January 2015
Volume 5 - Issue 7
Working with the
National Insurance
Crime Bureau (NICB),
DIF discovered that
more than $712,000 in
fraudulent PIP claims
were paid by 14
different insurance
companies during the
period the clinic
operated without a
license.
INSIDE THIS ISSUE
1
Clinic Owner Arrest
2
Most Wanted
3
PIP Fraud News
4
Statewide Arrests
5
Statewide Contacts
HEADEROwner
HERE
Chiropractor, Clinic
Arrested in
Fraud Scheme
Florida Chief Financial Officer Jeff Atwater announced the arrests last
month of a Pompano Beach chiropractor and the clinic operator for
allegedly conspiring to create a “straw” ownership arrangement to thwart
Florida’s clinic licensing laws.
Chiropractor Adam Matthew Strouse, 38, allegedly fronted ownership of
Sunnaco Health Center. An investigation by the Division of Insurance
Fraud (DIF) determined that Sunnaco Health Center was really owned,
operated and managed by non-physician Jean Louis Bernard Celestin,
60.
Arrest warrants were issued and Strouse and Celestin were arrested and
booked into the Broward County Jail by DIF detectives in December.
Strouse claimed to be the owner of Sunnaco Health Center, so the clinic
operated with a self-proclaimed exemption since its inception in June
2011. Because Strouse held a license with the Department of Health
(DOH), he was statutorily exempt from clinic licensing requirements
regulated by the Agency for Health Care Administration (AHCA).
Working with the National Insurance Crime Bureau (NICB), DIF
discovered that more than $712,000 in fraudulent PIP claims were paid by
14 different insurance companies during the period the clinic operated
without a license.
Sunnaco Health Center was originally incorporated by Celestin in June
2011, and he added Strouse as a director in September 2013. Strouse
has been licensed as a chiropractor in Florida since 2005.
Strouse and Celestin are charged with organized scheme to defraud first
degree and operating an unlicensed health care clinic.
The case is being prosecuted by the Broward County State Attorney’s
Office.
January 2015
Page 2
New DIF Regional Realignment Announced
An update to the reorganization at the
Division of Insurance Fraud (DIF).
The regions have been reorganized as
follows:
The Panhandle and North Regions, led by
Captains David Lindsay and Brian
McCoy, respectively, remain unchanged.
They join newly promoted Captain
Evangelina Brooks, who will lead the new
North Central Region, which includes
offices in Orlando, Tampa and St.
Petersburg. Together they form District I,
under the direction of Major Mike Byrne in
Tampa.
The South Central Region was also
reorganized to include the Broward, Palm
Beach and Ft. Myers offices, and is led by
Captain Rafael Delgado.
The South
Central Region joins the South Region,
led by Captain Steven Smith, to form District II, under the direction of Major Glen Hughes.
Majors Byrne and Hughes are supervised by Bureau Chief Buddy Hand in Tallahassee.
Huberto Del Sol Puerto
White Hispanic Male, 54 years old
5’11”, Brown Eyes, Black Hair
Warrant Information:
Warrant/Case #: F13000083
Felony Warrant Charge: Insurance Fraud, Money Laundering,
Organized Scheme to Defraud
Details:
The Florida Department of Financial Services, Division of Insurance
Fraud, DIF is attempting to locate Huberto Del Sol Puerto in
reference to the outstanding warrant.
In 2011, Del Sol Puerto allegedly hijacked a Florida corporation that
had closed in 2010 in order to submit nearly $900,000 in false
diagnostic claims for services that were never provided to patients.
Insurance companies paid more than $308,000 to Del Sol Puerto
before the scheme was uncovered.
If you know where Del Sol Puerto 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
Page 3
PIP FRAUD – In The News
The Division of Insurance Fraud (DIF) Announces New Promotions
Evangelina Brooks was promoted to Captain of the newly formed North Central Region, made up of the Orlando, Tampa
and St. Petersburg offices. Brooks began her law enforcement career in 2002 with the Vero Beach Police Department.
She joined DIF in May 2006 and was assigned to a Miami PIP Squad. In 2007, she transferred to the West Palm Beach
Workers’ Compensation Squad and in January 2009 she was promoted to Lieutenant of the new West Palm Beach PIP
Squad. Brooks was nominated in 2007 for Law Enforcement Detective of the year by FIFEC. Brooks is an active
member of the DIF training section and a Certified Fraud Examiner.
