A Bowie, Maryland nurse, Vera Nyiawung, 34, has pleaded guilty to participating in a health care fraud conspiracy that defrauded D.C. Medicaid of approximately $14 million, according to the U.S. Attorney’s Office for the District of Columbia. Nyiawung entered her plea before U.S. District Judge Emmet G. Sullivan, facing potential penalties of up to 10 years in prison, a $250,000 fine, and restitution.
The fraud scheme involved submitting thousands of false claims for mental health services that were either never provided or grossly exaggerated. Nyiawung, who was employed as a nurse at a D.C. Medicaid provider authorized to deliver mental health rehabilitative services to youth, engaged in deceptive practices such as billing for full hours of telephonic encounters that often lasted only a few minutes. Reports indicated that she and her colleagues were instructed to inflate billing hours and recycle notes from previous sessions to create the appearance of multiple services rendered.
U.S. Attorney Jeanine Ferris Pirro condemned the actions, describing them as “organized theft” rather than legitimate healthcare practices. She emphasized the betrayal of trust inherent in Nyiawung’s role, stating that the nurse exploited her position to validate fraudulent records, thereby contributing significantly to the loss suffered by Medicaid.
Investigators estimate that Nyiawung’s involvement resulted in a loss exceeding $550,000 to Medicaid. The case was part of a broader investigation by the FBI Washington Field Office, the D.C. Office of the Inspector General’s Medicaid Fraud Control Unit, and the Department of Health and Human Services Office of Inspector General, with assistance from the District Department of Health Care Finance’s Division of Program Integrity.
This case highlights ongoing efforts by federal and local agencies to combat health care fraud and protect public funds. As the national focus on fraud enforcement continues, cases like Nyiawung’s underscore the importance of integrity within healthcare services aimed at vulnerable populations.
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