Insurance Fraud NEWS
Grayson County woman admits to falsely billing Medicaid for more than $100K
March 26, 2019, Grayson County, VA
A Grayson County woman pleaded guilty in Abingdon federal court Monday to healthcare fraud and faces up to 10 years in prison and a $250,000 fine.
According to authorities, 50-year-old Crystal Michelle Smith entered into a provider agreement with the Department of Medical Assistance Services (DMAS) and received payments from 2011 to 2018. The payments were for services provided to Medicaid recipients through Virginia Medicaid’s Commonwealth Coordinated Care Plus Waiver Program.
Authorities said a review found that show Smith billed DMAS for 1,732 reassessment, routine visits and training that did not have the required supporting documentation or did not occur at all. Smith admitted to making copies of recipient’s signatures on DMAS forms, which she then re-used to create subsequent forms. From August 2011 to March 2018, Smith fraudulently billed DMAS $121,435 and was paid $113,877.
“Protecting federal health-care programs and their beneficiaries from fraud, waste, and abuse is among the top priorities of the U.S. Department of Justice,” U.S. Attorney Cullen stated. “We will continue to work closely with the Virginia Attorney General’s Office and the Medicaid Fraud Control Unit to investigate individuals and entities, like this defendant, who abuse the trust of these programs and the people they are supposed to serve.”
“We will continue to work closely with our federal partners to root our provider fraud because it weakens this important program for those who truly need it,” said Attorney General Mark Herring.