North Fairfax News

Unlicensed Group Home Owner Pleads Guilty to Medicaid Health Care and Wire Fraud Schemes

A Chester woman pleaded guilty today to charges of conspiracy to commit health care fraud, health care fraud, and wire fraud, all stemming from her operation of a Richmond metro-area health care services company.

According to court documents, between 2014 and 2021, Sharon Johnson, 58, owned and operated “Sharon Y. Johnson & Associates” (SYJA). Johnson’s company purportedly provided Medicaid-reimbursed services that included both Service Facilitator services—supervising a Medicaid recipient’s personal care plan and provider— and personal care services—home health care aid services designed to allow a recipient to remain at home, rather than entering a nursing home or group home. Johnson signed up numerous of her Service Facilitator clients, often without their awareness or informed consent, to receive personal care services from her company. Johnson utilized her personal residence in Chester—a single-story, three-bedroom, 1,326-square foot structure—as an unlicensed group home, housing up to a half-dozen Medicaid recipients, in addition to Johnson and another SYJA employee, at any given time.

Between 2014 and 2021, Johnson fraudulently billed Medicaid for personal care services purportedly provided to at least 14 of her patients, knowingly submitting timesheets to Medicaid that falsely claimed that certain SYJA aides had provided services, when, in fact, those purported SYJA employees had not provided home health care services to the patients in question. To execute this fraud scheme, Johnson and her co-conspirators created online patient portal accounts in the names of her patients, and thereafter assumed those patients’ identities when “approving” and routing billing requests for SYJA home health care services that had not, in fact, been provided.

Separately, Johnson also executed a scheme to defraud the Virginia Retirement System (VRS) of pension payments paid by the VRS to one of Johnson’s unlicensed group home residents. To obtain control over her patient’s financial affairs, Johnson submitted fraudulent documents to the VRS including a “Medical Power of Attorney” form, and, after her patient’s death, changed the direct deposit location of her now-deceased patient’s VRS pension payments to Johnson’s own bank account. VRS thereafter paid at least 8 monthly pension payments into Johnson’s bank account before belatedly confirming the patient’s death. Johnson, knowing she was not entitled to those VRS funds, spent those payments for her own purposes.

Johnson is scheduled to be sentenced on April 18, 2023. She faces a maximum penalty of 20 years in prison. Actual sentences for federal crimes are typically less than the maximum penalties. A federal district court judge will determine any sentence after taking into account the U.S. Sentencing Guidelines and other statutory factors.

Jessica D. Aber, U.S. Attorney for the Eastern District of Virginia, and Stanley M. Meador, Special Agent in Charge of the FBI Richmond Field Office, made the announcement after U.S. District Judge Hannah M. Lauck accepted the plea. The Virginia Medicaid Fraud Control Unit assisted in the investigation.

Original source can be found here