By Clark Kauffman 

A central Iowa nurse is accused of bilking taxpayers out of $1 million by prescribing unneeded Medicare-funded medical devices in return for kickbacks.

In a newly filed civil lawsuit, the U.S. Department of Justice alleges that Ashley Brown, a state-licensed advanced registered nurse practitioner from Des Moines, participated in a scheme to defraud Medicare. The DOJ claims Brown prescribed “unreasonable and medically unnecessary” durable medical equipment for 660 Medicare beneficiaries in return for illegal kickbacks.

The prescriptions were written between April 2020 and May 2021 and deprived Medicare of $1,055,672, according to the Justice Department. In return for her prescriptions, Brown allegedly collected $17,520.

The lawsuit alleges the scheme unfolded in the spring of 2020 as a result of the COVID-19 pandemic that caused a temporary and dramatic reduction in Brown’s employment, which was largely tied to dermatology. In response to the financial pressure, Brown allegedly signed a contract with an employment agency, Barton Associates, that helps provide work for physicians and nurses.

Barton allegedly offered Brown a telemedicine position with a flexible schedule and attractive pay. Under the terms of the alleged deal, Brown would be paid to assess each patient record given to her and then sign predetermined prescriptions for medical equipment. As part of what the DOJ calls a “scheme for easy cash,” Brown was paid $20 for each patient file she reviewed.

Through that process, Brown allegedly ordered costly and unnecessary equipment – including hundreds of back, shoulder, knee, wrist and elbow orthotic braces – for individuals without having had any professional interaction with them. The prescriptions were based on falsified medical records filled out not by people who were medical practitioners but by telemarketers who had made unsolicited calls to suspected Medicare beneficiaries.

Brown allegedly provided no follow-up care to the patients, nor did she assist them or advise them on how to use the devices. The patient files submitted to Brown were sent to her by email, and although she could open and read them, she could not edit or amend them except to affix her signature authorizing the purchase of medical equipment.

Over the course of 13 months, Brown allegedly received hundreds of patient assessments for her signature, “which she readily and uncritically provided,” according to the DOJ. Many of the records Brown signed allegedly included much of the same false, boilerplate language about each patient’s purported condition.

“Brown outsourced her medical judgment to increase her own profits by failing to provide any meaningful review of patient records or to even have contact with her ‘patients,’” the DOJ claims. “Frequently, Brown spent only seconds between opening the documents sent for her review and affixing her signature.”

Knee brace supplied for amputated leg

As an example, the DOJ says that on Nov. 23, 2020, Brown approved and certified prescriptions for 15 different patients, spending “a mere nine seconds per prescription with the records open before attesting to medical necessity.” Those 15 prescriptions cost the taxpayer-funded Medicare program almost $8,000 and would have generated $300 for Brown as payment for the 20 minutes she spent opening the documents and attaching her signature.

In one instance, the DOJ says, an Elkhart man received an unsolicited telemarketing call in which he was asked general questions related to aches and pains. The man was then sent a back brace, two knee braces, two knee-brace sleeves and two wrist braces. All five of the devices were prescribed by Brown, whom the man had never met. The patient later told investigators he was amused by the receipt of the two leg braces since his left leg had been amputated years before. Medicare was allegedly billed $8,292 for the devices and paid $3,355 for them.

The DOJ also claims that Brown was put on notice during her time with Barton Associates that the beneficiaries for whom she was writing prescriptions did not need, or even want, the medical equipment she prescribed. In May 2020, a patient called Brown to complain of being “wrapped up in a hoax,” and didn’t want the prescribed medical equipment.

A few months later, in August 2020, Brown allegedly received a voicemail from another Iowan, alerting her to the fact that that although the two had never had any contact, the “patient” had just received an unwanted orthotic brace prescribed by Brown.

The patient complaints, the DOJ says, “did nothing to slow Brown’s pace of prescribing.” Brown only stopped writing the fraudulent prescriptions, the DOJ alleges, when she was contacted by law enforcement in May 2021.

Brown is accused of violating the federal False Claims Act. The DOJ is seeking triple the amount of the United States’ damages, plus unspecified civil penalties.

Brown’s license is in good standing with the Iowa Board of Nursing, and she has no record of any disciplinary action against her license. Barton Associates is not a party to the lawsuit, and federal court records indicate there are no pending criminal charges in the case.

In 2022, a Kentucky doctor agreed to pay $561,800 to resolve allegations that while partnering with Barton, he violated the False Claims Act by submitting false claims to Medicare for unnecessary equipment.

Calls to Barton Associates were answered by an automated service offering callers a “very expensive” medical-alert device free of charge. When reached by instant messaging, the company routed inquiries for its media affairs office to a website where payment of a “refundable fee” was required.

The company did not immediately respond to an email sent to the corporate office.