August 2015
Volume 6 - Issue 2
Hernandez billed at
least $59,000
during the time he
owned and operated
C & N Therapy Center
without a license.
HEADERArrested
HERE
Miami Clinic Owner
Following
Long-Term PIP Fraud Investigation
It started as a typical PIP-fraud investigation in November
2010. The Division of Insurance Fraud (DIF) received
information that an August 20, 2010, accident reported to
Geico was actually a staged crash organized by a man
named “Flaco.”
By April 2011, Flaco, who was later identified as Michel
Perez, and another participant, were arrested by DIF, along
with the massage therapist who also owned C & N Therapy
Center. But when the therapist was arrested because of
the fraudulent billing at her clinic, she claimed that she was
not the owner of the clinic, and wanted to cooperate. Her
cooperation resulted in the arrests of the true clinic owners,
Nester Sanchez, 39, and Chakira Vila Puentes, 45, in Maximo J Hernandez
September 2013. Their case proceeded through the court
system, and Sanchez and Vila eventually agreed to cooperate in March 2015 and
confessed that they had sold the clinic to another person.
That person, Maximo J. Hernandez, 47, was arrested in July 2015 on insurance
fraud, grand theft and organized scheme to defraud charges, as a result of his
operation of an unlicensed clinic.
INSIDE THIS ISSUE
When Sanchez and Vila previously ran the clinic using a massage therapist as a
straw owner, they operated it under a false exemption obtained from the Florida
Agency for Health Care Administration (AHCA). Hernandez purchased C&N
Therapy Center from Sanchez and Vila in December 2010, and maintained the
existing straw ownership using the same massage therapist. Within six months
however, Hernandez made arrangements with another massage therapist to replace
her and act as the new straw owner. Statements were obtained from both massage
therapists that they were not the true owner of the clinic and that Hernandez was the
actual owner.
1
Clinic Owner Arrest
2
PIP Fraud News
3
Most Wanted
5
Statewide Arrests
7
Hernandez billed at least $59,000 during the time he owned and operated C & N
Therapy Center without a license.
Statewide Contacts
Another arrest was also made regarding fraud at C & N Therapy Center. Physician
assistant Carlos Millan, 76, was arrested in May 2013, as part of Operation No-Med
Services, for his falsification of treatment records. Millan was convicted in February
2015 and surrendered his medical license.
August 2015
Page 2
PIP FRAUD – In The News
Ted Padich Promoted to Captain of the DIF South Central Region
Ted Padich has been promoted to captain and will oversee the South Central Region for the Division of Insurance Fraud
(DIF), effective August 5, 2015.
Padich joined DIF in June 1998 and was promoted to lieutenant over the West Palm Beach General Fraud squad in April
2010. He has over 30 years experience as a law enforcement officer, retiring as a Captain from Boynton Beach Police
Department. Padich has made significant contributions to the Division, teaching courses on mortgage fraud, major case
investigations, and crimes against the elderly while working many high profile, complex cases. Padich is a graduate of
the FBI National Academy and has an Associate’s of Science degree in Criminal Justice from Suffolk Community
College in New York.
Congratulations to Captain Padich!
Division of Insurance Fraud Shines in A&E’s “American Takedown”
Florida's fight against insurance fraud was thrust into the national spotlight as investigators showcased what’s required
to crackdown on the fake car crashes and phony injuries that are costing taxpayers millions each year.
Undercover agents with Florida's Auto Fraud Squad spent more than a year embedded in a South Florida crime ring
fraud scheme, known as “Operation Cold Call”.
In "Operation Cold Call", investigators discovered a ring of attorneys, doctors and clinic employees allegedly recruiting,
then paying "so called patients" for injuries they really never received in staged car crashes.
Florida's CFO, Jeff Atwater tells 10 News that the national spotlight on A&E's American Takedown reveals the scam
that's costing auto insurance policy holders around a billion dollars a year in higher premiums for personal injury
protection or PIP.
Full story here:
money/29943537/.
http://www.wtsp.com/story/news/2015/07/09/florida-insurance-scam-is-costing-you-
Doctor Linked to Daytona Chiropractor Fraud Indicted by Feds
The West Palm Beach doctor accused of allowing a Daytona Beach chiropractor to use the physician's name and federal
drug license to prescribe pain pills to chiropractic patients pleaded not guilty to the scheme in federal court on July 21,
court records show.
