Advanced practice nurse defrauded New Jersey health benefits programs

A former Pennsville, New Jersey, advanced practice nurse admitted to defrauding New Jersey state and local health benefits programs and other insurers by submitting fraudulent claims for medically unnecessary prescriptions.

Ashley Lyons-Valenti, 66, of Swedesboro, New Jersey, pleaded guilty Tuesday, February 28, 2023, 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, and Brian Sokalsky, 44, of Margate, in a 33-count indictment in June 2020.

The indictments outline a far-reaching scheme that enlisted doctors, public employees, and pharmaceutical representatives to take advantage of health benefits through prescriptions for expensive and unnecessary compounding medications.

Republican Northfield Board of Education member Mark Bruno pleaded guilty in 2019 to conspiracy to commit health care fraud for his participation in the scheme, in which he admitted to making nearly $70,000.

The charges against Tornari and Sokalsky remain pending, and they are set to proceed to trial later this year.

According to federal prosecutors, Lyons-Valenti was involved in a scheme to profit off compounded 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 may be 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 the commissions that he received from Tornari.

As a result of the scheme, health insurance paid over $1.2 million for 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.

This site uses Akismet to reduce spam. Learn how your comment data is processed.

%d bloggers like this: