Grayson County Woman Sentenced for Health Care Fraud

Abingdon, VIRGINIA – 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.

“Medicaid providers, including those that provide home-based, education, and training services to disabled populations, are obligated to follow the letter of the law in billing for their work,” U.S. Attorney Cullen stated today.  “We will continue to prosecute those who engage in fraudulent billing schemes and hold them accountable.” 

“Anyone attempting to steal from Virginia’s Medicaid program needs to know we are watching, and we will hold you accountable,” said Attorney General Herring. “We cannot abide fraud that weakens this important program for those who truly need assistance.”

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.

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.