Category Archives: Palm Beach County

Palm Beach Post Receives National Recognition for Insurance Fraud Coverage

Washington-based policy and research group, Coalition Against Insurance Fraud, has awarded its inaugural journalism award for fraud reporting to The Palm Beach Post for its work on fraud in the sober-home industry. The award honored Post coverage dating back to 2015 when Post investigators Christine Stapleton and Pat Beall first wrote about how sober-home operators were defrauding insurers of millions of dollars for urine drug tests.

Sober homes were requiring residents to be tested every day, creating multimillion-dollar business empires. Palm Beach County treatment centers and affiliated labs were charging as much as $2,000 for urine tests that can be purchased for $25 at a drug store.

In 2016, a team of Post reporters and editors, including Stapleton, Beall, Lawrence Mower, Joe Capozzi, John Pacenti, Barbara Marshall and Mike Stuck produced “Heroin: Killer of a Generation,” a 12-page special section of stories about 216 men, women and teenagers who died of a heroin-related overdoses in Palm Beach County in 2015. One in 10 had died in a sober home.

The Post’s reporting played a role in the prosecution of sober-home operators Kenneth Chatman and Eric Snyder as well as the successful push to tighten state laws which have resulted in more than 40 people on charges related to brokering patients.

Congratulations to the Palm Beach Post on this national recognition for their work in fighting insurance fraud.

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Filed under Florida, Insurance, Insurance Fraud, Palm Beach County

Ringleader Pleads Guilty To His Role In $23 Million Auto Insurance Fraud Crime Ring

According to the Sun Sentinel, Felix Filenger of Sunny Isles, pleaded guilty this week to his role in an elaborate crime ring that operated at several South Florida chiropractor clinics. The fraud totaled at least $23 million from 10 auto insurance companies over the last seven years, per court records.

Federal prosecutors say Filenger and Andrew Rubinstein took over troubled clinics and hid their ownership by having chiropractors and other people register the practices in their names. The men told chiropractors what treatments they wanted to be performed, based on the potential revenue from the services, prosecutors said. Medical staff who refused to “play ball” were fired, they said.

Filenger admitted he, and other group leaders, paid kickbacks of $1,500 to $2,000 – per patient – to tow truck drivers and body shop workers who agreed to illegally steer accident victims to chiropractic clinics that were secretly owned by Filenger and his allies.

Filenger plead guilty to one count of racketeering conspiracy on Monday in federal court in Miami and is scheduled to go to trial on January 8.  Two co-defendants, who are still scheduled for trial that day, may plead guilty to related charges on Wednesday, court records show.

Andrew Rubinstein, 48, of Miami, is jailed on charges of racketeering and mail fraud conspiracies, wire fraud, health care fraud, and making false statements.

Olga Spivak, 59, a chiropractor from Hollywood, is free on bond. She faces the same charges.

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Filed under auto insurance, Auto Insurance Fraud, Broward County, Florida, Florida Division of Insurance Fraud, Insurance Fraud, Miami-Dade County, Palm Beach County, Personal Injury Protection, PIP, PIP/No Fault

Insurance Agent Allegedly Sold Fraudulent Insurance Policy

According to the Palm Beach Post, Fred Thomas Jr., 39, is facing charges of fraud and embezzlement between $300 and $2,000 after he allegedly sold a Palm Beach County woman fraudulent/fake car insurance during a three-year period. Thomas was arrested by the Florida Highway Patrol on Interstate 95 for driving with a suspended license when the trooper found an active warrant for Thomas in the insurance fraud case.

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Filed under auto insurance, Auto Insurance Fraud, Florida, Insurance, Insurance Fraud, Palm Beach County

Physicians able to keep practicing for years after they are arrested for pending felony charges

According to the Palm Beach Post, investigators with the Florida Department of Health (DOH) and Broward County Sheriff’s Office arrived at a Pompano Beach pain clinic in 2012 to search for evidence of crime. Dr. Donald Willems, the osteopathic physician admitted to signing blank prescriptions for powerful painkillers such as oxycodone, admitted to letting a clinic manager fill them out, for patients he had not seen.

Eight criminal charges were leveled against Willems, including racketeering and illegally providing oxycodone. With those felony charges still pending, Willems was arrested again on December 21, 2016, named in a federal complaint alleging insurance fraud orchestrated by a local treatment center.

Anyone checking out his background on the Florida Department of Health’s consumer website would never have known it. The site listed the doctors’ license to practice as “clear and active.”

The DOH, which participated in the 2012 clinic raid, did not file formal disciplinary charges against Willems until January 2016, three years after criminal charges were filed.

The Health Department has previously faced criticism for extensive lags between the time a physician is arrested on drug-related charges and the time the state files a disciplinary charge that could result in sanctions, which include revoking a doctor’s license.

In some ways, quick action by the DOH is hindered by law. State law does not require that a doctor tell the department when he or she is arrested; only when there is a conviction. It can be years between an arrest and a trial.

According to DOH spokesman Brad Dalton, when law enforcement agencies tell the state an investigation is underway, “there are times when the department is asked to wait until a criminal case resolves … to protect the confidentiality of an active law enforcement investigation.”

The agency does not impose sanctions. After investigating, it may file a formal disciplinary charge — an administrative complaint — seeking disciplinary sanctions.

The burden of proof needed to justify such disciplinary charges is high, said Dalton. In a civil court suit, lawyers need to prove a “preponderance” of evidence to win their case, he points out. To prove a discipline case against a doctor, the state has to prove “clear and convincing” evidence.

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Filed under Broward County, DOH, Insurance Claims, Insurance Fraud, Pain Clinics, Palm Beach County