September 2015
Volume 6 - Issue 3
Eleven individuals were
arrested for their
various roles in the
straw owner schemes,
and arrest warrants
have been issued for
three additional
individuals whose
arrests are pending.
INSIDE THIS ISSUE
1
Statewide Arrests
2
PIP Fraud News
3
Most Wanted
6
Statewide Arrests
8
Statewide Contacts
HEADER
HERE
Eleven Arrested
In Statewide
Sweep
For Straw Owner PIP Schemes
The Division of Insurance Fraud (DIF) announced multiple arrests related to a largescale personal injury protection (PIP) fraud schemes across Central Florida. Eleven
individuals were arrested for their various roles in the straw owner schemes, and
arrest warrants have been issued for three additional individuals whose arrests are
pending.
DIF partnered with the Federal Bureau of Investigation (FBI) to conduct
investigations into two personal injury clinics, First Medical Rehab of Bradenton
(FMRB) and Kirkman Family Chiropractic Care (KCFC) in Orlando, after insurance
carriers and former patients raised allegations of potential illegal activities.
In the early months of 2014, a DIF detective successfully infiltrated the Bradenton
clinic by going undercover and posing as a patient. As a direct result, investigators
were able to prove that FMRB was billing for medical treatments on injuries that did
not exist.
The investigation into Kirkman Chiropractic revealed an organized plot to circumvent
clinic licensure requirements set by the Agency for Health Care Administration
(AHCA). Because licensed health care professionals can operate clinics without the
necessity of an additional clinic license, co-conspirators solicited licensed
chiropractors to serve as straw owners, or owners on paper only. To date, more than
$100,000 in fraudulent claims has been paid by multiple insurance carriers.
Those who were arrested in Tampa and Orlando include Dadline Prospere, 29,
Shona Johnson, 34, Dieufort Irilus, 39, Evelyne Franclin, 42, Herode Saint Juste, 35,
Francilio Febe, 31, and chiropractor Barry Sutphin, 59. Charges varied based upon
each individual’s alleged role and included patient brokering, insurance fraud,
solicitation, grand theft and organized scheme to defraud.
Four related arrests were also made in the Fort Myers area in a $2 million dollar
scheme. Garry Joseph, 36, Nesly Loute, 51 and Wisler Cyrius, 34, were arrested
following a two-year joint federal and state law enforcement investigation dubbed
“Operation Fraudulent Pain”. Joseph and Sijames Melus, 32, were the true owners
of two chiropractic clinics in Naples, Parkway Medical and Rehab LLC and T&C
Consultants d/b/a Collier Chiropractic Center. Cyrius and Anouce Toussaint, 32,
were the actual owners of Tamiami Pain and Rehab LLC and First Choice Pain and
Rehab Inc. In both cases licensed health care practitioners were paid for the use of
their names on official documents as though they were the true owners of the clinics.
Clinic employee Maria Victoria Lopez, 43, was also arrested. Melus and Toussaint
are still at large.
For more information, see related links on page 2.
September 2015
Page 2
PIP FRAUD – In The News
Third Chiropractor Arrested In “Operation Cold Call” Case
Last month, Florida’s Department of Financial Services, Division of Insurance Fraud (DIF) arrested chiropractor Kenneth
Francis Labarge III, 48, on charges relating to Insurance Fraud for his role in the undercover investigation “Operation
Cold Call”. Labarge is the eighth individual arrested in the case. Those previously arrested included two runners, a clinic
employee, two chiropractors and two attorneys, all of which are allegedly involved in a scheme of illegal solicitation and
patient brokering. Labarge met with an undercover detective posing as a patient and signed treatment forms for services
that were never rendered. The forms were then submitted to the insurance company as part of an insurance claim for
payments, resulting in fraudulent insurance profits.
Update: Florida State Trooper Sentenced to Federal Prison
In an update to our June 2015 story on the former State Trooper arrested by the FBI for his role in a solicitation / bribery
scheme involving Pirate tow trucks, Kirk Chambers was sentenced to 51 months in federal prison.
During the months of September through November of 2014, Chambers used his position to download the personal
information of approximately 100 accident victims from FHP servers. During a series of transactions, Chambers
provided that information to a confidential source in return for $5,000.
Two weeks earlier, Chambers co-defendant, tow truck operator Guillermo “Tony” Sepulveda was sentenced to 37
months.
