Category Archives: Uncategorized

New Florida Law Deems Ridesharing Drivers As Independent Contractors & Provides Minimum Insurance Requirements

You may or may not be aware that there is a new Florida law deeming Uber, Lyft and other ridesharing drivers as independent contractors and NOT employees that is going to be taking effect on July 1st. The new Florida law also provides for insurance coverage requirements that will now be mandatory for such drivers and companies. We want to make sure you know how this legislation is going to affect your business.

On May 9, 2017, Florida Governor Rick Scott signed the Transportation Network Companies Act (HB 221), designating drivers for ridesharing companies in the on-demand or gig economy as “independent contractors” as long as the “transportation network company” meets four criteria that are currently met by Uber, Lyft, and other similar companies.

Under this newly enacted legislation, insurance coverage requirements are now also being made mandatory for the drivers and the ridesharing companies when they are engaged in the online application of the ridesharing company and/or in a prearranged ride. The coverage requirements under the new law can be satisfied in one of three ways. The new law also discusses the responsibilities of the driver’s personal auto insurance carrier when an accident occurs and provides avenues for the insurer to investigate the claim with the cooperation of the ridesharing company.

We recently presented a continuing education course at the 25th Annual Florida Insurance Fraud Education Committee (FIFEC) Conference called The Ridesharing Generation: Insurance Implications & Complications which discusses this topic. We are happy to provide a copy of the presentation to you if you are interested.

For questions, or to discuss this issue in greater detail, please feel free to contact Lissette Alvarez or Cecile Mendizabal.

For more information on how to schedule a complimentary continuing education course via webinar or live presentation, please contact the Marketing Department of ROIG Lawyers.

ROIG Lawyers is a minority-owned litigation firm with a primary focus on Insurance Defense Litigation. We serve as primary counsel for numerous national and regional carriers and corporations related to all aspects of insurance litigation. ROIG Lawyers does not intend to create an attorney-client relationship by offering this information, and anyone’s review of the information shall not be deemed to create such a relationship. You should consult a lawyer with regard to specific law issues that requires attention.

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Undercover Investigation Led to Arrests of Bradenton Area Chiropractors

According to ABC Action News, an undercover investigation led to the arrests of two Bradenton area chiropractors and other staff. Detectives say chiropractors Richard Tambe and Yusef Barnes, along with chiropractic assistant Johncina Harrell, performed a fraction of the treatments listed on insurance claims and were billing for treatment never rendered to patients.

The arrests and undercover investigation took place at the Back on Track clinic in Bradenton, Florida. According to the arrest report, all three were booked at the Manatee County Jail on insurance fraud, a third degree felony. Tambe faces 12 counts. Barnes is charged with 8 and Harrell is charged with 13 counts. If convicted each suspect faces as much as 5 years in prison.

Click here for full story.

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Filed under Florida, Insurance, Insurance Claims, Insurance Fraud, Uncategorized

Sixth Person Found Guilty in Unlicensed Chiropractic Clinics Scam

According to Southwest Florida Online News, a federal jury found Nesly Loute guilty of fraud after a six day trial where he and five others testified that they had conspired to operate five unlicensed chiropractic clinics and fraudulently billing auto insurers for Personal Injury Protection benefits. This ruling was the culmination of a two-year law enforcement investigation dubbed Operation Fraudulent Pain.

Loute and five other individuals who have also pleaded guilty are facing a maximum penalty of 20 years each in federal prison and must make restitution to the insurance companies they have defrauded. The unlicensed chiropractic clinics had received more that $2 million in fraudulent PIP payments.

Click here to view the full story.

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Filed under Auto Insurance Fraud, Florida, Insurance Fraud, PIP/No Fault, Uncategorized

Medicare Ban on Non-emergency Ambulance and Home Health Care Agencies Continues

Friday the Centers for Medicare and Medicaid Services extended a temporary ban on nonemergency ambulance and home health care agencies throughout six states, including Florida, as a continued effort to fight fraud.

