Unlicensed Group Home Owner Pleads Guilty to Medicaid Health Care and Wire Fraud Schemes | USAO-EDVA

RICHMOND, Va. – A Chester female pleaded guilty today to fees of conspiracy to dedicate overall health treatment fraud, health care fraud, and wire fraud, all stemming from her procedure of a Richmond metro-location wellbeing treatment solutions corporation.

According to court paperwork, between 2014 and 2021, Sharon Johnson, 58, owned and operated “Sharon Y. Johnson & Associates” (SYJA). Johnson’s company purportedly furnished Medicaid-reimbursed expert services that integrated both equally Services Facilitator services—supervising a Medicaid recipient’s individual treatment strategy and provider— and particular care services—home wellness treatment help providers designed to allow a recipient to continue being at property, relatively than getting into a nursing house or team property. Johnson signed up quite a few of her Service Facilitator purchasers, typically with no their consciousness or educated consent, to get particular treatment products and services from her corporation. Johnson utilized her individual home in Chester—a solitary-story, a few-bed room, 1,326-sq. foot structure—as an unlicensed team property, housing up to a 50 percent-dozen Medicaid recipients, in addition to Johnson and a further SYJA employee, at any provided time.

In between 2014 and 2021, Johnson fraudulently billed Medicaid for personalized care services purportedly supplied to at least 14 of her patients, knowingly submitting timesheets to Medicaid that falsely claimed that certain SYJA aides had provided providers, when, in truth, individuals purported SYJA staff members had not presented dwelling overall health care providers to the people in question. To execute this fraud scheme, Johnson and her co-conspirators produced on-line affected person portal accounts in the names of her patients, and thereafter assumed these patients’ identities when “approving” and routing billing requests for SYJA dwelling overall health care services that experienced not, in simple fact, been furnished.

Separately, Johnson also executed a plan to defraud the Virginia Retirement Program (VRS) of pension payments paid by the VRS to a person of Johnson’s unlicensed team dwelling inhabitants. To get hold of handle in excess of her patient’s financial affairs, Johnson submitted fraudulent documents to the VRS such as a “Medical Energy of Attorney” kind, and, just after her patient’s loss of life, transformed the direct deposit site of her now-deceased patient’s VRS pension payments to Johnson’s individual financial institution account. VRS thereafter compensated at minimum 8 month-to-month pension payments into Johnson’s financial institution account in advance of belatedly confirming the patient’s death. Johnson, being aware of she was not entitled to these VRS money, put in those people payments for her individual applications.

Johnson is scheduled to be sentenced on April 18, 2023. She faces a optimum penalty of 20 a long time in jail. Precise sentences for federal crimes are generally fewer than the most penalties. A federal district courtroom decide will identify any sentence soon after getting into account the U.S. Sentencing Recommendations and other statutory things.

Jessica D. Aber, U.S. Legal professional for the Eastern District of Virginia, and Stanley M. Meador, Particular Agent in Charge of the FBI Richmond Area Business office, made the announcement following U.S. District Choose Hannah M. Lauck recognized the plea. The Virginia Medicaid Fraud Manage Unit assisted in the investigation.

Assistant U.S. Lawyers Thomas A. Garnett and Shea Gibbons are prosecuting the circumstance.

A duplicate of this press release is positioned on the website of the U.S. Attorney’s Business for the Jap District of Virginia. Relevant court docket documents and facts are situated on the site of the District Courtroom for the Jap District of Virginia or on PACER by searching for Situation No. 3:22-cr-16.

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