Vera Nyiawung, 34, a registered nurse from Bowie, MD, pleaded guilty Thursday to one count of conspiracy to commit health care fraud before US District Court Judge Emmet G. Sullivan. She now faces up to 10 years in prison, a 250,000 fine, and restitution.

According to DOJ, Nyiawung was a nurse at a DC Medicaid provider who was authorized to provide mental health rehabilitative services to youth and adolescents starting in January 2023. In addition to being a nurse, Nyiawung was a Community Support Worker, supervised other employees, and reviewed encounter notes for approval.

Company employees instructed Nyiawung and other employees to bill for the maximum allowed time per patient, regardless of medical necessity or type of service provided, feds said.

DOJ writes that employees were billing for a full hour of a phone call that was only a few minutes long. Employees were trained to avoid detection by choosing random call times a few minutes shy of the 60-minute maximum billing threshold. Employees were told to bill for three hours, and later one hour, for diagnostic assessments, regardless of how much time they spent with the patient. Employees were instructed to take information from one telehealth encounter and use it to create multiple falsified encounter notes to bill for several days of services from one real conversation.

Nyiawung individually caused more than 550,000 in losses, investigators said.

"Padding call lengths, recycling notes, and billing Medicaid for care that never happened isn't healthcare-it's organized theft," US Attorney Jeanine Ferris Pirro said. "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."

The investigation was conducted by the FBI Washington Field Office, the DC Office of Inspector General's Medicaid Fraud Control Unit, and the HHS Office of Inspector General. The District's Department of Health Care Finance referred the case. The case is being prosecuted by Assistant US Attorney Jason Facci. A sentencing date has not yet been determined.