Division of Insurance Fraud - Florida Department of Financial Services

Transcription

Division of Insurance Fraud - Florida Department of Financial Services
May 2013
Volume 3 - Issue 11
“The arrest sweep,
dubbed Operation No
Med Services, is the
latest in aggressive
actions taken by DIF in
response to the
overwhelming PIP fraud
problem in Florida. ”
INSIDE THIS ISSUE
1
Miami Arrests
2
Jacksonville Sweep
3
PIP Fraud News
4
Most Wanted
5
Statewide Arrests
10
Statewide Contacts
HEADER
HERE
16 Nabbed in
Miami
Arrest Sweep
Operation No Med Services
The Division of Insurance Fraud (DIF) arrested 16 subjects including a medical doctor,
clinic owners, medical licensees, and staged accident organizers as part of a round-up
involving four accident clinics in Miami-Dade County. Dr. Hugo David Goldstraj, 66, was
charged with insurance fraud, organized scheme to defraud and grand theft for his role in
a massive false billing scheme that has been operating for several years. The arrest
sweep, dubbed Operation No Med Services, is the latest in aggressive actions taken by
DIF in response to the overwhelming PIP fraud problem in Florida.
Two of the massage therapists picked up in the sweep, Emilio Gomez, 60, and Rafael
Meana, 67, were previously arrested in 2012 by DIF for fraud in related cases.
Also arrested in the round-up were clinic owners Aurora Hernandez and Emilio
Fernandez, physician assistant Carlos Millan, massage therapists / clinic owners Alexei
Alvarez and Diego Vila, receptionist Dusleivys Hernandez, staged accident organizers
Alejandro Rojo, Amado Ramos Bouso, Osmel Carmona, Osvaldo Rodriguez and Julia
Rivero, and staged accident participants Bernardo Valdes, Dayami Rojo, Manuel Mayo
Estrada and Israel Ocanto Leiro. Warrants have been issued for an additional five
subjects. (Arrest details are on pages 8 and 9).
Investigation revealed that participants from five staged accidents were referred to clinics
for treatment that was not provided but billed to insurance companies in excess of
$408,000. The five staged accidents occurred between August 2010 and September
2012 in Miami-Dade County. Those involved in the staged accidents face a mandatory
minimum two-year prison sentence if convicted of staging an accident.
The four clinics, Clarke Medical Services, Emoge Medical Services, Magic Hands
Medical Services and New Life Rehab Services, are believed to be involved in an
organized scheme to defraud involving many more staged accidents and participants
than those identified and arrested in this sweep. Emoge opened in 2002, Clarke opened
in 2006, New Life opened in 2010 and Magic Hands opened in 2011.
This case is part of a continuing crackdown by CFO Atwater’s Division of Insurance
Fraud and the National Insurance Crime Bureau (NICB) in the fight against auto
insurance fraud in Florida. The insurance companies defrauded in these claims include
Allstate, Geico, Imperial Fire & Casualty, Kingsway Amigo, Mercury, State Farm and
United Auto.
May 2013
Page 2
DIF Arrests 36 Subjects in Jacksonville Rings
The Division of Insurance Fraud’s (DIF) Jacksonville office continues in its PIP fraud takedown of staged accident rings
in northern Florida. And it’s not over yet.
Following up on its initial strike with 19 arrests (covered in the January 2013 issue of the PIP Source), we can now report
an additional 36 arrests of clinic owners, organizers and participants.
Since September 2012, DIF has steadily chipped away at subjects who believed they were operating under the radar, far
from the regions where PIP fraud has been a mainstay like Miami, Tampa and Orlando.
In April, a federal grand jury indicted Jacksonville chiropractor Richie Cabigting, 35, and three other Jacksonville
residents with conspiracy to commit mail fraud and wire fraud where they face 10 years in federal prison on each count
in connection with a staged car accident scheme.
The indictment also revealed that the United States intends to confiscate $193,002 allegedly traceable to proceeds of the
offense, which was seized from a bank account.
Cabigting, owner of ChiroMed Plus, provided money to pay the “at fault” drivers in the staged accidents. The staged
accident participants were then allegedly treated at ChiroMed Plus by Cabigting, who knew that the participants did not
need treatment. Insurance companies were then fraudulently billed for services.
See the report from News4 in Jacksonville at http://www.news4jax.com/news/Chiropractor-3-others-accused-of-stagingcar-accidents/-/475880/19802554/-/jhva80z/-/index.html.
A list of subjects arrested begins below and continues on page 7.