In continuing the ban on nonemergency ambulance services, the ban on new emergency ambulance services was lifted. The ban, originally only implemented in Miami, Chicago and Houston, was expanded in January of 2014 to combat fraud in other metropolitan areas seen as fraud hotbeds, specifically in Michigan, Pennsylvania and New Jersey. The ban has been expanded for additional six months after being in place for three years so far.

According to CMS, Texas, Florida and Illinois are in the lower third for number of patients per home health care provider. Despite this statistic, these three states have the highest number of home health care providers according to CMS data.

Shantanu Agrawal, CMS’ deputy administrator for program integrity commented on the program:

CMS is continuing its efforts to tackle fraud, waste, abuse and protect benefits and services for those eligible for federal health care programs. . . CMS is also increasing its oversight efforts through the use of heightened screening and investigative tools for new providers in the moratoria areas.

According to the National Health Care Anti-Fraud Association, as much as $60 billion is lost due to fraud, waste and abuse of the federal health care programs.

Click here for full story.

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Filed under Florida, Insurance, Insurance Fraud, Medicare, Uncategorized

Three from Miami Sentenced in $40M Medicare Fraud

Jorge Lorenzo, Yahima Pardo and Roberto De Jesus Alonso, all of Miami, were sentenced to prison and ordered to pay more than $40 million as a result of their involvement in what is considered the Medicare fraud scheme that caused the greatest loss to the government in 2015.

In addition to the nearly $40.4 million in restitution, the government seized over $2 million in cash and personal assets including Rolex and Cartier watches and artwork by prominent Cuban artists.

The case, before U.S. District Judge William Dimitrouleas, centered around Lorenzo’s ownership or control of 8 home health agencies in Miami-Dade County that received in excess of $40 million from Medicare as a result of fraudulent claims by way shell owners at each agency funneling claim payments to other fictitious companies staffed by co-conspirators. Once indication of a Medicare fraud investigation arose, Lorenzo would close the home health agency, keeping them open for only 8 months on average.

Click here for full story.

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Filed under Florida, Insurance Fraud, Medicare, Miami-Dade County, Uncategorized

Third DCA at Odds With Another Court After OKing Red-Light Cameras

The Third District Court of Appeal ruled in favor of red-light camera programs, setting up a disagreement between appellate courts and likely meaning the issue will go to the Florida Supreme Court.

Red-light cameras run by municipalities have long come under fire from critics. Opponents decry the fact that traffic tickets can be given out by someone other than a police officer, especially a private company. That’s exactly what the Fourth DCA said in 2014, ruling that red-light cameras are an unlawful delegation of police power to the third parties issuing the tickets.

The Third DCA said the most recent case was a bit different though. Judges Thomas Logue, Kevin Emas and Linda Ann Wells ruled that it was legal for municipalities to hire private companies to review traffic images and decide which ones to forward to police officers. However, the Third DCA judges said a sworn police officer is required to review the evidence for a final decision and not just rubber-stamp the third-party recommendations.

The Third DCA case arose from a suit challenging red-light cameras in Aventura, while the Fourth DCA case concerned a similar program in Hollywood. Logue and Emas designated the case as one of great importance for the Florida Supreme Court to consider, while Wells asked to certify a conflict with the Fourth DCA.

Click here for the complete story (subscription required).

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Medicare Fraud Roundup Is Largest in U.S. History

A nationwide sweep on June 21 resulted in the largest coordinated takedown of alleged Medicare fraudsters in U.S. history.

The Medicare Fraud Strike Force led a sweep in 36 federal court districts that resulted in charges against 301 individuals, including 61 medical professionals. The schemes involved about $900 million in fraudulent billing. South Florida was home to 100 of those defendants participating in fraud schemes involving $220 million in false billings for home health care, mental health services and pharmacy fraud.

The defendants face charges of conspiracy to commit healthcare fraud, violations of anti-kickback statutes, money laundering and aggravated identity theft. More than 60 of the individuals arrested are charged with fraud related to Medicare Part D, the prescription drug plan that is the fast-growing part of Medicare.

The defendants were part of schemes to bill Medicare and Medicaid for treatments that were medically unnecessary or never performed. Medicare beneficiaries and patient recruiters were paid kickbacks for supplying beneficiary information to providers, who used that information for fraudulent billing.

