A New Jersey pharmaceutical sales representative who orchestrated a scheme that defrauded state health insurance programs of more than $50 million has been sentenced to 27 months in federal prison.
On Aug. 18, U.S. District Judge Edward Kiel sentenced William Hickman on one count of conspiracy to commit healthcare fraud and wire fraud and one count of conspiracy to commit money laundering, both of which he pleaded guilty to in June 2020.
Mr. Hickman was also ordered to pay $51.7 million in restitution. The largest share of that amount, roughly $45.1 million, is owed to the New Jersey Division of Pension and Benefits. Other victims listed in the judgment include Anthem Blue Cross Blue Shield, AmeriHealth, Horizon Blue Cross Blue Shield of New Jersey, the Department of Defense and the County of Bergen.
Mr. Hickman was indicted in March 2019 along with six co-defendants in what became one of the largest healthcare fraud cases in New Jersey history. The 50-count indictment alleged that Mr. Hickman, while employed as a pharmaceutical sales representative, created a side business called Boardwalk Medical LLC under his wife’s name and used it to run a kickback-driven prescription fraud ring.
The scheme, which ran from roughly July 2014 through April 2016, worked by recruiting state and local government employees who carried state-funded health benefits, including teachers, police officers and firefighters. Mr. Hickman and his network of recruiters persuaded those employees to obtain medically unnecessary compound prescriptions for products like pain creams, libido creams, scar creams and vitamin combinations from a Louisiana compounding pharmacy.
The pharmacy would bill New Jersey’s pharmacy benefits administrator for the medications, which were often thousands of dollars for a single month’s supply. The pharmacy then paid Boardwalk Medical a percentage of the insurance reimbursement for each prescription Mr. Hickman’s network secured, according to the indictment. In total, Boardwalk Medical received more than $26 million of those payments.
The broader conspiracy has resulted in more than 40 convictions and guilty pleas across New Jersey, with public employees and executives at the Louisiana compounding pharmacy among those convicted.
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