Arrested in Oct 2012
Todd Jackson, 26 - staged acct 01/20/11 (driver) $8,789 - Chiro-Med, Plus, LLC (Geico) J
Kassem Kazim Kazim, 31 - staged acct 01/20/11 (recruiter) $8,789 - Chiro-Med, Plus, LLC (Geico) J
Haidar Kazim, 27 - staged acct 01/20/11 (recruiter) $8,789 - Chiro-Med, Plus, LLC (Geico) J
Arrested in Nov 2012
Ali Mohammad Saaod, 33 - staged acct 01/20/11 (passenger) $12,682 - Chiro-Med, Plus, LLC (Geico) J
Maryam Salman Dawood, 22 - staged acct 01/20/11 (passenger) $13,500 - Chiro-Med, Plus, LLC (Amica Mutual / Geico) J
Haidar Kazim, 27 - staged acct 01/20/11 (driver) $12,883 - Chiro-Med, Plus, LLC (Geico) J
Wail Kazim, 23 - staged acct 01/20/11 (passenger) $4,991 - Chiro-Med, Plus, LLC (Geico / Infinity) J
Kristin Jeanine Honshul, 32 - staged acct 07/12/12 (driver) $37,000 - Gate Parkway Diagnostic Center / Wellness Rehab Services
(Direct General / Sentry) J
Kristin Jeanine Honshul, 32 - staged acct 03/31/11 (driver) $37,000 - Advanced MRI Diagnostics / Baymeadows Injury Center
(Farmers) J
Arrested in Jan 2013
Aldin Osorio Leesaca, 21 - staged acct 05/29/12 (driver) $39,000 - Gate Parkway Diagnostic Center / Indian Rehabilitation Center
(Farmers / Sentry / State Farm / USAA) J
Josephine Marie Valenzuela Byrne, 21 - staged acct 05/29/12 (passenger) $49,000 - Indian Rehabilitation Center (Farmers / State
Farm / USAA) J
Jessica Rivera Cruz, 34 - staged acct 03/31/11 (passenger) $17,375 - Advanced MRI Diagnostic / Baymeadows Injury Center
(Farmers) J
Keith Edward Howey, Jr, 22 - staged acct 05/29/12 (passenger) $39,000 - Indian Rehabilitation Center (Farmers / State Farm) J
Shelton Thomas Bell, 19 - staged acct 06/06/12 (driver) $unk - Indian Rehabilitation Center (Progressive) J
Hector Omar Berberena Soto, 28 - staged acct 03/31/11 (passenger) $34.977 - Advanced MRI Diagnostic / Baymeadows Injury
Center (Farmers / Progressive) J
(continued on page 7)
The PIP Source
Page 3
PIP FRAUD – In The News
Clinic Owners, Former Insurance Adjuster Convicted in PIP Fraud Scheme
Clinic owners Abel Hernandez and Jorge Ramos and former insurance adjuster Jose Serpa have been convicted in the
case originally reported on in the August 2012 PIP Source. The Division of Insurance Fraud conducted an investigation
into a PIP fraud scheme wherein Serpa created fictitious claims and issued checks for treatment never provided by
clinics operated by his co-conspirators.
MAPFRE Insurance Company of Florida had referred the case to DIF and the subsequent investigation proved that their
former employee Serpa, working with Hernandez and Ramos, stole approximately $186,000 by way of fraudulent
payments for treatment never provided by three Miami clinics, Lakes Advantage Rehab, Exclusive Home Health
Services and Unique Relief.
Hernandez received six months in jail and 10 years probation; Ramos received one year in jail and 10 years probation
and Serpa was sentenced to three years in prison and seven years probation. Each were ordered to pay back
$62,182.59 in restitution. Serpa also surrendered his adjuster license.
NICB Senior Special Agent Bill Kuhn Leaves South Florida For New Challenges
We take time to give our thanks and best wishes to William “Bill” Kuhn, who is
moving north after 10 years with the NICB South Florida Medical Fraud Task
Force. Kuhn was one of the most productive agents with the task force and
was involved in some of its most important cases including Operation Sunny
Skies, Operation TGIF and Operation Dark Horizon.
Before joining NICB in 2003, Bill worked for eight years at the Florida Division
of Insurance Fraud’s Miami office, leaving in 2002 after being promoted to
Lieutenant in 1999. Prior to his years at DIF, Bill had a 25-year law
enforcement career that included the Coast Guard, Miami Shores PD, and
Metro-Dade PD.
“Bill is one of the hardest workers you will ever know.” said Captain Steve Smith. “He worked big cases when he was at
DIF, and he helped us to continue to make big cases in his role at NICB. We will miss him.”
