Kasharel Forrest, DAB CR6975 (2026)

DECISION

Petitioner, Kasharel Forrest, pled guilty to one misdemeanor count of fraud.  Based on her guilty plea, the Inspector General (IG) has excluded her for five years from participating in Medicare, Medicaid, and all federal health care programs, as authorized by section 1128(a)(1) of the Social Security Act (Act).  Petitioner appeals the exclusion.  For the reasons discussed below, I find that the IG properly excluded Petitioner and that the statute mandates a minimum five-year exclusion.

Background

In a letter dated April 30, 2026, the IG notified Petitioner that she was excluded from participating in Medicare, Medicaid, and all federal health care programs for a period of five years because she had been convicted of a criminal offense related to the delivery of an item or service under Medicare or a state health care program.  The letter explained that section 1128(a)(1) of the Act authorizes the exclusion.  IG Ex. 1.

Petitioner timely requested review.

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The IG submitted a written argument (IG Br.) and five exhibits (IG Exs. 1-5).  Petitioner responded to the IG’s brief (P. Br.) and included two exhibits (P. Exs. 1-2.).1  The IG filed a reply brief on August 27, 2026.

In the absence of any objections, I admit into evidence IG Exs. 1-5 and P. Exs. 1-2.

The parties agree that an in-person hearing is not necessary.  IG Br. at 6; P. Br. at 4.  Additionally, neither party provided written direct testimony.  As stated in the May 14, 2026 Standing Order, a hearing will be held only if a party asks to cross-examine a witness for whom the opposing party has provided written direct testimony and the witness’ proposed testimony is found to be relevant and non-cumulative.  May 14, 2026 Order at 7-8; Civil Remedies Division Procedures § 19(d).  Therefore, a hearing is not necessary, and this matter will be decided on the written record.

Discussion

Petitioner must be excluded from program participation for a minimum of five years because she was convicted of a criminal offense related to the delivery of an item or service under a state health care program.  Act § 1128(a)(1).2

Under section 1128(a)(1) of the Act, the Secretary of Health and Human Services must exclude an individual who has been convicted under federal or state law of a criminal offense related to the delivery of an item or service under Medicare or a state health care program.  42 C.F.R. § 1001.101(a).

Petitioner was the owner of a staffing agency for healthcare facilities, including facilities who were enrolled in Indiana Medicaid.  IG. Ex. 5.  One of those healthcare facilities was Valley View Healthcare.  Pursuant to a contract with Petitioner’s staffing agency, Petitioner was responsible for verifying the licensure status of the individuals who were contracted to work at Valley View Healthcare.  Id.  An investigation showed that many of the individuals who provided health care services at Valley View Healthcare were not licensed or certified by the State of Indiana.  Id.   Petitioner admitted that she knew that some of the employees she sent to Valley View Healthcare were not licensed or certified.  Id.  The time cards signed by Petitioner included an employee’s nursing title.  Id.  In some cases, Petitioner signed the time cards knowing that the employee did not possess the licensure indicated on the time card.  Id.  Petitioner used the time cards to pay her employees.  But Valley View Healthcare submitted the time cards for payment from the Indiana State Medicaid program and those time cards included information that the

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employees were licensed or credentialed when they were not.  Id.  Therefore, Petitioner’s actions caused Valley View Healthcare to submit claims for healthcare services to the Indiana Medicaid that contained false information.  Id.

Petitioner was charged with one count of felony Fraud and one count of felony Theft on September 1, 2023.  IG Ex. 2.  Petitioner plead guilty to one count of misdemeanor Fraud in violation of Indiana statute 35-43-5-4(a)(1) on December 9, 2025.  IG Ex. 3.  The court entered a judgement of conviction on December 11, 2025, accepting Petitioner’s plea and sentencing her to one year, all suspended.  IG Ex. 4.

Petitioner was convicted of a criminal offense for exclusion purposes under section 1128(a)(1) of the Act.  The Act provides an individual or entity is considered “convicted” when a judgment of conviction has been entered by a federal, state, or local court, or a plea of guilty or no contest has been accepted in a federal, state, or local court.  42 U.S.C. § 1320a-7(i)(1), (3).  Here, the criminal complaint, the plea agreement, and the entry of judgment by the Court all make readily apparent that Petitioner was in fact convicted of such an offense.  IG Exs. 2, 3, 4.

