DUBOIS – Charges have been filed against a DuBois man accused of Medicaid fraud.
Shawn David Chesley, 33, was charged with a felony count of false/fraud medical assistance claim, a felony count of theft by deception and a misdemeanor count of forgery by an agent of the Pennsylvania Attorney General’s office after a grand jury investigation.
His preliminary hearing is scheduled for centralized court on Friday at 10 a.m.
According to court documents, Chesley, a behavioral specialist consultant, was employed by NHS, a company that serves children and adults with mental health diagnoses.
He allegedly had NHS bill the medical assistance program for services he did not provide and for which he was then paid. This position requires a Master’s degree and licensure by the state.
The job is to prepare treatment plans based on psychological evaluations for children with either autism or attention deficit disorder.
He was required to meet with the children and their parents at least twice a month.
A quality control specialist noticed that the paperwork Chesley was submitting did not include any corresponding documentation, such as encounter forms, treatment plans or 30-day reviews.
After she began looking at his work more closely, she discovered that he was submitting “new” treatment plans that were exactly the same as the last plans.
He then billed for updating the treatment plan. Some of the paperwork did not have the required parent signatures and others were signed by someone else or the signature was forged, according to testimony.
When the families were contacted, many of them said they only saw Chesley once or twice and verified the signatures were fake.
Some of the parents had questioned why Chesley was not providing treatment to their child and were told by him that they were receiving the services at school.
Teachers then confirmed they had not seen him more than a few times. Reportedly, the teacher signatures on these forms were sometimes either inaccurate or misspelled.
Chesley was a service employee that was paid for the work he performed and so the more work he did, the more he was paid.
In all between September of 2014 and February of 2015, Medicaid and other insurances were billed for more than $15,000. Chesley himself received more than $8,500 for services that he allegedly never provided.
