Getting your Trinity Audio player ready...

According to the United States Attorney’s Office of Eastern District of Virginia, a Suffolk services provider pleaded guilty to one count of healthcare fraud and six counts of making false statements regarding healthcare matters.

The release states that 43-year-old Whitteney Guyton has illegally obtained approximately $1,320,088. She is scheduled to be sentenced on Jan. 10, 2025 and faces 10 years in prison. Prosecuting the case will be Assistant U.S. Attorneys Elizabeth M. Yusi and Clayton D. LaForge.

Based on court documents dating from June 2016 to Oct. 2018, Guyton “engaged in a scheme to defraud the Virginia Department of Medical Assistance Services (DMAS)” which helps provide Medicaid in the Commonwealth. An owner and operator of Synergy Health Systems LLC (Synergy), which provided Medicaid patients healthcare services, Guyton billed Medicaid for services that she claimed Synergy provided to patients. The company’s records, however, were “falsified, incomplete, failed to comply with basic Medicaid requirements, and included inflated time.”

The press release further states that Synergy offered both personal and respite care as well as mental health skill building (MHSS), services offered that required assessments from licensed professionals to comply with Medicaid regulations. It stated that in order to be paid for personal care, a registered nurse (RN) must complete the patient assessment and that a licensed mental health professional (LMHP) such as a licensed clinical social worker (LCSW) must “fill out assessments for, and periodically reassess, patients receiving mental health services.”

The release details that while Guyton had an LCSW contractor from 2016 to July 2017, she did not have another LMHP to complete assessments or reassessments until Oct. 2018 and that she instructed her staff to “forge the original LCSW’s signature on assessments and certifications.” Both Guyton and Synergy submitted documents to DMAS for authorization for MHSS for over 35 patients containing “forged signatures and authorizations, fraudulently billing and receiving over $740,000 from DMAS.” Likewise, both did the same for personal care and respite services, forging signatures of an RN and fraudulently billing and receiving over $50,000 from DMAS. Synergy is said to have “billed and received from DMAS an additional $480,000 for patients for whom there was no documentation that any assessment had ever been done or while they were in the hospital or at other care settings.” Both Guyton and Synergy are reported to have inflated the time for billing for mental health services as well.