Pharmaceutical Sales Rep Pleads Guilty To Defrauding Insurance Companies

U.S. Attorney James P. Kennedy, Jr. has announced Scott Trapp of Clarence, NY, pleaded guilty before U.S. District Judge Lawrence J. Vilardo to conspiracy to commit health care fraud. The charge carries a maximum penalty of 10 years in prison and a $250,000 fine.

Assistant U.S. Attorney Maura K. O’Donnell, who is handling the case, stated that the defendant began working as a pharmaceutical sales representative for various pharmaceutical companies in 1996. In 2014, Trapp began marketing compounded medications, such as pain patches, pain creams, and scar creams.

The compounded medications marketed by the defendant, and his associates, were not tailored to the needs of individual patients. Instead, the medications were tailored to contain ingredients that carried high reimbursement rates from health insurers. Formulations of the medications were modified at times to permit reimbursement from health insurance companies and/or to maximize reimbursement rates. For example, a one month supply of one of the compounded pain creams marketed by Trapp carried a reimbursement rate of $22,000.

Unlike typical pharmaceutical sales representatives who market prescription drugs to physicians, the defendant, and his associates, identified patients whose health insurance covered the medications, and convinced the patients to agree to receive the medications.

In furtherance of the conspiracy, Trapp asked a friend, who was a physician, to sign blank, 12 month prescriptions for compounded medications, in the names of the defendant and his wife. Trapp then duplicated the prescriptions and substituted names of different patients for his own name, allowing for additional prescriptions for compounded medications to be filled without the physician knowledge.

Trapp also recruited, supervised, and compensated others to market the compounded pharmaceuticals. One of those individuals then recruited others to be part of the marketing scheme. The defendant received commission payments of approximately 20% of the reimbursement rate of each prescription he personally marketed which was approved and filled. Trapp also received commission payments of approximately 5% of each prescription marketed and filled by those he supervised, and by the individuals working for those people he supervised.

In total, between 2014 and December 2016, the health care benefit programs provided by Blue Cross Blue Shield (BCBS), the Verizon Medical Expense Plan for New York and New England Associates, National Grid USA, and Sunovion Pharma, paid approximately $5,821,331, for compounded prescriptions fraudulently filled, resulting in losses of: $7,352 to BCBS; $3,601,179 to the Verizon Medical Expense Plan for New York and New England Associates; $1,992,354 to National Grid USA; and $220,445 to Sunovion Pharma.

This plea is the result of an investigation by the Federal Bureau of Investigation, under the direction of Special Agent-in-Charge Gary Loeffert; the U.S. Department of Labor, Office of Inspector General, Office of Investigations – Labor Racketeering and Fraud, under the direction of Michael C. Mikulka, Special Agent-in-Charge, New York Region; the U.S. Food and Drug Administration, Office of Criminal Investigations, under the direction of Jeffrey Ebersole, Special Agent-in-Charge New York Field Office; the New York State Financial Services Department, under the direction of Superintendent Maria T. Vullo; and the Defense Criminal Investigative Service, under the direction of Special Agent-in-Charge Leigh-Alistar Barzey.

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