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Justice News

Department of Justice
U.S. Attorney’s Office
Western District of Virginia

Tuesday, March 26, 2019

Grayson County Woman Pleads Guilty to Health Care Fraud

Crystal Smith Admits to Falsely Billing Medicaid for $121,435

Abingdon, VIRGINIA – A Troutdale, Va. woman, who worked as a Consumer Directed Services Facilitator (CDSF) to assist elderly and disabled Virginia Medicaid recipients, pleaded guilty yesterday in federal court to healthcare fraud, United States Attorney Thomas T. Cullen and Virginia Attorney General Mark R. Herring announced.

Crystal Michelle Smith, 50, pleaded guilty yesterday to one count of health care fraud. At sentencing, she faces up to ten years in prison and up to a $250,000 fine.

“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 today.  “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 R. Herring.

According to information presented at yesterday’s guilty plea by Special Assistant United States Attorney and Virginia Assistant Attorney General Janine M. Myatt, 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 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.

The investigation of the case was conducted by the Virginia Attorney General’s Office Medicaid Fraud Control Unit.  Special Assistant United States Attorney and Assistant Attorney General Janine M. Myatt is prosecuting the case for the United States.

Health Care Fraud
Updated March 26, 2019