In a related case, Matthew Valdes Perez, 29, a former Miami-Dade Police Department (MDPD) public service aide and
Lazaro Garcia, 31, owner of a tow truck company, were charged in an illegal bribery and kickback scheme.
During the months of September 2014 and October 2014, Valdes accessed and collected the confidential personal
information of dozens of accident victims from MDPD databases. Valdes and Garcia sold this information to a
confidential source, in return for $4,200 in cash payments.
Valdes admitted receiving more than $10,000 in bribes from Garcia during the year 2014 and early 2015.
These cases are the result of investigative efforts of the FBI Miami Area Corruption Task Force and the MDPD Internal
Affairs Professional Compliance Bureau.
See more details in the press releases on these two cases at https://www.fbi.gov/miami/press-releases/2015/formerflorida-highway-patrol-trooper-sentenced-for-taking-bribes and https://www.fbi.gov/miami/press-releases/2015/
mdpd-psa-and-tow-truck-company-owner-charged-in-illegal-bribery-and-kickback-scheme.
NICB Recognizes Retiring BSO Deputy Marty Chastain For Years of Service
The National Insurance Crime Bureau (NICB) recognized seven years of
working with retiring Broward Sheriff’s Deputy Marty Chastain at their August
meeting. NICB Senior Special Agent Ralph Garcia teamed up with Chastain in
2008 working on an insurance card operation in Broward County. Their
teamwork continued through April 2015 when NICB conducted a tri-county
operation with Broward, Miami-Dade and Palm Beach counties. Chastain
coordinated with over 24 police municipalities during that operation which
resulted in more than 800 citations and 30 arrests in Broward County alone.
NICB estimates that with the coordinating efforts of Deputy Chastain, BSO
issued over 4000 citations and made more than 250 arrests during the 7 years
they teamed up.
We congratulate Deputy Chastain on his retirement and thank him for his years of service!
Pictured left to Right - NICB Supervisory Agent Fred Burkhardt, NICB Sr. Special Agent Ralph Garcia, BSO Capt. Neal
Glassman, BSO Deputy Marty Chastain, and BSO Deputy Barry Berhow.
Additional Links Related to Cover Story on Statewide Arrest Sweep
Press release by US Attorney’s office: http://www.justice.gov/usao-mdfl/pr/five-naples-residents-chargeddefrauding-auto-insurance-companies Bradenton Herald: http://www.bradenton.com/2015/08/12/5938194_bradenton-clinic-operators-arrested.html?rh=1 The News Press: http://www.news-press.com/story/news/crime/2015/08/14/five-naples-residents-chargeddefrauding-car-insurance-companies/31733505/
The PIP Source
Page 3
No-Med Services Fugitive Arrested
Ricardo Jimenez, 50, was arrested on August 4, 2015 by the Hialeah Police
Department on a warrant issued in February 2014 as a result of the Division of
Insurance Fraud (DIF) investigation dubbed Operation No-Med Services. That
case involved an organized scheme to defraud with four Miami-Dade PIP clinics;
Magic Hands Medical Services, Emoge Medical Services, Clarke Medical
Services and New Life Rehab Services.
Jimenez was the hidden owner of two clinics, Magic Hands and Clarke Medical,
both of which operated under straw ownership.
Jimenez was aware that a warrant for his arrest had been issued and was
actively eluding DIF detectives who were trying to locate him. When he was
pulled over last month in a traffic stop by Hialeah Police, Jimenez tried to run
away but his attempt failed and he was taken into custody. Jimenez is being held
in jail without bond.
In the months of August 2011 to September 2012, Jimenez and his partner, Delvis Gonzalez, 32,
participated in the staging of four accidents, and consequently billed insurance companies in excess of
$300,000 through their three clinics. Both men were charged with numerous counts of Organized Scheme to
Defraud, Operating an Unlicensed Clinic, Insurance Fraud and Grand Theft. Gonzalez, the true owner of
New Life Rehab, was arrested in February 2014 when the warrants were originally issued, and is awaiting
trial. All three clinics have since closed.
Twenty-three persons have been arrested in Operation No-Med Services, including three clinic owners, a
doctor, a physician assistant, a straw owner, four massage therapists, a clinic employee, six staged accident
organizers and six participants.
