Teresa Johnson of Lecanto has been charged with insurance fraud for allegedly defrauding Medicare and Medicaid while working as a bookkeeper for the now-closed Christ Medical Center. According to Johnson’s plea statement, she knowingly billed Medicaid and Medicare for services the now deceased clinic owner did not perform. She also ordered tests she knew were not medically necessary.
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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
Three individuals from the Miami physical therapy clinic Professional Medical Practice have been arrested in an alleged personal injury protection (PIP) fraud scheme. The clinic owner Alean Machado, recruiter Barbarito Leyva-Claro, and physical therapist Yoandra Rodriguez-Pena were charged with Insurance Fraud, Grand Theft, Patient Brokering and Organized Scheme to Defraud.
An undercover investigation uncovered the scheme which paid $2,500 for patients that participated in the fraudulent physical therapy sessions. Two insurance companies were billed over $39,000 in fraudulent claims from the clinic. Machado, Rodriguez-Pena and Leyva-Claro could face up to 45 years in prison if proven guilty.
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Filed under Fraud, Personal Injury Protection (PIP)
Eighteen new charges have been filed against Jacksonville contractor, Wyatt Green. Green was arrested in April on charges of organized fraud, forgery and grand theft. The list of Green’s victims has grown from a handful to 19. Homeowners contacted I-TEAM saying that their insurance companies had paid Storm RS to make repairs to their homes that were never completed.
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Filed under Fraud, Property (Homeowners)
Five people have been charged with patient brokering, insurance fraud, money laundering, and racketeering in connection with a scam that raked in hundreds of thousands of dollars in kickbacks. Authorities allege that hundreds of prescriptions, many of them fraudulent, were sent to Express Care Pharmacy with prices ranging from $646 to $5,614. Many of the prescriptions were forged, unnecessary, or submitted without the patients or treating physician’s consent, according to the police report.
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Filed under Fraud, Healthcare
Andrew Fisher, the president and part-owner of Physician Specialty Pharmacy, is being accused of conspiracy to commit health care fraud, wire fraud, and money laundering. Allegedly, Fisher and five co-conspirators submitted more than $4.8 million in fraudulent claims for prescriptions for compounded pain cream, scar cream, and wellness capsules. According to the indictment, Fisher agreed to fill prescriptions at his pharmacy while using drug formations that would maximize the amount his pharmacy could bill to insurance companies.
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Filed under Fraud, Healthcare
Former Miami insurance agent Antonio Jesus Zoghbi has been accused of stealing more than $1.7 million in insurance premiums. Zoghbi allegedly used fraudulent and stolen identities to create fictitious insurance policies and submit fake premium finance contracts. According to the investigation, Zoghbi diverted policy funds into his business account, which he used for personal gain. He faces up to 25 years in prison if convicted.
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Filed under Fraud
David Brock Lovelace, the owner of the medical marketing company DBL Management LLC, was found guilty of Medicare fraud. After a four-day trial, Lovelace was found guilty of conspiracy to pay health care kickbacks and structuring currency transactions to avoid the reporting requirement.
Lovelace paid cash kickback and bribes in exchange for the referral of Medicare beneficiaries’ DNA swabs. He was then paid a percentage of the reimbursements from the $2.2 million in claims submitted by a clinical lab.
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Filed under Fraud, Healthcare
Williston’s Regional General Hospital has been allegedly involved in a $57 million fraud scheme with Jacksonville businessman Kyle Marcotte. Marcotte ran a urine testing operation which used Regional General and another hospital to bill insurance companies. Marcotte has agreed to plead guilty on charges of money laundering.
Regional General lost its hospital license but still operates a clinical lab. The hospital is now being investigated for fraud in connection with Marcotte’s charges and an unnamed person who “exercised control” over the hospital.
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Filed under Fraud
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.
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Filed under Fraud