In one case in the Southern District of Florida, nine defendants were charged with operating six home health companies in the Miami area that gave bribes and kickbacks to bill for services that were not medically necessary. Those six companies defrauded Medicare of more than $24 million.

In the Middle District of Florida, which includes Orlando and Tampa, 15 individuals were charged with crimes including compounding pharmacy fraud and intravenous prescription drug fraud involving $17 million in fake bills. The owner of several infusion clinics is accused of being reimbursed by Medicare for $17 million for intravenous prescription drugs that were never purchased or administered to beneficiaries.

Click here for the press release.

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Filed under Health care, Insurance Fraud, Medicare, Miami-Dade Fraud, Southern District of Florida, Uncategorized

Google Compare Auto Insurance Launches in California

As reported earlier in FLPIPGuide.com, recent rumors about Google entering the U.S. auto insurance market have proven to be true as the tech giant recently announced its launch of Google Compare Auto Insurance in California. A roll-out in more states is planned.

According to a recent article in Insurance Journal, Google calls its online price-comparison service a “seamless, intuitive experience for connecting with your customers online.”

A company-issued news release said, “Whether you’re a national insurance provider or one local to California, people searching for car insurance on their phone or computer can find you along with an apples-to-apples comparison of other providers all in as little as 5 minutes.”

The Mountain View, Calif.-based company indicates that participation in Google Compare is based on a flexible cost-per-acquisition model.  Payment is not a factor in ranking or eligibility, according to Google.

The Google Compare Auto Insurance portal is user-friendly, and lists a variety of carriers, including Mercury and MetLife, who are partners in the project. Californians simply enter their zip code to bring up a form that asks for basic information such as name and date of birth. There is also a “speed things up” autofill feature, especially convenient to those on Google’s Chrome browser. Visitors to the site are self-directed through screens, eventually resulting in quotes for auto insurance.

Google Compare Auto Insurance Services Inc. has been licensed to sell insurance in at least 26 states and could reportedly be working with CoverHound, which currently offers online quotes for multiple insurers including Hartford, esurance, 21st Century, Travelers, Safeco, National General, Progressive, Foremost, Plymouth Rock and others, Insurance Journal said.

The company intends to introduce ratings and reviews, as well as local agent support for providers with agent networks.

Google’s entry into the insurance market, along with its role in building autonomous vehicles, could make it a dominant player in the field. William R. Berkley, CEO of W.R. Berkley Corp., revealed in a management seminar presentation to independent agents in January that “Google has the capacity to change auto insurance” because of the competitive advantage it gained when the company invested a significant amount of money to “actively build a rule-road map of America.”

An article in TechCrunch reported that several major insurance carriers may be taking a wait-and-see approach, however.

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Dangerous Driving Habits Revealed in AAA Study

Even though most drivers support safe driving habits, many do not put them into practice, a recent study by the AAA Foundation for Traffic Safety found. The Foundation’s research points to a “culture of indifference” among drivers who place a high value on safe travel, but also admit to engaging in behaviors they consider unsafe, such as speeding and impaired driving.

The 2014 Traffic Safety Culture Index reports the results of a study in which drivers were surveyed about their drinking and driving habits, texting and cell phone usage, speeding and driving through red lights, and drowsy driving. The following is an overview of the results.

Drinking, Drugs and Driving

The message about the dangers of drinking and driving has been sinking in, as 66 percent of those drivers surveyed view the practice as a very serious threat to personal safety. In addition:

  • 97% consider it unacceptable to drive when someone has had too much to drink
  • 80% believe that anyone convicted of driving while intoxicated more than once should have an alcohol interlock ignition device to prevent them from starting the car if they have been drinking
  • 73% think alcohol interlock ignition devices should be installed in all new cars
  • 63% favored lowering the blood alcohol level from .08 to .05 g/dl

Even so, one in eight drivers still reported driving in the past 12 months while their blood alcohol level might have been at or over the legal limit, and 19 percent said they did so in the past month.

As far as drug use, almost half of those surveyed believe it is a much larger problem than it was three years ago.