William Jean
Black Male, 37 years old
5’6”, 160 lbs, Brown Eyes, Black Hair
Warrant Information:
Warrant/Case #: 140007839
Felony Warrant Charge: Staged Accident, Grand Theft, Solicitation
and Patient Brokering
Details:
The Florida Department of Financial Services, Division of Insurance
Fraud (DIF) is attempting to locate William Jean in reference to the
outstanding warrant.
Jean is wanted for his role in multiple PIP fraud related crimes,
including organizing a staged accident, soliciting patients and patient
brokering.
Jean has yet to be found since his warrant was issued in June 2014.
His warrant is full extradition. Jean may have returned to Haiti.
If you know where Jean can be located, please contact the Division of
Insurance Fraud at 1-800-378-0445.
Check out the DFS Most Wanted at http://www.myfloridacfo.com/PressOffice/MostWanted/
The PIP Source
Do You Know Where This Man Is?
Page 4
The PIP Source
Sabe Donde Esta Este Hombre?
Page 5
The PIP Source
Page 6
Statewide PIP Arrests – August 2015
Each issue will provide a list of PIP arrests made by the offices throughout the State. Along with each defendant’s name
and age, we will include: the type of scheme involved; the fraud dollar amount; clinic name(s); victim insurance company
name(s); and the arresting office. If you need additional details on any of these arrests, please contact Capt. Smith.
Carlos Jermaine Solomon, 42 - sale of fake ins card (Assurance American) T
Carlos Jermaine Solomon, 42 - sale of fake ins certificate (Direct General) T
Ashley Marie Diaz, 28 - false claim - $3,161 (Geico) O
Jessenia Morales, 37 - jump-in 10/21/14 - (Geico) W
Ricardo Jimenez, 50 - clinic owner / insurance fraud - $309,247 – Clarke Medical Services / Magic Hands Medical Services / New
Life Rehab Services (Allstate / Geico / Imperial Fire / Kingsway Amigo / State Farm / United Auto) M
Michelle Soto, 35 - staged acct 11/16/12 (passenger) $85,634 - Facility Medical Center / Family Medical / ISO Diagnostic Testing /
Med Rehab of Florida / Millennium Diagnostic Imaging Center / Rehab and Wellness Services / YH Medical (Geico / Progressive /
State Farm) M
Yosniel Hernandez, 24 - staged acct 12/03/11 (passenger) $47,754 - Arlington Rehabilitation Services / Gate Parkway Diagnostic
Center / One Touch Therapy Center (State Farm) J
Kenneth F Labarge, 48 - chiropractor / solicitation, patient brokering - (Geico / Progressive) W
Maria Cecilia Calbeiro, 55 - staged acct 08/24/12 (driver) $96,923 - Cedar Valley Medical Group / Intensive Therapy / MS Medical
Rehab Corp (United Auto / York) M
Miguel Calbeiro, 55 - staged acct 08/24/12 (passenger) $96,923 - Cedar Valley Medical Group / Intensive Therapy / MS Medical
Rehab Corp (United Auto / York) M
Errol Charles Baugh, 61 - false claim - $13,997 (Gainsco) W
Justin Lee Sellas, 37 - application fraud / theft (Windhaven) J
Jonathan Manuel Calbeiro, 20 - staged acct 08/24/12 (passenger) $96,923 - Cedar Valley Medical Group / Intensive Therapy / MS
Medical Rehab Corp (United Auto / York) M
Marvin Anthony Shika, 30 - damage to vehicle - (Progressive) M
Isael Marco Tulio Riviera Perez, 31 - fake ins card (Gainsco) W
Shauntria La’trease Mayo, 25 - application fraud (Gainsco) O
Barry William Sutphin, 59 - chiropractor / insurance fraud - First Medical Rehab of Bradenton (21st Century) T
Rauniel Marin, 26 - staged acct 10/20/12 () $89,305 - Emmanuel Therapeutic / Lauralex Medical (ELCO / FAJUA) M
Garry Joseph, 36 - unlicensed clinic owner / mail fraud - $1,986,829 - Parkway Medical & Rehab, LLC / T & C Consultants dba
