Billing Fraud

Two women have been indicted on multiple health care fraud-related charges for allegedly providing medical services without proper credentials and improperly billing the Medicaid program. See article here.

The indictment names Esney Davis-Sharpe, 63, of East Orange, New Jersey, who owned and operated the Bessie Mae Women’s Health Center, and Nataliya Lushchak, 48, of Lower Gwynedd, Pennsylvania, a clinic worker. Prosecutors allege that neither woman held a valid New Jersey medical license, yet both performed medical procedures, including gynecological services at the clinic and submitted about 2,500 reimbursement claims to the New Jersey Medicaid Program under the names of licensed physicians who were not involved and did not consent to the billing.

As a result, they’re each charged with conspiracy to commit health care claims fraud, unlicensed practice of medicine, health care claims fraud, and Medicaid fraud. State officials described the case as a deliberate abuse of Medicaid that diverts public resources and endangers patient trust, and emphasized that those accused are presumed innocent until proven guilty in court.