John Peter Christensen, 63, was arrested in early July for his role in defrauding Medicare along with local chiropractor
Joseph Wagner, 65, who was arrested in May 2012. Christensen is charged with conspiracy to commit health care fraud,
conspiracy to violate the controlled substances act, illegal distribution and dispensation of controlled substances and
transactional money laundering. Wagner has been in federal prison since 2012 and is serving a 15-year sentence.
Christensen's medical license was suspended by the state in August 2011, after both the Florida Department of Law
Enforcement and the FBI accused him of allowing Wagner to dispense pain medication to his patients with Christensen's
Drug Enforcement Administration license. Christensen had been licensed in Florida since 1975, first as a chiropractor,
and then as a medical doctor since 2004.
See the full story by Lyda Longa of the Daytona Beach News-Journal at http://www.news-journalonline.com/
article/20150721/NEWS/150729893/.
CFO Atwater Appoints Sha’Ron James as Insurance Consumer Advocate
Chief Financial Officer Jeff Atwater today announced the appointment of Sha’Ron James, a long-time voice for the
people of Florida, as the state’s Insurance Consumer Advocate effective August 3. The role of Florida’s Insurance
Consumer Advocate is to independently and ardently represent the needs of policyholders when insurance decisions are
made. James enters the role with a history highlighted by years of dedication advocating for Floridians on insurancerelated matters.
“Sha’Ron’s experience holding insurance companies accountable and her in-depth understanding of the insurance
industry raises the bar for Florida’s advocacy efforts,” said CFO Atwater. “Sha’Ron has fought to ensure that the
interests of consumers come before profit and special interests, and I am confident she will carry her passion for the
people of Florida into this role.”
See the full press release at http://www.myfloridacfo.com/sitePages/newsroom/pressRelease.aspx?id=4540.
The PIP Source
Page 3
Two Miami PIP Clinic Owners Among 4 Arrested
The Division of Insurance Fraud (DIF) announced four South Florida arrests of individuals on charges related
to their involvement in three separate personal injury protection (PIP) fraud schemes that resulted in the
billing of more than $145,000 in fraudulent insurance claims.
Nayef Casas Diaz, owner of Miami PIP clinic M & N Rehabilitation Center, was arrested after allegedly
organizing a staged accident scheme. Diaz reportedly paid each participant in the staged vehicle accident
$1,000 to receive treatment from M & N and another clinic, Magic Hands Medical Service, for phony injury
claims. As a result, fraudulent claims in excess of $63,000 were filed against two insurance carriers.
In a separate undercover investigation led by DIF, Alexis A. Gonzalez, owner of Health Max Medical Center
(HMMC) in Hialeah, and HMMC clinic employee Erick A. Perez were both arrested for their involvement in a
PIP fraud scheme. Both are alleged to have directed an undercover posing as a patient to sign documents
for treatment that were not rendered. Gonzalez compensated the undercover with $1,000 for participating in
the scheme which produced claims in excess of $11,000.
Vicente Ortiz Alpizar was also arrested for his participation in a staged accident that resulted in more than
$70,000 in fraudulent claims. Participants, including Alpizar, went to A & J Rehabilitation Center and D & J
Rehabilitation Center, both located in Miami, to fraudulently receive unnecessary treatments following the
staged accident. DIF has now made 15 arrests for five different staged accidents involving the two
clinics. Also previously arrested were the clinic owner and a runner from A & J Rehabilitation and two
employees from D & J Rehabilitation, including a massage therapist.
These cases are being prosecuted by the office of Miami-Dade County State Attorney Katherine Fernandez
Rundle.
Manuel Valerino Acosta
Hispanic Male, 50 years old
5’9”, 165 lbs Brown Eyes, Black Hair
Warrant Information:
Warrant/Case #: W680014841
Felony Warrant Charge: Staged Accident, Insurance Fraud, Grand
Theft
Details:
The Florida Department of Financial Services, Division of Insurance
Fraud (DIF) is attempting to locate Manuel Valerino Acosta in
reference to the outstanding warrant.
Acosta organized two staged accidents in 2008, which resulted in
nearly $14,000 in fraudulent claims to be filed.
