Virginia tackles Medicaid fraud: Convictions in $11M case

(The Daily Signal) – A federal jury in Richmond convicted three people this week on charges that they defrauded Medicaid out of more than $11 million. The charges relate to billing by their company, Divine Youth Counseling LLC.

The three people, 31-year-old twin sisters E’mon and Armone’ Ambers, as well as 32-year-old Traquan Brown, billed Medicaid for a service known as Crisis Stabilization and Mobile Crisis.

“The defendants falsely claimed that two mental health professionals simultaneously provided services to Medicaid recipients, when in truth, at most a single mental health professional was present for the service,” the Justice Department wrote. “The false claims that two professionals provided ‘Team Treatment’ services caused millions of dollars of loss to Medicaid.”

In addition to the billing fraud, the three were also convicted on charges that they illegally provided hotel rooms for Medicaid recipients to encourage them to obtain Medicaid services from Divine Youth.

E’mon Ambers could be sentenced to up to 92 years in prison, while Armone’ Ambers could be sentenced to 42 years in prison. Traquan Brown could be sentenced to up to 10 years in prison.

On Dec. 14, the court will hold a hearing to consider whether to claw back some of the money that the trio misappropriated. “The assets subject to forfeiture include $5,937,156.30 in funds seized pursuant to a federal seizure warrant,” the Justice Department noted.

Elsewhere in Richmond, Gov. Abigail Spanberger launched an effort this week to improve state services and reduce the size and scope of bad state contracts. The Democrat named Andrea Fletcher to be the first director of the Virginia Digital Service. Fletcher previously worked as the first chief digital strategy officer at the Centers for Medicare and Medicaid Services.

Spanberger had called for the creation of the team earlier this year as part of the compromise that allowed lawmakers to pass a budget in June. “Virginia Digital Service will bring together expert technical talent to modernize state systems, improve government websites, and speed up the delivery of the services that families rely on every day,” the governor said.

The creation of the team follows last month’s revelation that a previous reform effort launched by then-Gov. Glenn Youngkin had fallen short. “We uncovered a $52 million loss at the Department of Social Services on a failed effort to replace the commonwealth’s antiquated child support enforcement system,” Spanberger said. “Virginia paid serious money, and all we got were tools that barely worked.”

Spanberger also tapped Daniel Young to be the state’s next inspector general. Young has spent years working for the federal government, including stints at the Public Company Accounting Oversight Board, the U.S. Securities and Exchange Commission, and as an assistant United States attorney.

“I have worked to combat fraud and corruption throughout my career in public service, and I look forward to fighting fraud, waste, and abuse in this new role,” Young said last week. “The dedicated public servants who work in the Office of the State Inspector General are committed to making government more transparent and more accountable for all Virginians, and it is a privilege to support their efforts.”

If his nomination is approved by the General Assembly, Young would serve a four-year term investigating allegations of waste, fraud, and abuse in Virginia’s state government.