Acting Attorney General Jennifer Davenport, the Division of Criminal Justice, and the Office of the Insurance Fraud Prosecutor announced on January 26th that the owner of a health center and one of her employees have been indicted for health care fraud and other related crimes for allegedly illegally performing medical procedures.

The owner, Esney Davis-Sharpe, 63, of East Orange, New Jersey, and the employee, Nataliya Lushchak, 48, of Lower Gwynedd, Pennsylvania, were both charged with one count each of conspiracy to commit health care claims fraud (second degree); unlicensed practice of medicine (third degree); health care claims fraud (second degree); and Medicaid fraud (third degree).

“This case alleges a deliberate abuse of the Medicaid system and a betrayal of patient trust,” said Acting Attorney General Davenport. “Submitting claims for medical services performed by unlicensed individuals undermines the integrity of Medicaid and diverts critical resources from those who rely on the program. OIFP will continue to hold accountable those who abuse the Medicaid program and place patients at risk.”

“This case shows the importance of state agencies working together to respond to reports of allegedly illegal activity and root it out,” said DCJ Director Theresa L. Hilton. “Thousands of claims were allegedly submitted to Medicaid for reimbursement to which these defendants are not entitled. Health care fraud endangers the public and wastes limited public resources.”

“Medicaid provides a vital health care safety net, and anyone who files fraudulent claims leads to all of us paying more to run that system,” said Acting Insurance Fraud Prosecutor Al Garcia. “Our medical licensing regime is created to ensure that health care providers are properly educated and trained to provide needed health care services. Performing services without holding the proper licenses presents a risk to patients that we will not allow.”

According to documents filed in this case, in August 2023, the New Jersey Division of Consumer Affairs referred a case regarding the unlicensed practice of medicine at Bessie Mae Women’s Health Center, a women’s and family health practice located in East Orange, New Jersey. The practice offered, among other services, obstetrics/gynecology, primary care, and family care services and was owned by Davis-Sharpe, who was not licensed to practice medicine.

On May 26, 2021, Davis-Sharpe allegedly hired Lushchak as a practitioner at Bessie Mae.  Davis-Sharpe and Lushchak were not licensed to practice medicine in New Jersey, yet they are alleged to have performed gynecological services on patients.

From December 2020 to February 2024, approximately 2,500 claims for reimbursement for medical services were allegedly submitted from Bessie Mae to the New Jersey Medicaid Program, all naming a doctor – identified as “Dr. N.J.” in the indictment — and another provider, identified as “Dr. K.R.,” without the permission, knowledge or consent of said doctors.

On January 25, 2024, the New Jersey Department of Health served a cease-and-desist order to Davis-Sharpe, instructing Bessie Mae to cease providing all services from the facility.

Lushchak is allegedly enrolled as a medical student at Suburban Community Hospital in Norristown, Pennsylvania.

Second-degree charges carry a sentence of five to 10 years in prison and a fine of up to $150,000.

Third-degree charges carry a sentence of three to five years in prison and a fine of up to $15,000.