Acosta has yet to be found since his warrant was issued in March
2010. His warrant has nationwide extradition.
If you know where Acosta 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/
August 2015
Page 4
CFO Atwater Launches Serve, Save, Succeed
Chief Financial Officer Jeff Atwater announced a new, socially interactive website called Serve Save Succeed
that provides Florida’s military service members and veterans a virtual resource for collaborative discussion
and creative thinking about money management. Members of the military community face unique financial
challenges. Serve, Save, Succeed offers them an opportunity to share the successes and misfortunes they’ve
experienced.
“I know that financial success stories come in all sizes and by sharing with one another, we can learn
valuable information about how to make smarter financial decisions,” said CFO Atwater. “I hope that our
Serve, Save, Succeed community offers financial support that helps guide you and your family on a lifelong
path of financial security.”
Few understand the financial challenges faced by current and former military service members and their
families. With more than 61,000 service members and 1.5 million veterans calling the state of Florida home,
we recognize the need to address these financial challenges, which is why we've launched Serve, Save,
Succeed. This new website is an online collaborative community where users are invited to share photos and
videos to tell their personal stories of saving and budgeting. We believe this site will provide a rich learning
environment that will thrive on the camaraderie of the military community.
The success of the site is based on user interaction, and users are encouraged to submit personal photos or
videos in order to more vividly share their stories. In order to kick-start the website’s success, the Department
has uploaded a series of photos and videos from individuals
across Florida, including a personal story shared by Seminole
County Supervisor of Elections Mike Ertel.
In order to properly foster learning through collaboration, the
following financial topics and resources are available on the
Serve, Save, Succeed site. These include:
 Personal videos featuring current service members and veterans discussing their personal stories of
saving and budgeting
 Financial tips tailored specifically for the military community
 Identity theft resources that will enable users to properly protect their identity and financial information
 Scams affecting active service members and veterans are detailed in addition to suggested prevention
tips
 Budgeting calculators for assessing your financial choices during specific life events such as retirement,
buying a car, budgeting for a baby and much more
 A Resource Guide with in-depth information regarding budgeting, credit scores, identity theft and other
related topics
 Additional resource links are provided, which pertain to unemployment, homelessness, health care and
disability
We're eternally grateful to all active duty service members and veterans for their commitment to our country.
My gratitude and respect for their sacrifice plays a large part in my commitment to ensuring Florida's military
community has the necessary tools, information and resources vital to financially prepare them for the road
ahead.
For more information and resources to assist Florida’s military community in preparing for a solid financial
future or to share your unique story, visit the Department’s Serve Save Succeed, Financial Frontlines and
Your Money Matter$ websites.
The PIP Source
Page 5
Statewide PIP Arrests – July 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.
Catherine Lorena Wiggins, 38 - sale of fake ins card (Direct General) T
Edward Scott Richards, 56 - staged acct 05/05/12 (passenger) $8,296 - One Touch Therapy Center (MetLife) J
Javier Luis Lorenzo, 52 - application fraud / false claim - $9,013 (Progressive Select) O
Julian Alonso Ocampo, 27 - staged acct 08/16/11 (driver) $13,359 - EMED Urgent & Primary Care / Health Point Injury Center
(Direct General / Geico) J
Judeline Lubin, 25 - inflated claim - $1,285 (Esurance / Infinity) O
