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Tipsheet

Two Train Operators Plead Guilty in $60K Health Care Fraud Scheme

AP Photo/Gene J. Puskar, File

Michelle Shropshire, 55, of Waldorf, Md., and Harlisha Jones, 50, of Clinton, Md., and Washington, D.C., pleaded guilty in U.S. District Court in connection with a health care fraud scheme in which they conspired to obtain fraudulent health care and disability payments totaling nearly $60,000. 

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Shropshire also admitted to spearheading a broader scheme involving other WMATA employees that resulted in approximately $360,000 in fraudulent health care and disability payments. 

Shropshire and Jones pleaded guilty before U.S. District Judge Rudolph Contreras to conspiracy to commit mail fraud, wire fraud, and health care fraud. Sentencing for Shropshire is scheduled for June 11, 2026. Jones will be sentenced on June 15, 2026. Judge Contreras will determine any sentences for Shropshire and Jones after considering the U.S. Sentencing Guidelines and other statutory factors. 

In pleading guilty, Shropshire and Jones admitted that, from approximately June 2021 through January 2024, while employed as train operators by the Washington Metropolitan Area Transit Authority, they conspired to use Jones’s insurance policies with American Family Life Assurance Company of Columbus to submit fraudulent health care and short-term disability insurance claims for injuries, medical treatments, and disability periods that did not exist. 

Shropshire and Jones also admitted that, in executing their scheme, they used the information of real doctors to create fraudulent medical excuse notes and physicians’ statements, including forged doctors’ signatures, and then submitted those documents to AFLAC in support of the insurance claims. 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.

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Shropshire also admitted that in addition to Jones, she assisted numerous other WMATA employees with submitting fraudulent health care and short-term disability insurance claims to AFLAC. As a result of that broader scheme, AFLAC paid at least $362,035 in phony insurance benefits to Shropshire, Jones, and other WMATA employees. In addition to Shropshire and Jones, five other former WMATA employees previously 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.

Joining in the announcement were Assistant Director in Charge Darren B. Cox of the FBI Washington Field Office and Inspector General Michelle Zamarin of the Washington Metropolitan Area Transit Authority Office of Inspector General.

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.

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