The U.S. Attorney’s Office of the Southern District of West Virginia announced Wednesday, March 19, that Shawn R. Blankenship, 54, of Winfield, has pleaded guilty to four counts of health care fraud.
Blankenship is a licensed nurse practitioner and owner of Holistic Inc., a medical clinic in St. Albans. He admitted to knowingly and willfully causing materially false claims to be submitted to Medicaid and its Managed Care Organizations for medical services that were not provided and not medically necessary.
Blankenship admitted that four materially false claims were filed for services that were not provided. Holistic submitted three claims for smoking cessation services and one for a 15-minute office outpatient visit which were purportedly conducted on October 29, 2020. The investigation revealed that services required a licensed provider to be present. From on or about October 28, 2020, through on or about October 30, 2020, Blankenship and Holistic’s other licensed nurse practitioners were in Hilton Head, South Carolina, and not in St. Albans on October 29, 2020.
Holistic provided multiple services to patients during the October 2020 time period, including primarily office-based opioid treatment, weight loss counseling, and smoking and tobacco use cessation counseling. 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.
Acting United States Attorney Lisa G. Johnston 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) for their multi-year investigation of Blankenship’s fraudulent medical billing practices.
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 prosecutors for the case.
