Criminally Charged for Alleged Health Care Insurance Fraud
NEWARK – Attorney General Gurbir S. Grewal and the Division of Consumer Affairs today announced that the state Board of Nursing (“Board”) has
permanently revoked the license of a nurse who faces criminal charges for her alleged role in a health care insurance fraud scheme while engaged in nursing and advanced nursing practice at a medical office in Pennsville.
Ashley Morgan Lyons-Valenti, a Registered Professional Nurse (RN) and Advanced Practice Nurse (APN), who allegedly prescribed unnecessary compounded medications in exchange for more than $90,000 in kickbacks, agreed to permanently surrender her practicing credentials with an additional penalty of $170,000.
The 33-count indictment handed down on June 24, 2020 by a federal grand jury in Camden alleges that Lyons-Valenti and two other individuals defrauded state health benefits programs and other insurers out of more than $6 million by submitting fraudulent claims. In this case, Lyons-Valenti prescribed vitamin combinations, pain creams, scar creams, antifungal creams, and libido creams when they were medically unnecessary. This is contrary to the typical practice of licensed pharmacists, who only create compounded drugs to meet the specific medical needs of a patient.
"Professionals who abuse their position of trust to enrich themselves by breaking the law will be held accountable in New Jersey,” said Attorney General Grewal. “Lyons-Valenti faces serious criminal charges as a result of her conduct, and she is banned from the nursing profession in the state for good.”
Lyons-Valenti, a 63-year-old resident of Swedesboro, faces federal criminal charges for knowingly and willfully conspiring with others to commit health care fraud; depriving her employing medical practice and her patients of honest services, including by wire fraud; committing commercial bribery and receipt of kickbacks; and making false statements relating to health care matters in connection with the delivery of and payment for health care services.
“The criminal charges and serious fraud allegations faced by this practitioner are clear violations of the professional standards every nurse must abide by,” said Paul R. Rodríguez, Acting Director of the Division of Consumer Affairs. “By permanently revoking her practicing credentials we are holding her accountable and protecting the integrity of the profession.”
The indictment alleges Lyons-Valenti, who was authorized to prescribe medications as an APN, signed costly prescriptions for compounded medications, and claimed to have reviewed medical records and conducted examinations for patients she had not met. Federal prosecutors also allege that insurance paid over $1.25 million for the fraudulent prescriptions between April 2014 through 2016.
Additionally, Lyons-Valenti is also charged with obstruction of justice to tamper with a grand jury after allegedly telling a witness in 2019 to make a false statement to the FBI, and falsely telling the witness she had not received money for writing prescriptions.
According to the Consent Order, Lyons-Valenti’s alleged criminal conduct, if proven, would also constitute malpractice, and a failure to comply with Board regulations and the ongoing requirement of good moral character. This provides the basis for the revocation of her RN and APN practicing credentials and for the imposition of financial sanctions.
To resolve the allegations against her in advance of the criminal trial, Lyons-Valenti agreed to return her prescribing registration and professional licenses to the Board, and to divest herself from any current and future financial interest in, or benefit derived from, the practice of nursing.
Under the terms of the Order filed today, Lyons-Valenti is permanently precluded from seeking a license as an RN or APN in New Jersey. Lyons-Valenti must also notify current patients, make their medical records available, and refer them to other treatment providers within 30 days of the order’s filing.
Senior Deputy Attorney General Joan D. Gelber of the Professional Boards Prosecution Section in the Division of Law represented the State in the Lyons-Valenti matter.