Arrests in scheme to exploit medical info, defraud Florida MedicaidStaff Writer | July 25, 2016
Florida Attorney Pam Bondi’s Medicaid Fraud Control Unit and the Cocoa Police Department announced the arrests of three Brevard County residents, Bobby Lyons, Valerie Jackson and Kwanya Sanders.
Cocoa Police Medicaid Fraud Control Unit
The defendants allegedly gave children fake mental health diagnosis as a pretext for billing Medicaid for mental health services that the children never received and their parents never authorized.
Jackson and Sanders, owners of Changes Youth and Family Services, Inc., a Florida Medicaid provider in Melbourne, entered into a business partnership with Lyons, who ran a mentoring program through Orange County Schools.
As part of the agreement, Lyons provided Changes with a list of students and the students’ Medicaid identification to allow Changes to bill for services rendered by Lyons. Lyons provided the names and information of 94 children to Jackson and Sanders, who paid Lyons $2,500.
According to the investigation, Lyons never provided any of the billed services and did not have parental consent or the required documents for Medicaid billing.
Even after realizing Lyons’ fraud, Jackson and Sanders did not notify authorities or attempt to return the funds of more than $100,000 received illegally from Medicaid for services never rendered.
The investigation revealed that Lyons only mentored students and did not provide any actual psychosocial counseling for the fraudulent diagnoses of serious mental health issues.
In a separate case, the Medicaid Fraud Control Unit arrested Lyons earlier this year for selling the information of other children to another Medicaid provider. Lyons is currently facing Medicaid Fraud charges for this case in Orlando.
Lyons is charged with one count of Medicaid provider fraud for $50,000 or more, a first-degree felony, one count of criminal use of personal identification information, a first-degree felony, and one count of organized scheme to defraud, a third-degree felony. Jackson and Sanders are both charged with one count of organized scheme to defraud, a third-degree felony.
If convicted, Jackson and Sanders face up to five years in prison and 5,000 in fines. If convicted Lyons, faces up to 65 years in prison and $30,000 in fines. The State Attorney’s Office for the Ninth Judicial Circuit will prosecute the case. ■