Collier Chiropractic Center () F
Pedro Giles, 30 - staged acct 12/05/12 (passenger) $55,280 - 86 Medical Rehab Center / B & A Diagnostic / Blue Village Medical
Center Corp / Florida Superior Imaging / Intermas Medical Center / Karow Chiropractic Center (Kingsway Amigo / Liberty Mutual /
Ocean Harbor) M
Maria Victoria Lopez, 43 - clinic employee - First Choice Pain and Rehab / Parkway Medical & Rehab, LLC / T & C Consultants dba
Collier Chiropractic Center / Tamiami Pain and Rehab, LLC () F
Wisley Cyrus, 34 - unlicensed clinic owner / mail fraud / money laundering - $110,721 - First Choice Pain and Rehab / Tamiami Pain
and Rehab, LLC () F
Nesly Loute, 51 - mail fraud / money laundering - $110,721 - First Choice Pain and Rehab / Tamiami Pain and Rehab, LLC () F
Evelyn Franclin Laguerre, 42 - patient brokering - First Medical Rehab of Bradenton (21st Century) T
Dieufort Irilus, 39 - patient brokering - First Medical Rehab of Bradenton (21st Century) T
Shona Sherinika Johnson, 34 - clinic employee / false claims - $68,024 - Kirkman Family Chiropractic (Direct General / Esurance /
Geico / Infinity / Liberty Mutual / Progressive / State Farm) O
Code – B (Broward) F (Ft Myers) J (Jacksonville) M (Miami) O (Orlando) P (Pensacola) TL (Tallahassee) T (Tampa/St Pete) W (West Palm Beach)
September 2015
Page 7
Statewide PIP Arrests – August 2015
Each issue will provide a list of PIP arrests made by the offices throughout the State. Along with each defendant’s name
and age, we will include: the type of scheme involved; the fraud dollar amount; clinic name(s); victim insurance company
name(s); and the arresting office. If you need additional details on any of these arrests, please contact Capt. Smith.
Dadline Prospere aka Shelove Lagu, 29 - unlicensed clinic employee / false claims - $68,024 - Kirkman Family Chiropractic (Direct
General / Esurance / Geico / Infinity / Liberty Mutual / Progressive / State Farm) O
Erica Vol-Helena Serrano, 26 - false claim (Progressive) J
Edgar Sarmiento Bustamante, 45 - staged accident 08/16/11 (recruiter) $11,928 - Baymeadows Injury Center (Farmers) J
Prudencia Brunilda Echavarria, 64 - staged acct 10/23/11 (passenger) $41,655 - Physicians Medical Center / Saint Jose Injury
Center (Farmers / Gainsco) J
Leandro Raul Sanchez, 26 - staged acct 10/23/11 (passenger) $41,655 - Physicians Medical Center / Saint Jose Injury Center
(Farmers / Gainsco) J
Miguelina Echavarria Urena-Anthony, 52 - staged acct 10/23/11 (driver) $41,655 - Physicians Medical Center / Saint Jose Injury
Center (Farmers / Gainsco) J
Eric Van Jenkins, 55 - staged acct 10/23/11 (driver) $41,655 - Physicians Medical Center / Saint Jose Injury Center (Farmers /
Gainsco) J
Herode Saint Juste, 35 - patient brokering - First Medical Rehab of Bradenton (21st Century) T
Michael Angelo Hernandez, Jr, 27 - staged acct 06/07/12 (recruiter) $28,148 - One Touch Therapy Center (Direct General / Geico /
Titan) J
Milquiades Ramon Espiritu, 30 - staged acct 10/23/11 (recruiter) $41,655 - Physicians Medical Center / Saint Jose Injury Center
(Farmers / Gainsco) J
Asleny Alvarez, 27 - false injury claim - $7,881 - Oasis Medical Center / Silver Medical Center (Allstate) M
Francilio Febe, 31 - unlicensed clinic owner / false claims - $68,024 - Kirkman Family Chiropractic (Direct General / Esurance /
Geico / Infinity / Liberty Mutual / Progressive / State Farm) O
Edisvel Rodriguez Riveron, 32 - staged acct 10/20/12 (driver) $89,305 - Emmanuel Therapeutic / Lauralex Medical (ELCO / FAJUA)