Operation No Med Services Subject Also Arrested in Medicare Fraud Case
Rafael Meana, a massage therapist arrested by the Division of Insurance Fraud in the Operation No Med Services
sweep was also charged federally in a separate case involving massive fraud in South Florida. Meana is accused of
participating in a $5 million Medicare fraud scheme at Lord’s Medical & Rehab Center and a nearly $2 million fraud
scheme at Lord Family Services, both clinics in Miami-Dade county. See the press release from the US Attorney’s office
at http://www.fbi.gov/miami/press-releases/2013/twenty-four-south-florida-residents-charged-as-part-of-nationwide-coordinatedtakedown-by-medicare-fraud-strike-force-operations?utm_campaign=email-Immediate&utm_medium=email&utm_source=miamipress-releases&utm_content=225187.
Insurance Company SIUs Attend Operation No Med Services Press Conference
Representatives from the seven victim
insurance companies in Operation No Med
Services attended the press conference at
the Miami-Dade State Attorney’s Office on
May 1.
Pictured left to right are Alexandra Magid, Rick Wickliffe, and Kim
Lawrence (State Farm); Sumitra Singal
(Allstate); Capt. Steve Smith (DIF); Rene
Cubas (Geico); Yolanda Velasquez
(Mercury); Lisa Lowe and Henry Cuadra
(Imperial Fire & Casualty); Lt. Rafael
Delgado (DIF); Brett Kelley (Kingsway
Amigo); Maj. Simon Blank (DIF); Jayme
Harrington (NICB); and Freddy Garcia and
Oscar Herrera (United Auto).
May 2013
Page 4
Most Wanted: Fugitive
Eduart Gonzalez
Hispanic Male, 35 years old
5’10”, 200 lbs, Blue Eyes, Brown Hair
Warrant Information:
Warrant/Case # 13-001440 CFAXX
Felony Warrant Charge: False and Fraudulent Insurance Claim / Staged
Accident
Details:
The Florida Department of Financial Services, Division of Insurance
Fraud is attempting to locate Eduart Gonzalez.
Eduart Gonzalez committed acts of Insurance Fraud resulting from
knowingly participating in an intentional staged motor vehicle crash on
February 2, 2011 for the purpose of claiming personal injury protection
(PIP) benefits. After the crash, Gonzalez treated at a chiropractic clinic.
This case is part of Operation Sledgehammer, a multi-agency task force
investigation involving insurance fraud in the West Palm Beach area.
If you know where Gonzalez can be located, please contact the Division
of Insurance Fraud at 1-800-378-0445.
Check out the DFS Most Wanted at http://www.myfloridacfo.com/PressOffice/MostWanted/
12 Arrested in Health Clinic Scam
In April, the Miami-Dade Police Department’s public corruption bureau, working with the Division of Insurance Fraud,
arrested five people who worked at AZJ Medical Center in Miami. Investigators say the clinic recruited transit workers to
file bogus claims with AvMed, which administers the county’s self-funded health insurance program. While this case
involves alleged health care fraud, AZJ Medical was also a PIP provider allegedly treating participants from staged
accidents.
Those arrested: Juan Carlos Avila, the company’s current president; staffers Caridad Menendez Diaz and Aracelys Cruz;
physical therapy assistant Hector Gutierrez; and occupational therapist Ovide Miguez. The company’s former president,
Elvis Garcia, was not immediately arrested and was considered a fugitive.
The arrests of the upper ranks of the clinic comes one year after Miami-Dade police and prosecutors arrested seven
transit bus employees for their role in the scheme that involved more than $280,000 in fraudulent billing. Six of those
pleaded guilty and agreed to cooperate against the ringleaders The investigation began when a cooperating source told
authorities that Nancy Maradey, a bus driver, had approached the source asking to participate in the scheme.
Maradey later told detectives that Garcia paid her more than $6,000 cash to use her name to file claims for phantom
treatments and to recruit other fake patients. In another case, a former Miami-Dade County bus driver allowed the clinic
to bill for 135 visits and 758 treatments even though all she got was a handful of massages. Authorities said they believe
the health insurance scam began in 2008. AZJ Medical has since closed.
See on page 9 the full list of persons arrested and read more
www.miamiherald.com/2013/04/23/3360792/westchester-pain-clinic-managers.html.
by
David
Ovalle
at
http://
The PIP Source
Page 5
Statewide PIP Arrests – April 2013
Each issue will provide a list of PIP arrests made by the offices throughout the State. Along with each defendant’s name
and age, we will include: the type of scheme involved; the fraud dollar amount; clinic name(s); victim insurance company
name(s); and the arresting office. If you need additional details on any of these arrests, please contact Capt. Smith.
