HUMAN SERVICES EMPLOYEE DISTRIBUTED MEDICAID FUNDS TO FRIENDS, FAMILY OUTSIDE THE USA

CHARLOTTE AMALIE — Virgin Islands Attorney General Denise George today announced the arrest of Department of Human Services employee Edith Brathwaite of St. Thomas.

At the time of the alleged crime, Brathwaite was employed as an Eligibility Specialist I with the Virgin Islands Medicaid Program, under the Virgin Islands Department of Human Services (DHS) and received government employee health insurance benefits.

Brathwaite was arrested on a Superior Court warrant charging her with violations of the V.I. Medicaid Fraud statute, fraudulent claims upon the government, conversion of government property, embezzlement, or falsification of public records, obtaining money by false pretenses, and grand larceny, for allegedly falsifying her income information on a hospital document to a lower amount in order to qualify for presumptive Medicaid benefits of which she knew was not lawfully eligible.

The investigation began in February of 2020 when the MFCU received an anonymous complaint alleging that several employees of the Virgin Islands Medicaid Program were defrauding the Medicaid program by fraudulently granting Medicaid benefits to themselves, family members, persons living outside of the United States, and their friends.

The investigation revealed that some employees of the Virgin Islands Medicaid Program were under-reporting their income in order to obtain Medicaid benefits. In some instances, the employees worked on each other’s Medicaid case and failed to report income when the income, if reported, would have disqualified the employees/applicants for benefits. In other cases, employees attempted several income levels until they arrived at the levels that would qualify their co-workers for benefits.