M
Juan Enrique Rodriguez Guevara, 55 - staged acct 10/20/12 (passenger) $89,305 - Emmanuel Therapeutic / Lauralex Medical
(ELCO / FAJUA) M
Ulises Reyes, 43 - jump-in 05/16/15 - $2,080 - Alternative Medical Center (Windhaven) M
Johnathan Tyler White, 22 - application fraud / false claim - $6,865 (Geico) O
Jessie Jorge de la Pena, 59 - massage therapist / straw clinic owner - $21,604 - Health Point Injury Center (Direct General /
Peachtree / Windhaven) J
Lanieska Peraza Acosta, 30 - staged acct 12/05/12 (driver) $55,280 - 86 Medical Rehab Center / B & A Diagnostic / Blue Village
Medical Center Corp / Florida Superior Imaging / Intermas Medical Center / Karow Chiropractic Center (Kingsway Amigo / Liberty
Mutual / Ocean Harbor) M
Yesenia Rodriguez Gonzalez, 25 - staged acct 12/05/12 (passenger) $55,280 - 86 Medical Rehab Center / B & A Diagnostic / Blue
Village Medical Center Corp / Florida Superior Imaging / Intermas Medical Center / Karow Chiropractic Center (Kingsway Amigo /
Liberty Mutual / Ocean Harbor) M
Lintretha Jamee Hall, 27 - sale of fake ins card (Direct General) T
Meagan Louise McCoggle, 39 - identity theft / false use of ins card (Security National) B
Code – B (Broward) F (Ft Myers) J (Jacksonville) M (Miami) O (Orlando) P (Pensacola) TL (Tallahassee) T (Tampa/St Pete) W (West Palm Beach)
The PIP Source
Page 8
Statewide PIP Contacts
DISTRICT I
Major Michael BYRNE
DISTRICT II
Major Rafael DELGAGO
PANHANDLE REGION
Counties: Bay, Calhoun, Escambia, Franklin, Gadsden, Gulf,
Holmes, Jackson, Jefferson, Lafayette, Leon, Liberty,
Madison, Okaloosa, Santa Rosa, Taylor, Wakulla, Walton,
Washington
SOUTH CENTRAL REGION
Counties: Broward, Charlotte, Collier, Glades, Hendry,
Highlands, Indian River, Lee, Martin, Okeechobee,
Palm Beach, St. Lucie
Pensacola Field Office - 850.453.7802
Capt. David LINDSAY
Lt. Sandra FITZSIMONS
Tallahassee Field Office - 850.413.3115
Lt. Ernie STOLL
NORTH REGION
Counties: Alachua, Baker, Bradford, Citrus, Clay, Columbia,
Dixie, Duval, Flagler, Gilchrist, Hamilton, Levy, Marion,
Nassau, Putnam, St. Johns, Sumter, Suwannee, Union
Jacksonville Field Office - 904.798.5802
Capt. Brian McCOY
Lt. Kevin JONES
NORTH CENTRAL REGION
Counties: Brevard, Hillsborough, Lake, Orange, Osceola,
Seminole, Volusia
Orlando Field Office - 407.835.4402
Capt. Evangelina BROOKS
Lt. Laquanda GREEN
Lt. John SAVINO
WEST CENTRAL REGION
Counties: DeSoto, Hardee, Hernando, Manatee, Pasco, Pinellas, Polk, Sarasota
Tampa Field Office - 813.972.8602
Capt. Darrell WILSON
Lt. Carlos ROSARIO
St Petersburg Field Office - 727.563.1142
Lt. Carl LANE
Copy goes her.
Editor’s
Corner
On page 1, we cover the statewide arrest
sweep that captured eleven subjects involving
unlicensed PIP clinics and patient brokering in
Ft. Myers, Orlando and Tampa.
On page 3, we feature another fugitive in
Insurance Fraud’s Most Wanted.
As always, we report on PIP Fraud in the News
and the latest PIP-related arrests.
West Palm Beach Field Office - 561.837.5601
Capt. Ted PADICH
Lt. James FEENEY
Ft. Lauderdale Field Office - 954.958.5402
Lt. Bill LEE
Ft. Myers Field Office - 239.278.7527
Lt. Glen CLASEN
SOUTH REGION
Counties: Dade, Monroe
Miami Field Office - 305.536.0302
Capt. Steven SMITH
Lt. Violeta SERRANO
Lt. Stanley JEAN-FELIX
Lt. Missael DIAZ
South Florida Major Medical Fraud Task Force
Supervisory Special Agent Fred Burkhardt 847.544.7141
Central Florida Major Medical Fraud Task Force
Supervisory Special Agent Jose Olivier 813.558.6387