Bloomfield Man Pleads Guilty to Health Care Fraud Charge

Vanessa Roberts Avery, United States Attorney for the District of Connecticut, Roberto Coviello, Special Agent in Charge of the U.S. Department of Health and Human Services, Office of the Inspector General, and Robert Fuller, Special Agent in Charge of the New Haven Division of the Federal Bureau of Investigation, today announced that, on June 21, 2024, SHAWN TYSON, 54, of Bloomfield, waived his right to be indicted and pleaded guilty before U.S. District Judge Kari A. Dooley in Bridgeport to health care fraud.

According to court documents and statements made in court, Tyson was a Licensed Alcohol and Drug Abuse Counselor (LADC) with an office located at 330 Main Street in Hartford.  From November 2019 to April 2023, Tyson, together with an individual identified in court as “Provider 1,” defrauded the Connecticut Medicaid program (“Medicaid”) by submitting fraudulent claims for psychotherapy counseling sessions that were not provided by Tyson or Provider 1.  In addition, Tyson and Provider 1 agreed to submit claims to Medicaid under Tyson’s unique Medicaid provider number for services purportedly provided by Provider 1 that falsely represented that Tyson had personally provided the services to Medicaid patients.

In order to conceal the fraud scheme, in October and November 2022, Tyson provided fraudulent patient records in response to an audit of his claims performed by the Medicaid program.

Health care fraud carries a maximum term of imprisonment of 10 years.  As part of his plea, Tyson agreed to pay $670,960.72 in restitution to the Connecticut Medicaid program.

Tyson is released on a $15,000 bond pending sentencing, which is not scheduled.

This investigation has been conducted by the U.S. Department of Health and Human Services, Office of the Inspector General (HHS-OIG) and the Federal Bureau of Investigation, with the assistance of the Connecticut Department of Social Services.  The case is being prosecuted by Assistant U.S. Attorney David J. Sheldon and Auditor Susan Spiegel.

This matter is part of the Department of Justice’s 2024 National Health Care Fraud Enforcement Action, a strategically coordinated, two-week nationwide law enforcement action that resulted in criminal charges against 193 defendants for their alleged participation in health care fraud and opioid abuse schemes that resulted in the submission of over $2.75 billion in alleged false billings.  The defendants allegedly defrauded programs entrusted for the care of the elderly and disabled to line their own pockets, and the government, in connection with the enforcement action, seized over $231 million in cash, luxury vehicles, gold, and other assets.

The U.S. Attorney’s Office, Connecticut Chief State’s Attorney’s Office, and Connecticut Attorney General’s Office meet regularly as part of The Medicaid Fraud Working Group.  The Working Group also includes representatives from the Connecticut Department of Social Services; the Connecticut Department of Public Health; the Drug Control Division of the Connecticut Department of Consumer Protection; the Office of the Inspector General of the U.S. Department of Health and Human Services, and the FBI.  The Working Group reviews pending issues and cases, identifies trends that might indicate fraudulent activity, and coordinates efforts for maximum results.

People who suspect health care fraud are encouraged to report it by calling 1-800-HHS-TIPS.