  • 56% view using illegal drugs as a serious threat
  • 28% see prescription drug use an issue
  • Over 90% agreed that it was unacceptable for a driver to “drive one hour after using marijuana”
  • 85% supported laws that would make it “illegal to drive with a certain amount of marijuana in one’s system”

Texting and Cell Phone Usage

When it comes to cell phone use, drivers rate certain behaviors more risky than others. The study found:

  • 69% reported talking on a cell phone while driving in the past 30 days
  • 33% said they “talk on their cell phone while driving fairly often or regularly”
  • Over 50% say the habit is dangerous
  • 66% say the habit is unacceptable

However, 65% of drivers consider it acceptable to use hands-free phones, while only 33% view it as unacceptable.

In terms of texting, 78% of drivers believe that texting and emailing while driving are dangerous.

  • 89% of drivers support laws against texting, typing and emailing while driving
  • 68% strongly support such a law

However:

  • 36% admit to reading a text message or email while driving in the last 30 days
  • 9% admit that they do it fairly regularly
  • 27% like to multi-task and admit to driving and typing a text or email at the same time over the past 30 days
  • Less than 50% support the federal government regulating “non-driving-related in-vehicle technologies” for being considered a distraction.

Age definitely has an impact on how distracted driving is perceived. Drivers over the age of 60 are the least likely to engage in these types of activities, while drivers aged 25-39 are most likely to talk on the phone, text and email, and view these activities as acceptable. Younger drivers, ages 16-18, also believe it’s acceptable to text, email and use the internet while driving.

Speeding, Red Lights and Drowsy Driving

A behind-the-wheel feeling of apathy toward speeding, running red lights and drowsy driving is also apparent in drivers, according to results from the study.

While 76% consider it unacceptable to drive more than 15 mph over the speed limit and 30% view speeding on the highway as a serious threat to their safety, 46% said they have driven 15 mph or more over the speed limit in the past 30 days and 14% said they do it fairly regularly. In addition, 95% consider driving 10 mph over the speed limit in a school zone unacceptable, but only 44% view speeding on residential streets as a very serious threat.

In terms of how drivers handle red lights, 94% consider it unacceptable to drive through a red light in cases where they could have stopped, but 33% admit to running a red in the past 30 days and 2% do it regularly.

As far as driving while sleep deprived, 96% consider it unacceptable to drive when they are so tired that they have trouble keeping their eyes open, but 29% reported that they had driven while struggling to stay awake in the past 30 days, 20% said they had done this more than once, and 2% do it on a regular basis.

Click on the link to read more about the AAA 2014 Traffic Safety Culture Index.

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Florida Hit-and-Run Accidents Jump in 2014

One out of four crashes in Florida now involves a hit-and-run driver, according to statistics recently released by the Florida Department of Highway Safety and Motor Vehicles (DHSMV).

Florida hit-and-run crashes increased by seven percent from 2013 to 2014, reaching a new high of more than 80,000 accidents. The three South Florida counties of Miami-Dade, Broward, and Palm Beach collectively represent 40 percent of the statewide totals, according to the department.

The severity of hit-and-run accidents also appears to be increasing, with a 23 percent increase in hit-and-run fatalities in 2014 over 2013. Pedestrians are particularly at risk. Almost 50 percent of the 2014 hit-and-run fatalities were pedestrians, representing a jump of 17 percent over 2013.

An infographic published as DHSMV as part of Florida’s driver education campaign, “Hit & Run: Bad2Worse,” appears below.

Florida Hit & Run Accident Statistics 2014.

It is a first-degree felony to leave the scene of an accident when a fatality is involved, and a felony of the third degree when an accident results in an injury, according to law enforcement personnel. Leaving the scene of an accident involving property damage is a second-degree misdemeanor.

The Aaron Cohen Life Protection Act, which became law in Florida last year, imposes a mandatory minimum prison sentence of four years for a driver convicted of leaving the scene of a crash resulting in the death of a person.

Click on the link for more information on Florida hit-and-run accidents from the Florida Department of Highway Safety and Motor Vehicles.

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