June 13 – Michelle Shropshire, 54, of Waldorf, Maryland, and Harlisha Jones, 49, of Clinton, Maryland, and Washington, DC, were arrested this morning on health care fraud, wire fraud, mail fraud, aggravated identity theft, and conspiracy charges filed in U.S. District Court.
According to the indictment, from June 2021 through January 2024, Shropshire and Jones, both Train Operators employed by the Washington Metropolitan Area Transit Authority (WMATA), conspired to use Jones’s insurance policies with American Family Life Assurance Company of Columbus (AFLAC) to submit fraudulent health care and short-term disability insurance claims for injuries, medical treatments, and disability periods that did not exist.
Court documents allege that the defendants used the information of real doctors to create fraudulent medical excuse notes and physician’s statements, including forged doctors’ signatures, that were submitted to AFLAC in support of the insurance claims. Then, shortly after AFLAC paid each claim to Jones, she paid a kickback to Shropshire using a percentage of the total claim payment. As a result of those fraudulent insurance claims, AFLAC paid Jones approximately $58,750, of which Jones paid approximately 20% back to Shropshire.
The indictment further alleges that in addition to Jones, Shropshire assisted numerous other WMATA employees with submitting fraudulent health care and short-term disability insurance claims to AFLAC. As a result of that scheme, AFLAC paid at least $362,035.14 in phony insurance benefits to Shropshire, Jones, and other WMATA employees.
Those employees included Sharon Washington, 53, of Woodbridge, VA, Selethia Blake, 53, of Waldorf, MD, Brady Turner, 56, of Clinton, MD, Lushawn Foreman, 51, of Upper Marlboro, MD, and Margot Jackson, 52, of Hughesville, MD, among others.
Washington, Blake, Turner, Foreman, and Jackson have each admitted to their involvement in Shropshire’s scheme, including paying kickbacks to Shropshire using a portion of the claim payments they received, and have pleaded guilty to conspiracy to commit health care fraud. Each is currently awaiting sentencing.
If convicted, Shropshire and Jones each face a maximum statutory sentence of 20 years in prison for the charged offenses, with an additional mandatory sentence of two years in prison for the offense of aggravated identity theft. The maximum statutory sentence for federal offenses is prescribed by Congress and is provided for informational purposes. If convicted, the defendants’ sentence will be determined by the court based on the advisory Sentencing Guidelines and other statutory factors.
These cases are being investigated by the FBI Washington Field Office and the WMATA Office of Inspector General. They are being prosecuted by Assistant U.S. Attorneys Brian P. Kelly and Diane Lucas.
An indictment is merely an allegation, and all defendants are presumed innocent until proven guilty beyond a reasonable doubt in a court of law.
Source: U.S. Attorney’s Office, District of Columbia