N.J. U.S. Attorney Office: Former Advanced Practice Nurse Admits Role in Health Care Fraud Conspiracy

CAMDEN, New Jersey, March 1 -- The office of the U.S. Attorney for the District of New Jersey issued the following news release on Feb. 28, 2023:

A former Pennsville, New Jersey, advanced practice nurse today admitted defrauding New Jersey state and local health benefits programs and other insurers by submitting fraudulent claims for medically unnecessary prescriptions, Attorney for the United States Vikas Khanna announced.

Ashley Lyons-Valenti, 66, of Swedesboro, New Jersey, pleaded guilty today by videoconference before U.S. District Judge Robert B. Kugler to an information charging her with one count of conspiring to commit health care fraud.

Lyons-Valenti was previously charged with Vincent Tornari, 49, of Linwood, New Jersey, and Brian Sokalsky, 44, of Margate, New Jersey, in a 33-count indictment in June 2020. The charges against Tornari and Sokalsky remain pending, and they are set to proceed to trial later this year. The charges and allegations against Tornari and Sokalsky are merely accusations, and they are presumed innocent unless and until proven guilty.

According to court documents and statements made in court:

Compounded medications are specialty medications mixed by a pharmacist to meet the specific medical needs of an individual patient. Although compounded drugs are not approved by the Food and Drug Administration (FDA), they are properly prescribed when a physician determines that an FDA-approved medication does not meet the health needs of a particular patient, such as if a patient is allergic to a dye or other ingredient.

Lyons-Valenti was previously an advanced practice nurse at a medical office in Pennsville, New Jersey. At the same time, Tornari hired Lyons-Valenti's live-in boyfriend to be a sales representative for his company which promoted compound medications, even though Lyons-Valenti's boyfriend had no background or experience in medicine and pharmaceutical sales. Tornari and Lyons-Valenti's boyfriend had an agreement that the boyfriend would receive a commission on all prescriptions authorized by Lyons-Valenti. Lyons-Valenti then authorized numerous medically unnecessary prescription medications associated with Tornari and her boyfriend - including for her patients, staff members and co-workers at the medical office where she worked, and her children - for the sole purpose of financially benefitting herself, her boyfriend, and Tornari. In exchange for authorizing the prescriptions, Lyons-Valenti's boyfriend paid her half of his commissions that he received from Tornari. As a result of the scheme, health insurance paid over $1.2 million for medically unnecessary medications and Lyons-Valenti received over $90,000 in kickbacks for signing the prescriptions.

As part of her plea agreement, Lyons-Valenti also admitted to attempting to obstruct or impede the administration of justice with respect to the investigation of the health care fraud conspiracy by trying to influence the testimony of a grand jury witness.

Lyons-Valenti faces a maximum penalty of 10 years in prison and a $250,000 fine. Sentencing is scheduled for July 11, 2023.

Attorney for the United States Khanna credited agents of the FBI's Atlantic City Resident Agency, under the direction of Special Agent in Charge James E. Dennehy in Newark; special agents of IRS - Criminal Investigation, under the direction of Acting Special Agent in Charge Tammy Tomlins in Newark; and the U.S. Department of Labor Office of Inspector General, New York Region, under the direction of Special Agent in Charge Jonathan Mellone, with the investigation leading to today's guilty plea.

The government is represented by Christina O. Hud, Senior Trial Counsel in the Health Care Fraud Unit; R. David Walk, Jr., Chief of the Opioid Abuse Prevention and Enforcement Unit; and Assistant U.S. Attorney Daniel A. Friedman of the Criminal Division in Camden.

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Original text here: https://www.justice.gov/usao-nj/pr/former-advanced-practice-nurse-admits-role-health-care-fraud-conspiracy