Virginia Woman Sentenced in Medicaid Fraud Case

by Andrew Murray | August 12th, 2019

On July 30, 2019, the Department Of Justice announced the sentence.

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Crystal Smith, a Troutdale, Va. woman who worked as a Consumer Directed Services Facilitator (CDSF) to assist elderly and disabled Virginia Medicaid recipients, was sentenced today to four months in prison and ordered to pay $113,877 in restitution. United States Attorney Thomas T. Cullen and Virginia Attorney General Mark R. Herring made the announcement today following Smith’s sentencing hearing in U.S. District Court in Abingdon.

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Smith, 51, pleaded in March 2019 to one count of health care fraud. According to court documents, 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, formerly known as the Elderly or Disabled with Consumer Direction Waiver Program.

However, a review of Smith’s case files and Medicaid Billing reels, show Smith billed DMAS for 1,732 reassessments, routine visits, and trainings 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.

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