Richmond Mental Health Agency Co-Owner Indicted in $49 Million Medicaid Fraud Case; Earlier Filing Says She Signed a Session Note While Flying From Grand Cayman

A federal grand jury in Virginia has indicted the co-owner of a Richmond-area mental health agency on charges that she helped bill Virginia Medicaid more than $49 million for crisis services that were not provided as billed, the Justice Department announced Wednesday.

Mikia Antoneice Noble, 37, of North Chesterfield, was arrested Wednesday, according to the department. The indictment, returned Oct. 20 in the Eastern District of Virginia, charges her with conspiracy to commit health care fraud and three counts of health care fraud. Each count carries a maximum of 10 years in prison.

Noble was the co-owner and chief operating officer of Advancing Communities Everywhere LLC, known as ACE, which the department said claimed to serve people in acute behavioral health crises. Prosecutors allege that from January 2022 through April 2026, she took part in submitting more than $49 million in false and fraudulent claims to Virginia Medicaid.

What the Medicaid Fraud Indictment Alleges

According to the Justice Department, the indictment alleges that Noble conspired with her co-owner to bill Medicaid for crisis services described as delivered by teams that included a licensed professional, when the services were provided by a single, less qualified worker. The department said the scheme also involved paying more than $2 million for hotel rooms offered to Medicaid recipients to get them to let ACE bill for services they did not need.

The release says Noble falsified medical records by adding the signatures of licensed professionals who had not taken part in the services, and by adding her own signature to claim she had taken part when she was out of the country. Prosecutors also allege that she lied to the Medicaid managed care organizations that audited ACE's crisis services.

An Earlier Charge in June

The indictment is not the first federal charge against Noble. On June 18, prosecutors filed a one-count criminal information in Richmond federal court charging her with conspiracy to commit health care fraud. The court docket shows that a plea agreement hearing was set for July 14 and that Noble's lawyer later filed a consent motion to postpone her initial appearance and plea hearing. The Justice Department's Wednesday release does not mention the June case.

The June filing, which identifies Noble's partner only as "Co-Conspirator 1," lays out the government's case in more detail. It says ACE billed Medicaid more than $49.6 million between January 2022 and January 2026 for Community Stabilization and Mobile Crisis services involving thousands of recipients, and that Medicaid paid about $38.6 million. It says the agency billed Medicaid's higher "Team Treatment" rate on at least 93% of its Community Stabilization claims and at least 98% of its Mobile Crisis claims.

The information also gives examples. It says that on Sept. 14, 2023, Noble signed a progress note saying she had taken part in a Mobile Crisis session in person while she was on an international flight from the Cayman Islands to Atlanta. It says that on Aug. 13, 2023, she signed notes for about ten Community Stabilization sessions, several of which overlapped in time.

According to the June filing, Noble received at least about $2 million from the Medicaid payments and spent fraud proceeds on travel and luxury clothing, shoes and jewelry.

"An indictment is merely an allegation," the department said, and Noble is presumed innocent unless proven guilty in court. The FBI's Richmond field office and the Medicaid Fraud Control Unit of the Virginia attorney general's office are investigating. Trial attorneys from the Fraud Division's Health Care Fraud Section and the U.S. Attorney's Office for the Eastern District of Virginia are prosecuting the case.

Cover photo: Spottswood W. Robinson III and Robert R. Merhige Jr. Federal Courthouse, Richmond, Va. U.S. District Court for the Eastern District of Virginia, public domain, via Wikimedia Commons.

Sources: Justice Department, "Virginia Mental Health Professional Charged in $49M Medicaid Fraud Scheme" (Oct. 28, 2026): https://www.justice.gov/opa/pr/virginia-mental-health-professional-charged-49m-medicaid-fraud-scheme ; Criminal information, United States v. Noble, No. 3:26-cr-00069 (E.D. Va., filed June 18, 2026): https://www.justice.gov/criminal/media/1446926/dl?inline ; U.S. Attorney's Office for the Eastern District of Virginia, case page: https://www.justice.gov/usao-edva/united-states-v-mikia-noble-crim-no-326-cr-69 ; Court docket via CourtListener: https://www.courtlistener.com/docket/73505535/united-states-v-noble/