Lazaro Garcia Bermudez, 54 - staged acct 04/14/12 (driver) $30,709 - Gate Parkway Diagnostic Center / Wellness Rehab Services
(Geico / State Farm) J
Yolanda Demetria Herring, 39 - false reinstatement of policy / false claim - (Direct General) T
Maite Aguilera, 42 - staged acct 07/07/11 (recruiter) $88,760 - A & J Rehabilitation Center / D & J Rehabilitation Center / Lauralex
Medical Services / (State Farm / United Auto) M
Ladaisha Loray Henderson, 30 - application fraud (Infinity) TL
Lasandra Posetella Bradley aka Lasandra Roshun Murphy, 52 - fake ins card (Geico) W
John Edward Kaltenmeier, 46 - application fraud / false claim - $1,359 (Progressive) O
Danika Christine Fleurantin, 25 - application fraud (Esurance) T
Javier Montes de Oca, 30 - application fraud (Gainsco) M
Erve Dorcely, 27 - staged acct 05/29/13 (driver) $15,222 - Disa Med aka City Med (Allstate / Progressive) O
Guillermo Trujillo Rodriguez, 28 - staged acct 03/14/12 (passenger) $50,765 - Sunshine Medical Health Services (United Auto) M
Maximo J Hernandez, 47 - unlicensed clinic owner - $27,000 – C & N Therapy Center (Geico / Infinity / State Farm / United Auto) M
Cathy Tursi Hermosillo, 55 - false receipts - $3,500 (Allstate) M
Joana Lilly Thornton, 43 - staged acct 08/30/11 (driver) $23,627 - Baymeadows Injury Center / EMED Primary Care (Geico / Infinity /
Peachtree) J
Melisha Laurice Graham-Bryan, 31 - application fraud / false claim - $2,992 (Infinity) B
Damion Antonio Bryan, 23 - application fraud / false claim - $2,992 (Infinity) B
Terry Washington Davis, 29 - sale of fake ins card (Florida Farm Bureau) T
Acelia Izquierdo Macias, 43 - false claim auto theft - $7,368 (United Auto) M
Ariel Martin Lopez, 38 - staged acct 07/12/12 (driver) $37,000 - Gate Parkway Diagnostic Center / Wellness Rehabilitation Services
(Sentry) and staged acct 03/31/11 (passenger) $10,000 - Baymeadows Injury Center (Farmers) J
David Costella Ross, Jr, 34 - application fraud (Esurance) J
Julissa Alexandra Salas Perez, 26 - staged acct 08/30/11 (passenger) $23,627 - Baymeadows Injury Center / EMED Primary Care
(Geico / Infinity / Peachtree) J
Jorge Reinaldo Williams Boyce, 45 - jump-in 12/24/14 - $0 - Context Medical Center (State Farm) M
Eddie Silvia Quintana, 49 - jump-in 12/24/14 - $0 - Context Medical Center (State Farm) M
Marlesha Lavern Parker, 22 - application fraud (Geico) J
Marie Claude Pierre, 41 - paper crash 10/28/11 (recruiter) $32,417 - Spine Chiropractic Center (Imperial Fire) M
Jennifer Lisset Pajuelo, 32 - staged acct 05/21/12 (passenger) $13,450 - Gate Parkway Diagnostic Center (Progressive) J
Code – B (Broward) F (Ft Myers) J (Jacksonville) M (Miami) O (Orlando) P (Pensacola) TL (Tallahassee) T (Tampa/St Pete) W (West Palm Beach)
August 2015
Page 6
Statewide PIP Arrests – July 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.
Ana V Torres, 53 - application fraud (Windhaven) M
Dania Susel Rodriguez, 29 - jump-in 03/03/14 - $15,351 - AP & JP Medical Rehab / New Health Rehab Center (Allstate) M
Rebecca Sue Clark, 39 - false claim / lost wages - $4,627 (Geico) TL
Michael Renaldo Wilson, Jr, 28 - application fraud (USAA) J
Deanna Lynn Brooks, 46 - application fraud (Progressive) P
Vicente Ortiz Alpizar, 48 - staged acct 11/21/11 (passenger) $70,736 – A & J Rehabilitation Center / D & J Rehabilitation Center /
Performance Health & Wellness Center (Gainsco / Geico) M
Nayef Casas Diaz, 37 - clinic owner / staged acct 12/28/11 (recruiter) $63,751 - B & A Diagnostic / Doctors Professional Medical Office / Emoge Medical Services / M & N Rehabilitation Center / Magic Hands Medical Services (Imperial Fire / United Auto) M
Erick A Perez Ferrero, 42 - clinic owner / false claim - $11,356 - Health Max Medical Center (ELCO) M
Alexis A Gonzalez, 28 - clinic owner / false claim - $11,356 - Health Max Medical Center (ELCO) M
Francisco Ramos, Jr, 49 - false claim - pedestrian - $10,467 (Responsive) M
John Peter Christensen, 63 - doctor () 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)
The PIP Source
Page 7
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 arrest of a Miami
clinic
owner
following
a
long-term
investigation by DIF.
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