Mecene Dorlus Cavanaugh, 35 - patient brokering - Health South Rehab (Windhaven) B
Moses Yveto Georges, 30 - patient brokering - Health South Rehab (Windhaven) B
Malcolm G Brown, 49 - jump-in - $0 (Allstate) T
Brittany Domonique Donar, 23 - fake ins card (First Acceptance) T
Juan Carlos Sanchez-Reyes, 39 - staged acct 06/06/10 (passenger) $52,306 - Health Professional Services (Progressive / State
Farm) M
Juvenal Castro Duque, 45 - staged acct 05/31/11 (recruiter) $99,781 - ORD Medical / RCR Rehabilitation Center (Geico / MGA /
State Farm) M
Ryan Michael Smith, 31 - jump-in - $15,155 (State Farm) F
Jorge Aviel Sabates, 32 - staged acct 06/06/10 (driver) $49,833 - Miami Dade Medical Center (Republic Western / State Farm) M
Graciela Maria Gutierrez, 28 - staged acct 01/25/12 (driver) $70,791 - Advanced Orthopedics and Pain Management / Angels
Diagnostic Group / Atrium Chiropractic & Rehab / Biscayne Rehab Center / Gentle Care Rehab Services / South Florida Medical
Health Center / YH Imaging (Esurance / Geico / State Farm) M
Jermelle Sharod Stlot, 24 - fake ins card (Kingsway Amigo) W
Ailenys Carmenate, 24 - staged acct 04/21/12 (recruiter) $46,465 - Gentle Care Rehab Services / Well-Care Rehab Services (State
Farm / Titan) M
Josue Hildalgo Pena, 35 - staged acct 06/06/10 (driver) $52,306 - Health Professional Services (Progressive / State Farm) M
Johnson Delhomme, 21 - staged acct 06/22/11 (driver) $10,426 - Grace Chiropractic (Farmers / Mendota) O
Macquilon Mitil, 52 - staged acct 06/22/11 (recruiter) $10,426 - Grace Chiropractic (Farmers / Mendota) O
Denise Suzetter Brown, 41 - fake ins card (Progressive) T
Carlos M Torres, 44 - PIP patient - $5,435 - (Liberty Mutual) T
Carlos Manuel Torres, 22 - PIP patient - $5,435 - (Liberty Mutual) T
Eva Ledesma, 40 - PIP patient - $5,435 - (Liberty Mutual) T
Wilguerre Brianvil, 42 - jump-in - $921 - NU-Look Chiropractic Center (Farmers) W
Francisco Silva, 41 - staged acct 03/12/12 (driver) $61,729 - All Future Medical Center / Benefica Health Center, Corp (United Auto)
M
Luz Maria Castro Blanco, 26 - PIP patient - $1,294 - Columbus Rehabilitation Center (Farmers) T
Matthew James Buchner, 21 - false injury claim - $1179 (Allstate / Infinity) T
Lumey Vegas, 38 - staged acct 09/27/11 (recruiter) $72,695 - A & O Service Corp / Doctors Professional Medical Center / RCR
Rehabilitation Center (Geico / State Farm) M
Luis Guzman-Martinez, 51 - staged acct 07/23/12 (pedestrian) $4,091 - (Geico / Infinity) T
Stacy Nordelus, 18 - PIP patient - $5,440 - Health South Rehab (Windhaven) O
Sharlyne Nordelus, 24 - PIP patient - $5,440 - Health South Rehab (Windhaven) O
Donna Clarice Crawler, 44 - fake ins card (Assurance America) T
Maritza de Villarino Machado, 50 - staged acct 03/25/10 (driver) $46,208 - B & A Diagnostic / Pentacle Rehabilitation Center /
Sunlight Rehabilitation (Geico / MGA / Progressive) M
Yankiel Borrego, 31 - clinic employee - $5,435 - Auto Injury Doctors of Tampa (Liberty Mutual) T
Code – B (Broward) F (Ft Myers) J (Jacksonville) M (Miami) O (Orlando) P (Pensacola) TL (Tallahassee) T (Tampa/St Pete) W (West Palm Beach)
May 2013
Page 6
Statewide PIP Arrests – April 2013
Each issue will provide a list of PIP arrests made by the offices throughout the State. Along with each defendant’s name
and age, we will include: the type of scheme involved; the fraud dollar amount; clinic name(s); victim insurance company
name(s); and the arresting office. If you need additional details on any of these arrests, please contact Capt. Smith.
