A Louisiana nurse practitioner faces a lengthy prison sentence when sentences for her federal jury conviction yesterday for her role in an over $2 million health care fraud scheme.
According to court documents and evidence presented at trial, Shanone Chatman-Ashley, was a nurse practitioner and enrolled provider with Medicare. Chatman-Ashley worked as an independent contractor for companies that purportedly provided telehealth services to Medicare beneficiaries. As part of the scheme, the Chatman-Ashley caused the submission of false and fraudulent claims to Medicare for medically unnecessary durable medical equipment (“DME”). Chatman-Ashley routinely ordered knee braces, suspension sleeves, and other types of DME for patients without an examination by her or another medical provider. Chatman-Ashley concealed the scheme by signing documentation falsely certifying that she had consulted with the beneficiaries and personally conducted assessments of them. From 2017 to 2019, the defendant signed more than 1,000 orders for medically unnecessary DME, causing over $2 million in fraudulent Medicare claims and over $1 million in reimbursements. In exchange for the orders, Chatman-Ashley received kickbacks and bribes from the telehealth services companies.
in the Justice Department’s announcement of the conviction, Matthew R. Galeotti, the Head of the Justice Department’s Criminal Division warned:
The Department of Justice will not tolerate medical professionals who fraudulently enrich themselves at the expense of American taxpayers.
Chatman-Ashley was convicted of five counts of health care fraud. She is scheduled to be sentenced on July 31. She faces a maximum penalty of 10 years in prison on each count. A federal judge will determine any sentence after considering the U.S. Sentencing Guidelines and other statutory factors.
The author of this update, Cynthia Marcotte Stamer has decades of experience advising health care providers, Medicare and Medicaid Advantage and other public and private health plans and plan sponsors, government contractors and grant recipients, and their technology, data, third party administrators, and other managed care and other health care, defense, technology, life sciences and other clients about health industry quality, technology, reimbursement, licensing and accreditation, compliance, enforcement, governmental affairs, dispute resolution, and other compliance, risk management and operational matters. If you have questions or need advice or help evaluating or addressing these or other compliance, risk management, or other concerns, contact her.
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About the Author
Recognized by her peers as a Martindale-Hubble “AV-Preeminent” (Top 1%) and “Top Rated Lawyer” with special recognition LexisNexis® Martindale-Hubbell® as “LEGAL LEADER™ Texas Top Rated Lawyer” in Health Care Law and Labor and Employment Law; as among the “Best Lawyers In Dallas” for her work in the fields of “Labor & Employment,” “Tax: ERISA & Employee Benefits,” “Health Care” and “Business and Commercial Law” by D Magazine, Cynthia Marcotte Stamer is a practicing attorney board certified in labor and employment law by the Texas Board of Legal Specialization and management consultant, author, public policy advocate and lecturer widely known for her more than 35 years of health industry and other management work, public policy leadership and advocacy, coaching, teachings, and publications including leading edge work on workforce and other risk management and compliance.
Ms. Stamer’s work throughout her career has focused heavily on working with health care, health insurance and managed care, insurance and financial services, defense contractors, and other workforce and data sensitive businesses domestically and internationally on employment, benefits, data and other knowledge use and protection, Federal Sentencing Guidelines and other workforce and heath care management, internal and operational controls, regulatory and public policy and other legal and operational concerns. As a part of this work, she has had extensive involvement in the design, enforcement, investigation, mitigation and defense of trade secret and other information privacy and confidentiality, HRIS, claims, electronic medical records, payment, and other systems and technologies; HIPAA and other health industry, DOD, FACTA, GLB, EU, and other data privacy and security, trade secret and other confidential information; and other information privacy and security laws, policies, practices, contracts and requirements.
In addition, Ms. Stamer serves as a Scribe for the American Bar Association (“ABA”) Joint Committee on Employee Benefits annual agency meetings with OCR and shares her thought leadership as International Section Life Sciences Committee Vice Chair, and a former Council Representative, Past Chair of the ABA Managed Care & Insurance Interest Group, former Vice President and Executive Director of the North Texas Health Care Compliance Professionals Association, past Board President of Richardson Development Center (now Warren Center) for Children Early Childhood Intervention Agency, past North Texas United Way Long Range Planning Committee Member, and past Board Member and Compliance Chair of the National Kidney Foundation of North Texas, and a Fellow in the American College of Employee Benefit Counsel, the American Bar Foundation and the Texas Bar Foundation, Ms. Stamer also shares her extensive publications and thought leadership as well as leadership involvement in a broad range of other professional and civic organizations.
Author of many highly regarded compliance, training and other resources on cybercrime and other data privacy and security, health and other employee benefits, health care, insurance, workforce and other risk management and compliance, Ms. Stamer is widely recognized for her thought leadership and advocacy in these matters.
For more information about Ms. Stamer or her health industry and other experience and involvements, see www.cynthiastamer.com or contact Ms. Stamer via telephone at (214) 452-8297 or via e-mail here.
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