Maryland Nurse Pleads Guilty to Health Care Fraud Conspiracy for Role in $14 Million D.C. Medicaid Scheme
WASHINGTON / Thursday, September 17, 2026 – Vera Nyiawung, 34, a registered nurse from Bowie, Maryland, pleaded guilty today in connection with a $14 million health care fraud scheme that billed D.C. Medicaid for mental health services that were never provided or were grossly inflated, announced U.S. Attorney Jeanine Ferris Pirro.
“Padding call lengths, recycling notes, and billing Medicaid for care that never happened isn’t healthcare—it’s organized theft,” said U.S. Attorney Pirro. “Vera Nyiawung was trusted to oversee care for vulnerable youth but instead used her position to validate fake records and facilitate a multi-million-dollar fraud scheme. My office will relentlessly prosecute those who exploit public healthcare programs for personal gain.”
Nyiawung pleaded guilty today before U.S. District Judge Emmet G. Sullivan to one count of conspiracy to commit health care fraud. Nyiawung faces up to 10 years in prison a $250,000 fine and restitution.
According to court documents, Nyiawung was employed as a nurse at a D.C. Medicaid provider authorized to deliver mental health rehabilitative services to youth and adolescents, beginning in January 2023. In addition to her nursing duties, Nyiawung performed Community Support Worker (CSW) duties, supervised other staff, and reviewed encounter notes for approval.
Nyiawung conspired with company employees and other community support workers to siphon millions from D.C. Medicaid through thousands of fraudulent claims for reimbursement. Company employees directed Nyiawung and other workers to bill the maximum allowable time per consumer regardless of medical necessity or actual service.
To execute the scheme, workers, like Nyiawung, billed a full hour for telephonic encounters even if the calls only lasted a few minutes. Workers were trained to evade false claims detection by randomly selecting times a few minutes below the 60-minute maximum call length. Workers were directed to bill three hours, and later one hour, for diagnostic assessments regardless of how much time was spent with the consumer. Community support workers were told to recycle information from a single telehealth session to generate multiple fabricated encounter notes. This resulted in bills to D.C. Medicaid for several days of services that were based on only one actual conversation with the consumer.
Investigators determined that Nyiawung’s participation in the conspiracy resulted in a loss to Medicaid of over $550,000.
Joining in the announcement was Matthew Wilcoxson, Interim Inspector General for the District of Columbia.
This case was investigated 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. The District Department of Health Care Finance’s Division of Program Integrity referred this matter and provided assistance during the investigation.
The matter was prosecuted by Assistant U.S. Attorney Jason Facci of the Fraud, Public Corruption, and Civil Rights Section.
On April 7, the Department of Justice announced the creation of the National Fraud Enforcement Division (“Fraud Division”). The Fraud Division is laser-focused on investigating and prosecuting those who commit fraud against the American people. The Department’s work to combat fraud supports President Trump’s Task Force to Eliminate Fraud, a whole-of-government effort chaired by Vice President J.D. Vance to eliminate fraud, waste, and abuse within Federal benefit programs.
The Department of Justice’s Health Care Fraud Strike Force Program, currently comprised of nine strike forces operating in federal districts across the country, has charged more than 6,200 defendants who collectively billed federal health care programs and private insurers more than $45 billion since 2007. In addition, the Centers for Medicare & Medicaid Services, working in conjunction with the Office of the Inspector General for the Department of Health and Human Services, are taking steps to hold providers accountable for their involvement in health care fraud schemes. More information can be found at www.justice.gov/criminal-fraud/health-care-fraud-unit.
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Source: U.S. Attorney's Office, District of Columbia