Amado Rodriguez, 45 - staged acct 08/23/10 (driver) $16,244 - Universal Rehab Medical Group (State Farm) W
Rene Aquino, 45 - staged acct 08/23/10 (passenger) $14,144 - Universal Rehab Medical Group (Safeco) W
Wanda Ivette Rivera Torres, 44 – staged acct 02/05/12 (driver) $11,936 - Advanced 3D Diagnostic / HR Healthy Rehab, LLC
(Infinity / USAA) O
Victor Jimenez, 35 – staged acct 02/05/12 (passenger) $10,000 - Vity Medical Center (USAA) O
Sabrina Vonshakatrice Turner, 27 - staged acct 11/26/10 (driver) $8,354 - Pompano Beach Chiropractic Center and South Florida
Orthopedic Specialists (Gainsco / Travelers) B
Vivian Lopez, 40 - staged acct 03/12/12 (passenger) $61,729 - All Future Medical Center / Benefica Health Center (United Auto) M
Dorgis Ernesto Lemoynes Galardy, 45 - staged acct 03/12/12 (recruiter / driver) $61,729 - All Future Medical Center / Benefica
Health Center (United Auto) M
Jesus Quintano Bello, 29 - staged acct 07/12/11 (passenger) $154,407 - Centinel Medical Center / HET Medical / Rosenberg Clinic
(21st Century / Allstate / Geico / State Farm) M
Soradi Velazquez, 43 - certified chiropractic physician assistant – $14,778 - Centinel Medical Center (State Farm) M
Soradi Velazquez, 43 - certified chiropractic physician assistant – $47,085 - Centinel Medical Center (Geico) M
Ralph Joly, 29 – staged acct 05/10/12 (recruiter) $36,811 - First Choice Care Chiropractic & Rehabilitation Center (Nationwide) O
Angel Pena, 53 – staged acct 02/05/12 (passenger) $9,701 - Advanced 3D Diagnostic / HR Healthy Rehab, LLC (USAA) O
Yakiely Cepero Casanas, 29 - staged acct 03/25/10 (passenger) $46,208 - B & A Diagnostic / Pentacle Rehabilitation Center /
Sunlight Rehabilitation (Geico / MGA / Progressive) M
Misleiby Oviedo Laza, 34 - staged acct 07/12/11 (passenger) $154,407 - Centinel Medical Center / HET Medical / Rosenberg Clinic
(21st Century / Allstate / Geico / State Farm) M
Lea Gomez Mittrany, 27 - staged acct 08/13/12 (driver) $55,610 - Emanuel Therapeutic Massage / Miami Medical Care Corp /
Palmetto West Rehab (Esurance / Windhaven) M
Josue Raziel Zavala, 20 - staged acct 08/13/12 (passenger) $55,610 - Emanuel Therapeutic Massage / Miami Medical Care Corp /
Palmetto West Rehab (Esurance / Windhaven) M
Ashley Lynne Hunt, 30 - massage therapist / insurance fraud - $20,163 - Sunshine Medical & Rehabilitation (Nationwide / Titan) T
Arrested in Oct 2012
Emilio Gomez, 59 - massage therapist / unlicensed clinic - $196,763 - RER Medical Services (State Farm / United Auto) M
Code – B (Broward) F (Ft Myers) J (Jacksonville) M (Miami) O (Orlando) P (Pensacola) TL (Tallahassee) T (Tampa/St Pete) W (West Palm Beach)
The PIP Source
Page 7
Statewide PIP Arrests – April 2013
Each issue will provide a list of PIP arrests made by the offices throughout the State. Along with each defendant’s name
and age, we will include: the type of scheme involved; the fraud dollar amount; clinic name(s); victim insurance company
name(s); and the arresting office. If you need additional details on any of these arrests, please contact Capt. Smith.
