WASHINGTON – 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…
Insurance fraud involves making false or exaggerated claims to an insurance provider.
- Hard Fraud: Someone deliberately causes a loss (e.g., setting fire to a warehouse or staging a car accident) specifically to collect a payout.
- Soft Fraud: More common and often viewed as “victimless” by the perpetrator. It involves exaggerating a legitimate claim, such as overstating the value of stolen items in a home burglary to cover the deductible.