Ten people have been indicted in a complex scheme to allegedly defraud private insurance companies of more than $1 billion for medical testing. The Justice Department unsealed the indictments Monday in Jacksonville, Florida. Eight of the defendants are from Florida. The others are from Atlanta and Chicago. The charges include conspiracy to commit health care fraud and money laundering.
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Filed under Fraud, Healthcare
Brevard County Sheriff’s Office arrested Roger Garrett for allegedly setting his car on fire and causing a 300-acre brush fire. Investigators determined that Garrett set his car on fire to defraud his insurance company and ended up starting a brush fire that quickly covered 300 acres.
Garrett is being charged with several crimes, including arson, burning with intent to defraud an insurer and insurance fraud.
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Filed under Fraud
Sabrinea Brooks of Port St. Lucie was sentenced to four years in federal prison after pleading guilty to wire fraud, access device fraud and forgery. Brooks used her four jobs in healthcare billing from June 2014 through April 2015 to simultaneously work her fraud scheme rerouting over $873,000 to bank accounts that she controlled.
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Filed under Fraud, Healthcare
Jacksonville roofer and owner of Kinnecorps LLC, Roger Van Den Bosch, has been arrested and charged with insurance fraud, grand theft, uttering and failing to begin work. The roofing company has been under investigation since 2018 due to complaints from homeowners who signed Assignment of Benefits allowing their insurance companies to pay Van Den Bosch who in turn never completed the work.
Two other Kinnecorps employees, Van Den Bosch’s sister and girlfriend both face felony charges of uttering and knowingly notarizing a false document.
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Filed under Property (Homeowners)
Florida Department of Financial Services detectives arrested ten people for using 15 fake clinics to submit 23,000 fraudulent claims totaling $42.7 million. They used fake clinics as drop boxes for insurance payments. Four more arrests are pending with the alleged ring leader, Jorge Valido, still on the run. He previously served time in prison for healthcare fraud.
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Filed under Fraud
Margarita Palomino of Homestead, Florida pleaded guilty to conspiracy to commit health care fraud and wire fraud. Palomino who worked for three home health agencies where she allegedly accepted kickbacks for the referral of Medicare beneficiaries, even ones that did not qualify for home health services and changed claims coding to increase reimbursement by Medicare. Palomino also admitted that she performed home health care nursing visits and prepared related medical records although she does not have a license to do so in the United States.
Medicare made payments of at least $4.65 million as a result of false and fraudulent claims submitted as part of this conspiracy. Palomino was sentenced to over six years in prison to be followed by three years of supervised release for her role in the health care fraud scheme.
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Filed under Fraud, Healthcare
Pinellas County Detectives arrested 35 unlicensed contractors in an undercover sting operation coined “Operation Cast Out.” The suspects’ charges include unlicensed specialty contracting violations, workers compensation fraud, and various other criminal charges unrelated to unlicensed contracting.
The sting operation was conducted from November 3-5 at a vacant storefront in Madeira Beach. The unlicensed contractors were found advertising on social media platforms and came to the business agreeing to engage in illegal contracting work without a license or permit.
Citizens in Pinellas County can search for licensed contractors or report unlicensed construction activity by visiting the PCCLB website.
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Filed under Fraud
Carlos Guillermo Aponte of Palmetto Bay was arrested in September for three counts of insurance fraud and grand theft for allegedly defrauding Citizens Property Insurance Corp. The Department of Financial Services’ Disaster Fraud Action Strike Team (DFAST) investigated Aponte after receiving a tip about fraudulent invoices and false rental agreements with letters claiming lost of rent for more than $30,000.
Aponte could face prison time of up to 45 years and fines up to $45,000.
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Filed under Fraud, Property (Homeowners)
Carlton DeWayne Dunko and Frank Martin Pureber, once known for using their former company NBRC Construction in a roofing insurance scam that cheated nearly 100 Tampa Bay residents out of at least $632,000 have taken their talents to Connecticut.
After serving two years in a Florida prison and being placed on probation, Dunko and Pureber fled to Connecticut to start a similar operation, CTST Construction. Dunko was leading a sales meeting in Milford, CT when Florida fraud agents busted him. They have been found guilty of larceny and sentenced to a year in a Connecticut prison.
When Dunko and Pureber finish their Connecticut prison time, they will face trial for the alleged fraud they committed in Missouri with another roofing company, American Shingle and Siding.
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Filed under Uncategorized
Over 600 medical professionals in 35 states across the U.S. are on the hook for submitting more than $2B in fraudulent claims in what the U.S. attorney’s office is calling the largest healthcare fraud crackdown in the history of the Department of Justice. Of the 601 charged in this crackdown, almost 150 of the accused are from Florida.
Many of the crimes committed in this crackdown are linked to the opioid crisis, but also includes money laundering, check cashing and billings to Medicare.
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Filed under Fraud