Jacksonville Arrests (continued from page 2)
Arrested in Feb 2013
Terrence Kevin Franklin, 22 - staged acct 05/29/12 (passenger) $49,000 - Indian Rehabilitation Center (Farmers / State Farm /
USAA) J
Jassim Jawad, 30 - staged acct 05/09/11 (driver) $6,684 - Chiro-Med Plus Chiropractic (MGA / Peak) J
Noujoud Zaytoun, 37 - staged acct 05/09/11 (passenger) $6,100 - Chiro-Med Plus Chiropractic (MGA) J
Michelle Lynn Watson, 43 - staged acct 06/06/12 (passenger) $unk - Indian Rehabilitation Center (Direct) J
Marlena Nancy Nasca, 22 - staged acct 06/06/12 (passenger) $unk - Indian Rehabilitation Center (Direct) J
Yamil A Delgado, 29 - staged acct 06/06/12 (passenger) $3,000 - Indian Rehabilitation Center (USAA) J
Rene Ricky Cardenas, 19 - staged acct 05/07/12 (passenger) $7,000 - Indian Rehabilitation Center (Direct) J
Roman Shane Alistair Walsh, 21 - staged acct 06/06/12 (driver) $10,000 - Indian Rehabilitation Center (unk) J
Emmanuel Santiago, 25 - staged acct 05/30/12 (driver) $34,000 - Gate Parkway Diagnostic Center / Wellness Rehab Services
(Farmers / Geico / Progressive) J
Freddie Alberto Freytes, 41 - staged acct 05/30/12 (passenger) $34,000 - Gate Parkway Diagnostic Center / Wellness Rehab
Services (Farmers / Geico / Progressive) J
George Orlando Ortiz, Jr, 32 - staged acct 05/30/12 (passenger) $34,000 - Gate Parkway Diagnostic Center / Wellness Rehab
Services (Farmers / Geico / Progressive) J* (also charged in 3 other accidents)
Arrested in Mar 2013
Emilio deJesus Zapata, 25 - staged acct 05/30/12 (driver) $34,000 - Gate Parkway Diagnostic Center / Wellness Rehab Services
(Geico) J
Renier Ferrer, 40 - staged acct 03/14/12 (passenger) $10,000 - Indian Rehabilitation Center (Sentry) J
Kijora Trevel Hall, 25 - staged acct 06/01/12 (driver) $0 (USAA) J
Clifford Bernard Davis, 43 - staged acct 05/16/12 (driver) $unk - unk (Infinity) J
Kenny Edward Adcock, III, 22 - staged acct 06/17/12 (driver) $6,150 - Indian Rehabilitation Center (Progressive) J
Yoan Manuel Moreno, 30 - staged acct 05/18/12 (driver) $29,000 - Indian Rehabilitation Center (Sentry) J
Abed Jasim Albashagha, 45 - staged acct 06/25/11 (passenger) $1,519 - Chiro-Med Plus Chiropractic / Lakewood Chiropractic
Clinic (Geico) J
Arrested in Apr 2013
Richie Cabigting, 35 - chiropractor - Chiro-Med Plus - mail fraud () J
Vicente Rodriguez, 49 - clinic owner - accessory after the fact / tampering with evidence - Indian Rehabilitation Center - J
Leonardo Santos Rodriguez, 41 - money laundering - J
David Rodriguez Lopez, 46 - organized scheme to defraud / staged acct 03/14/12 () $35,000 - Indian Rehabilitation Center (Geico) J
Code – B (Broward) F (Ft Myers) J (Jacksonville) M (Miami) O (Orlando) P (Pensacola) TL (Tallahassee) T (Tampa/St Pete) W (West Palm Beach)
May 2013
Page 8
Statewide PIP Arrests – April 2013
Each issue will provide a list of PIP arrests made by the offices throughout the State. Along with each defendant’s name
and age, we will include: the type of scheme involved; the fraud dollar amount; clinic name(s); victim insurance company
name(s); and the arresting office. If you need additional details on any of these arrests, please contact Capt. Smith.
