DHS Employee Arrested for Allegedly Falsifying Documents to Allow Undocumented and Unqualified People to Receive Medicaid Benefits

A V.I. Dept. of Human Services employee was arrested by the V.I. Dept. of Justice on Thursday for allegedly committing Medicaid fraud.

Among the charges, the suspect, Everton Garvey is said to have committed conversion of government property, fraudulent claims upon the government, forgery, and embezzlement or falsification of public accounts, all of which the V.I. D.O.J. said is tied to Medicaid Program Fraud perpetrated by Mr. Garvey. The suspect is employed as an eligibility specialist for the V.I. Medicaid Program at the V.I. Dept. of Human Services.

Mr. Garvey turned himself in and was arrested by the V.I. D.O.J.

According to an affidavit in support of the arrest warrant, the investigation revealed that Garvey fraudulently entered information into the Virgin Islands Benefits and Eligibility Enrollment System (VIBES), a computer program, which resulted in certain applicants becoming eligible for benefits when they would otherwise not have been eligible. The VIBES Program is utilized by employees of the DHS, Medicaid program to determine whether an applicant is eligible for Medicaid benefits. Employees are required to enter proof of citizenship, social security information, income, household information, and other documents required by the Medicaid program into VIBES.

The D.O.J. alleges that Mr. Garvey fraudulently underreported income for certain applicants which caused them to unlawfully obtain medical funds when he knew the applicants were not lawfully eligible for Medicaid benefits. In one other instance, Garvey fraudulently entered an incorrect social security number which caused an undocumented recipient to unlawfully obtain Medicaid funds, according to the affidavit.

In February of 2020, the Virgin Islands Medicaid Fraud Control Unit (VIMFCU), a division of the V.I. Department of Justice, received an anonymous call alleging the fraud in the administration of the Virgin Islands Medicaid Program, according to the release. Consequently, VIMFCU began a preliminary investigation of the Medicaid Program in March of 2020.

Upon completion of the preliminary investigation in July of 2020, there was sufficient information gathered to investigate thirteen employees of the Medicaid Program. As a result, VIMFCU discovered that roughly $54,000 in Medicaid funds was improperly appropriated by some employees of the Medicaid Program when they unlawfully enrolled each in the Medicaid program, according to the Justice Department. VIFMCU, however, was unable to recommend criminal charges be brought against some employees because VIMFCU was unable to obtain some program files although the files were subpoenaed.

“The arrest of Everton Garvey does not conclude the investigation. The investigation continues and additional arrests are expected”, said V.I. Attorney General Denise George