Petitioner was thus convicted within the meaning of the Act.  Petitioner does not dispute that she was convicted of fraud.

The Act requires Petitioner be excluded from participation in federal programs if she was convicted of an offense relating to the delivery of an item or service under Medicare or a state health care program.  See 42 U.S.C. § 1320a-7(a)(1).  The term “related to” simply means that there must be a nexus or common sense connection.  See Friedman v. Sebelius, 686 F.3d 813, 820 (D.C. Cir. 2012) (describing the phrase “related to” in another part of section 1320a-7 as “deliberately expansive words,” “the ordinary meaning of [which] is a broad one,” and one that is not subject to “crabbed and formalistic interpretation”) (internal quotation marks omitted); see also Quayum v. U.S. Dep’t of Health and Human Servs., 34 F. Supp. 2d 141, 143 (E.D.N.Y. 1998).

Petitioner states in her brief that she disputes that her conviction is related to the delivery of an item or service under Medicare or a State health care program.  P. Br.  The record clearly demonstrates a nexus between the criminal offense for which Petitioner was convicted and the delivery of an item or service under a state health care program.  Petitioner provided invoices to Valley View Healthcare that included the names of the employees of her staffing agency who worked at the facility.  IG Ex. 5.  The invoices included the names of the employees, the alleged nursing certification of the employees,3 the days and hours worked, and the total amount owed.  Id.  Valley View Healthcare used the invoices to bill the Indiana Medicaid program for the services provided by the

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Petitioner’s staffing agency’s employees.  Id.  The conduct to which Petitioner admitted by virtue of her guilty plea, and which forms the factual basis of her criminal conviction, is clearly related to the delivery of an item or service as contemplated by section 1128(a)(1) of the Act.

I, therefore, conclude that Petitioner was convicted of a criminal offense related to the delivery of an item or service under Medicare or state health care program as contemplated by 42 U.S.C. § 1320a-7(a)(1).

Petitioner additionally argues that her staffing agency used paper and electronic employee time sheets when services were provided at Valley View Healthcare.  P. Br.  She argues that the time sheets were signed by the employee and the supervisor and that the time sheets were used to determine compensation.  Id.  She argues that these time sheets are proof that the services were actually performed and, therefore, she was not participating in Medicaid fraud.  P. Br.  She also argues that she did not understand that she was participating in Medicaid fraud.  Id.  However, Petitioner plead guilty to fraud in Indiana state court.  Petitioner’s conviction based on her guilty plea is a “prior determination where the facts were adjudicated and a final decision was made” within the meaning of 42 C.F.R. § 1001.2007(d).  Therefore, Petitioner may not collaterally attack her conviction in this forum.

Similarly, Petitioner argues that Covid-19 allowed facilities to employ individuals beyond four months in a nurse-aide role without completion of a state approved training program.  P. Br.  While this may be true, this argument again amounts to an attack on the underlying facts of Petitioner’s criminal conviction.  Petitioner plead guilty to fraud and the affidavit for probable cause underlying the conviction explains that Petitioner submitted invoices to Valley View Healthcare indicating that employees of her staffing agency were licensed, when they were not.  Those invoices were then used by Valley View Healthcare to submit claims to the Indiana Medicaid program that contained the materially false information.

Because I have concluded that a basis exists to exclude Petitioner under 42 U.S.C. § 1320a-7(a)(1), Petitioner must be excluded for a minimum period of five years.  42 U.S.C. § 1320a-7(c)(3)(B); 42 C.F.R. §§ 1001.102(a), 1001.2007(a)(2).  The IG has no discretion to impose a lesser period of exclusion, and I may not reduce the period of exclusion below five years.

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Conclusion

For these reasons, I conclude that the IG properly excluded Petitioner from participation in Medicare, Medicaid, and all federal health care programs, and an exclusion brought under section 1128(a)(1) must be for a minimum period of five years.  Therefore, I sustain the five-year exclusion.