Subjects Arrested in Operation No Med Services case
Hugo Goldstraj, 66 - doctor - $14,925 - Clarke Medical Services (United Auto) M
Hugo Goldstraj, 66 - doctor - $16,807 – Clarke Medical Services (United Auto) M
Hugo Goldstraj, 66 - doctor - $60,075 - Clarke Medical Services (Geico) M
Hugo Goldstraj, 66 - doctor - $15,009 - Clarke Medical Services (Geico) M
Carlos Millan, 74 - physician assistant - $42,310 – C & N Therapy Center / Emoge Medical Services / M & E Diagnostic Services
(Geico) M
Carlos Millan, 74 - physician assistant - $75,541 - Clarke Medical Services / Emoge Medical Services / Magic Hands Medical
Services (Geico / United Auto) M
Carlos Millan, 74 - physician assistant - $39,326 – Emoge Medical Services (Imperial Fire & Casualty) M
Carlos Millan, 74 - physician assistant - $17,622 - Emoge Medical Services (United Auto) M
Carlos Millan, 74 - physician assistant - $26,855 – Emoge Medical Services (Mercury) M
Carlos Millan, 74 - physician assistant - $33,150 – Emoge Medical Services / New Life Rehab Services (Allstate / State Farm) M
Rafael Meana, 67 - massage therapist - $39,326 - New Life Rehab Services (Imperial Fire & Casualty) M
Rafael Meana, 67 - massage therapist - $60,075 – Magic Hands Medical Services (Geico) M
Rafael Meana, 67 - massage therapist - $26,855 – Emoge Medical Services (Mercury) M
Rafael Meana, 67 - massage therapist - $33,150 - New Life Rehab Services (Allstate / State Farm) M
Emilio Gomez, 60 - massage therapist - $29,824 – Clarke Medical Services (United Auto) M
Emilio Gomez, 60 - massage therapist - $37,439 – Clarke Medical Services (United Auto) M
Alexei Ariosa Alvarez, 30 - massage therapist - $45,717 - Magic Hands Medical Services (Geico) M
Alexei Ariosa Alvarez, 30 - physical therapist - $60,075 - Magic Hands Medical Services (Geico) M
Alexei Ariosa Alvarez, 30 - massage therapist - $15,009 - Magic Hands Medical Services (Geico) M
Dusleivys Cabrera Hernandez, 34 - clinic employee - $29,824 – Clarke Medical Services (United Auto) M
Dusleivys Cabrera Hernandez, 34 - clinic employee - $37,439 – Clarke Medical Services (United Auto) M
Dusleivys Cabrera Hernandez, 34 - staged accident 09/15/12 (driver) $78,790 - Clarke Medical Services / Emoge Medical Services /
Magic Hands Medical Services / New Life Rehab Services (Allstate / Geico / Kingsway Amigo / State Farm) M
Diego Vila, 48 - massage therapist / clinic owner - $39,326 - New Life Rehab Services (Imperial Fire & Casualty) M
Diego Vila, 48 - massage therapist / clinic owner - $14,572 - New Life Rehab Services (United Auto) M
Diego Vila, 48 - massage therapist / clinic owner - $33,150 - New Life Rehab Services (Allstate / State Farm) M
Aurora Hernandez, 32 - clinic owner / staged acct 01/12/12 (recruiter) $94,051 – Clarke Medical Services / Emoge Medical Services /
Magic Hands Medical Services / New Life Rehab Services (Geico / United Auto) M
Aurora Hernandez, 32 - clinic owner / staged accident 09/15/12 (recruiter) $78,790 - Clarke Medical Services / Emoge Medical
Services / Magic Hands Medical Services / New Life Rehab Services (Allstate / Geico / Kingsway Amigo / State Farm) M
Code – B (Broward) F (Ft Myers) J (Jacksonville) M (Miami) O (Orlando) P (Pensacola) TL (Tallahassee) T (Tampa/St Pete) W (West Palm Beach)
The PIP Source
Page 9
Statewide PIP Arrests – April 2013
Each issue will provide a list of PIP arrests made by the offices throughout the State. Along with each defendant’s name
and age, we will include: the type of scheme involved; the fraud dollar amount; clinic name(s); victim insurance company
name(s); and the arresting office. If you need additional details on any of these arrests, please contact Capt. Smith.
Subjects Arrested in Operation No Med Services case (continued from page 8)
Alejandro Rojo, 52 - staged acct 10/25/11 (recruiter) $75,541 – Clarke Medical Services / Magic Hands Medical Services (Geico /
United Auto) M
Bernardo Valdes, 46 - staged acct 10/25/11 (driver) $75,541 – Clarke Medical Services / Magic Hands Medical Services (Geico /
United Auto) M
Osvaldo Rodriguez, 39 - staged acct 08/16/11 (recruiter) $76,765 – Clarke Medical Services / Emoge Medical Services / New Life
Rehab Services (Imperial Fire & Casualty / United Auto) M
