Shawn R. Blankenship, 54, of Winfield, pleaded guilty to four counts of healthcare 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.
