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Press Release
CHARLESTON, W.Va. – Shawn R. Blankenship, 54, of Winfield, pleaded guilty today to four counts of health care fraud.
According to court documents and statements made in court, Blankenship is a licensed nurse practitioner and owner of Holistic Inc., a medical clinic in St. Albans. Blankenship admitted that he knowingly and willfully caused the submission of materially false claims to Medicaid and its Managed Care Organizations for medical services that were not provided and not medically necessary.
Holistic provided multiple services to patients during the time period in question, primarily office-based opioid treatment and weight loss counseling as well as smoking and tobacco use cessation counseling. The investigation revealed that claims submitted to Medicaid for smoking cessation counseling, office visits, and weight loss counseling required a licensed provider to be present.
Blankenship admitted that four materially false claims were filed during the time period. Three were for smoking cessation services and one was for a 15-minute office outpatient visit, all purportedly conducted on October 29, 2020. Blankenship admitted that he knew such services were not provided because he and Holistic’s other licensed nurse practitioners were in Hilton Head, South Carolina, and not at Holistic from on or about October 28, 2020, through on or about October 30, 2020.
Investigators concluded the losses from Blankenship’s criminal conduct is approximately $600,000.
Blankenship is scheduled to be sentenced on July 21, 2025, and faces a maximum penalty of 40 years in prison, at least three years of supervised release, and a $1 million fine. Blankenship also owes restitution in an amount to be determined by the Court.
Today’s guilty pleas result from a multi-year investigation of fraudulent medical billing practices in the Southern District of West Virginia. Acting United States Attorney Lisa G. Johnston made the announcement and commended the outstanding investigative work of the U.S. Department of Health and Human Services-Office of Inspector General (HHS-OIG), the Federal Bureau of Investigation (FBI), the West Virginia Medicaid Fraud Control Unit (MFCU), the Drug Enforcement Administration (DEA), and the U.S. Department of Homeland Security-Homeland Security Investigations (HSI).
United States Magistrate Judge Omar J. Aboulhosn presided over the hearing. Trial Attorney Jody King of the U.S. Department of Justice Criminal Division-Fraud Section and Assistant United States Attorney Owen Reynolds are prosecuting the case.
A copy of this press release is located on the website of the U.S. Attorney’s Office for the Southern District of West Virginia. Related court documents and information can be found on PACER by searching for Case No. 2:24-cr-37.
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