Julia Rivero, 42 - staged acct 08/16/11 (recruiter) $76,765 – Clarke Medical Services / Emoge Medical Services / New Life Rehab
Services (Imperial Fire & Casualty / United Auto) M
Manuel Pastor Mayo Estrada, 46 - staged acct 08/16/11 (passenger) $76,765 – Clarke Medical Services / Emoge Medical Services /
New Life Rehab Services (Imperial Fire & Casualty / United Auto) M
Israel Ocanto Leiro, 35 - staged acct 08/16/11 (passenger) $76,765 – Clarke Medical Services / Emoge Medical Services / New Life
Rehab Services (Imperial Fire & Casualty / United Auto) M
Emilio Fernandez, 46 - clinic owner - $26,855 – Emoge Medical Services (Mercury) M
Osmel Carmona Reyna, 26 - staged accident 09/15/12 (recruiter) $78,790 - Clarke Medical Services / Emoge Medical Services /
Magic Hands Medical Services / New Life Rehab Services (Allstate / Geico / Kingsway Amigo / State Farm) M
Subjects Arrested in AZJ Medical Center case
Arrested in August 2012
Nancy M Maradey, 36 - runner - $280,800 - AZJ Medical Center
Ada F Grath, 52 - insurance fraud / patient brokering - $38,440 - AZJ Medical Center
Bruno Pulcini, 53 - insurance fraud / patient brokering - $7,595 - AZJ Medical Center
Jorge L Pujadas, 35 - insurance fraud / patient brokering - $30,260 - AZJ Medical Center
Mercedes R Alba, 53 - insurance fraud / patient brokering - $16,040 - AZJ Medical Center
Daniel E Diaz, 29 - insurance fraud / patient brokering - $34,185 - AZJ Medical Center
Jose A Nunez, 51 - insurance fraud / patient brokering - $11,635 - AZJ Medical Center
Arrested in April 2013
Carlos Juan Avila, 42 - clinic owner - AZJ Medical Center
Caridad Diaz, 50 - clinic employee - AZJ Medical Center
Aracelys Cruz, 37 - clinic employee - AZJ Medical Center
Hector Claudio Gutierrez Jr, 37 - physical therapist assistant - AZJ Medical Center
Ovide Joseph Miguez Jr, 64 - occupational therapist - AZJ Medical Center
Code – B (Broward) F (Ft Myers) J (Jacksonville) M (Miami) O (Orlando) P (Pensacola) TL (Tallahassee) T (Tampa/St Pete) W (West Palm Beach)
May 2013
Page 10
Statewide PIP Contacts
PANHANDLE REGION
Counties: Bay, Calhoun, Escambia, Franklin, Gadsden, Gulf,
Holmes, Jackson, Jefferson, Lafayette, Leon, Liberty,
Madison, Okaloosa, Santa Rosa, Taylor, Wakulla, Walton,
Washington
Tallahassee Field Office - 850.413.3115
Lt. Ernie STOLL
Pensacola Field Office - 850.453.7802
Capt. David LINDSAY
NORTH REGION
Counties: Alachua, Baker, Bradford, Citrus, Clay, Columbia,
Dixie, Duval, Flagler, Gilchrist, Hamilton, Levy, Marion,
Nassau, Putnam, St. Johns, Sumter, Suwannee, Union
Jacksonville Field Office - 904.798.5802
Capt. Brian McCOY
Lt. Kevin JONES
WEST CENTRAL REGION
Counties: Charlotte, Collier, DeSoto, Glades, Hardee, Hendry,
Hernando, Hillsborough, Lee, Manatee, Pasco, Pinellas, Polk,
Sarasota
Tampa Field Office - 813.972.8602
Capt. Michael BYRNE
Lt. Carlos ROSARIO
Lt. Darrell WILSON
Fort Myers Field Office - 239.278.7527
Lt. Mark FRITZ
Copy goes her.
Editor’s
Corner
On page 1, we cover Operation No Med
Services in Miami, involving 16 arrests.
On page 2, we cover 37 more arrests in the PIP
takedown under way in Jacksonville.
On page 4, we feature another fugitive in
Insurance Fraud’s Most Wanted.
As always, we report on PIP Fraud in the News
and this month we have 5 pages of the latest
PIP-related arrests.
And remember, not just on Memorial Day, but
every day, the sacrifices of those who serve to
protect our freedoms in the United States.
EAST CENTRAL REGION
Counties: Brevard, Lake, Orange, Osceola, Seminole, Volusia
Orlando Field Office - 407.835.4402
Capt. Glen HUGHES
Acting Lt. Laquanda GREEN
Lt. Paul MEYERS
SOUTH CENTRAL REGION
Counties: Broward, Highlands, Indian River, Martin,
Okeechobee, Palm Beach, St. Lucie
Plantation Field Office - 954.958.5402
Capt. John DYGON
Lt. Bill LEE
West Palm Beach Field Office - 561.837.5601
Lt. Evangelina BROOKS
SOUTH REGION
Counties: Dade, Monroe
Miami Field Office - 305.536.0302
Capt. Steven SMITH
Lt. Violeta SERRANO
Lt. Stanley JEAN-FELIX
Lt. Rafael DELGADO
South Florida Major Medical Fraud Task Force
Supervisory Special Agent Fred Burkhardt 847.544.7141
Central Florida Major Medical Fraud Task Force
Supervisory Special Agent Jose Olivier 813.558.6387