Author Archives: Mark J. Rose, Esq.

Clearwater Man Pleads Guilty in VA Benefits Fraud Scheme

Home care businessman Roland Brown pleaded guilty to paying $1M in bribes to a long-time friend who worked for the Department of Veteran Affairs. The scheme defrauded the organization’s benefits program for children with spina bifida. According to Brown’s plea, he allegedly set up Legacy Home Health in order to submit more than $3 million in false claims to the VA. This scheme is only one of several scams pulled off by Brown’s friend.

Click here to read the article.

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Filed under Fraud, Healthcare

Florida CFO Urging Insurers to “Step Up” in Closing Out Remaining Hurricane Michael Claims

Florida CFO Jimmy Patronis is urging insurance companies to resolve the more than 21,000 open insurance claims related to Hurricane Michael. On the 9-month anniversary of Hurricane Michael, CFO Patronis released a statement to acknowledge “great strides in recovery,” but noted there’s a lot more work to do.

Click here to read the release.

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Filed under Property (Homeowners)

Brothers Sentenced in $20 Million Insurance Fraud Scheme

Former insurance agent Stuart Alan Starr of One Stop Insurance Agency pled guilty to conspiracy to commit wire fraud and wire fraud in April 2019. Starr’s brother, Glen Wayne Starr pled guilty to the conspiracy to commit wire fraud in August 2018. The brothers received the same sentence of 101 months in prison, followed by three years of supervised release. They are both been ordered to pay over $20 million in restitution to the financial institutions they defrauded.

Click here to read the article.

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Filed under Fraud

Florida CFO Jimmy Patronis says a Quarter of Pedestrian Accidents in 2018 are Faked

According to Florida Chief Financial Officer Patronis, “In 2018, there were 9,300 pedestrian crashes and of those, an estimated 25 percent were staged.”

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Filed under Fraud, Personal Injury Protection (PIP)

Tampa Bay Residents Charged in $200M Health Care Fraud Scheme

Jessica Linton of Clearwater and Juan Rodriguez of Tampa are two of 10 people who were charged in an indictment alleging over $200 million in insurance fraud. Linton is facing 24 charges in the indictment while Rodriguez is facing 6 charges including health care fraud, mail fraud and aggravated identity theft. The scheme included altering prescriptions to add non-prescribed drugs including Tramadol and ketamine.

Click here to read the article.

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Filed under Fraud, Healthcare

Favorable Third District Court of Appeals Decision

Favorable decision from the Third District Court of Appeal upholding Defendant’s Proposal for Settlement and entitlement to attorney’s fees in a case where the Plaintiff claimed that the declaratory relief count filed along with a breach of contract count invalidated the Insurer’s Proposal for Settlement.

To read the appellate decision, click here.

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Filed under Property (Homeowners)

Fort Myers Woman Arrested for Insurance Fraud

Crystal Danielle Clarkson of Fort Myers was arrested for submitting false claims to her insurance company for treatments she did not receive. She sent 34 extra claims totaling $70,546.12 although she had only been seen by hospital medical providers two times. Clarkson is facing up to 30 years for charges of organized scheme to defraud, grand theft, insurance fraud.

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Filed under Fraud

Stuart OB/GYN Found Guilty in Health Insurance Fraud Scheme

A federal court jury found Dr. Sheetal Kanar Kumar, former Stuart obstetrician and gynecologist, guilty of 23 counts of health insurance fraud. Kumar faces up to 10 years in prison and fines of $250,000 for each charge as a result of her fraudulent claims to Medicare, Medicaid and Blue Cross Blue Shield. Kumar’s claims involved charges for patient office visits involving complex cystometrogram, anorectal manometry, uroflowmetry and voiding pressure studies.

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Filed under Fraud, Healthcare

Two Arrested in Patient-Brokering and Insurance Fraud Scheme

Licensed pharmacist Richard Vallette and a “middleman” Todd Mulvaney were arrested in patient-brokering and insurance fraud scheme. Vallette and Mulvaney conspired to split thousands of dollars in insurance reimbursements from fraudulent prescriptions with who they thought was a drug-treatment center owner, but turned out to be an undercover cop.

Both men are facing six counts of patient brokering and six counts of insurance fraud. According to the Palm Beach County State Attorney’s Office, this is an active investigation and there will likely be additional arrests.

Click here to read the article.

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Filed under Fraud

Crooked Opioid Treatment Center Owner Arrested for Insurance Fraud

James Durkin, owner of a Boynton Beach opioid treatment facility The Hope Center of Recovery, has been arrested for insurance fraud. Durkin was charged for allegedly submitting fraudulent insurance billing for over $104,000.

CFO Jimmy Patronis said, “Insurance fraud at crooked addiction treatment centers fuels the ongoing opioid epidemic in Florida.” An investigation revealed Durkin’s was falsified billings to Cigna and United Health Care for addiction recovery treatments that were never performed.

Durkin faces up to 30 years in prison.

Click here to read the press release.

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Filed under Uncategorized