nicholas and Lisette Maulucci obtained doctors’ prescriptions for Assured Rx medications for themselves — which cost taxpayers $394,403 for him and $442,477 for her. That total of $836,880 was paid to Assured Rx by the Pharmacy Benefit Plan, a comprehensive prescription benefit program that covers state employees, retirees and members of their families.
  • Another 13 alleged participants named in the suit — 10 Department of Correction employees or retirees, along with two of their spouses, as well as one still-active employee of the state Department of Developmental Services — obtained similar six-figure Assured Rx prescriptions costing taxpayers a total of $5.2 million.
  • All told, those 13 participants, who were allegedly recruited by the Mauluccis, received kickback payments through NLM LLC that totaled more than $230,000 (ranging from $14,000 to $47,400 each), the AG’s office said.
  • But there were more participants, yet unnamed, who accounted for another $5.7 million in prescription costs to bring the alleged scheme’s total to $10.9 million — and the AG’s office suggested they may face legal action as its the investigation continues.

Jepsen’s office explained that last point as follows: “Additionally, Nicholas and Lisette Maulucci and their company, NLM, allegedly used other marketers who are not named as defendants who also arranged for prescriptions of Assured Rx … drugs for themselves [and] certain covered family members and others. ... [T]hese marketers are alleged to have cost the Pharmacy Benefit Plan a total of $5,745,773 in prescriptions and were allegedly paid $230,764 for their roles in the scheme.”

“Legal action against these or other culpable individuals is possible as the state's investigation proceeds,” the AG’s office said.

As of now, the suit names 17 defendants: Assured Rx; the two Mauluccis; NLM LLC; and the 13 recruits alleged to have participated. The suit was prepared by a team of assistant attorneys general led by Michael Cole, chief of the AG’s Antitrust and Government Program Fraud Department.

"The fraud we are alleging in this lawsuit is simply egregious," Jepsen said. "My office will continue to aggressively investigate.”

Lembo said: “Today’s action should send a clear-cut message: When you defraud the state’s health plan, you will get caught and you will face consequences.”

Gov. Dannel P. Malloy said: “These allegations are deeply troubling... If proven true, they run afoul of the very core of what it means to be a public servant. ... [A]nyone who is guilty of defrauding the taxpayers must be held fully accountable. … [M]y administration stands ready to fully assist the Attorney General in their investigation.”

The lawsuit seeks unspecified civil penalties, treble damages and other relief under the Connecticut False Claims Act. The other defendants, besides Assured Rx, the two Mauluccis and NLM, include 10 correction department retirees: Ricardo Collazo of Bloomfield; James Corcoran of Wethersfield; Benjamin Franco, of East Haven, and his spouse, Jill Franco; Paul Germano of Berlin; Edward Heller of Enfield; Joseph Heller of Enfield; Francis Mancini of Southwick, Mass., and his spouse, Sarah Mancini; Todd Sokolowski of Stafford Springs; Todd Vining of Enfield; and Joyce Wright, of East Longmeadow, Mass.

The suit doesn’t say how many retirees were still active state employees at the time of the alleged scheme.

Another defendant is Carol Boardman-Scruse, of Bloomfield, an active employee of the state Department of Developmental Services.

None of the individual defendants could be reached Tuesday.

Jepsen expressed appreciation to Defense Criminal Investigative Service's New Haven resident agent for “considerable assistance provided in the investigation.”

Meanwhile, charges are pending in U.S. District Court against the defendants in Jepsen’s first lawsuit. Kwasi Gyambibi, 40, of Stamford, and his wife, Kakra Gyambibi, 37, a physician formerly of New Canaan and now living in Maryland, were indicted in June on 17 counts in an alleged fraud scheme involving compounded medicines. The case has been continued until early next year.


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