Sandra Fitzsimons was promoted to Lieutenant of the Division of Insurance Fraud’s Pensacola field office. Prior to
joining DIF in 2000, Fitzsimons served six years with the Santa Rosa County Sheriff’s Office. She has been presented
the prestigious “Bronze Eagle” award four times by the United States Attorney’s Office for her work with the Healthcare
Task Force since 2009 and also received the 2009 Investigation of the Year award from the National Healthcare AntiFraud Association. Fitzsimons is also a Certified Fraud Examiner.
Sledgehammer Defendant Sentenced in Cargo Theft Ring Case
Alien Moya, 30, was sentenced to 44 months in prison after previously pleading guilty to an Information charging him
with conspiracy to steal goods valued in excess of $1,000. Moya was previously arrested May 2013 for his role in
Operation Sledgehammer. Moya was a recruiter of participants for staged accidents in the scheme. Moya had been
sentenced to 58 months in federal prison and was prepared to testify against co-defendants in separate trials when he
was arrested in this new case.
See the full press release at http://www.fbi.gov/miami/press-releases/2014/four-men-sentenced-on-charges-ofparticipating-in-a-cargo-theft-ring.
Chiropractor Lovell Loses Appeal in Federal Court, 60-Month Sentence Affirmed
Chiropractor Stephen Mark Lovell, 57, lost the appeal of his sentence for his February 2013 conviction in federal court.
In September 2014, the U.S. Court of Appeals for the Eleventh Circuit affirmed his sentence of 60 months for his role in
Operation Whiplash. (See the March 2013 issue of the PIP Source for details.)
Lovell argued that the district court clearly erred in applying a four-level enhancement for his role as an organizer or
leader in the health care fraud conspiracy, given that he was merely a straw owner of the clinic operated by the coconspirators. Lovell contends that, while he received a small sum for permitting the clinic to use his chiropractic license,
his co-conspirators developed the idea for the clinic; performed the work to create the clinic’s legal and physical
existence; hired all of the employees and set their salaries; maintained all bookkeeping for the clinic; and received nearly
all of the clinic’s profits.
In assessing a defendant’s role in the offense, district courts consider the following factors:
1 - the exercise of decision making authority
2 - the nature of participation in the commission of the offense
3 - the recruitment of accomplices
4 - the claimed right to a larger share of the fruits of the crime
5 - the degree of participation in planning or organizing the offense
6 - the nature and scope of the illegal activity
7 - the degree of control and authority exercised over others
The court stated that the evidence indicates that Lovell had a significant degree of participation in planning and
organizing the conspiracy. Lovell met with the other co-conspirators to discuss how to form the clinic, agreed to the
continued use of his license to open and operate the clinic, incorporated the clinic and served as its sole legal owner,
loaned the clinic $20,000 to fund its opening, signed the clinic’s lease, and opened the clinic’s bank account. Moreover,
Lovell appointed Jackson the clinic’s office manager, and hired and paid the salary of the clinic’s only chiropractor. His
exertion of control over at least one other person in the conspiracy qualifies him as an organizer or leader.
The court found that Lovell exercised some decision making authority in the conspiracy, such as instructing his coconspirators to form shell corporations to launder money without raising suspicion. The fact that co-conspirators made
daily business decisions for the clinic and controlled the clinic’s finances did not negate Lovell’s organizational or
leadership role in the conspiracy, because there can be more than one organizer or leader of a conspiracy.
See the full court ruling at https://www.courtlistener.com/opinion/2732118/united-states-v-stephen-m-lovell/.
January 2015
Page 4
Statewide PIP Arrests – December 2014
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.
Gilda Arelis Rondon, 31 - staged acct 05/22/12 (driver) $8,258 - Gate Parkway Diagnostic Center / Wellness Rehab Services
(Peachtree) J
Oriana Curvelo, 26 - staged acct 05/22/12 (passenger) $14,650 - Gate Parkway Diagnostic Center / Wellness Rehab Services
(Peachtree) J
Marc Anthony Rivera, 34 - staged acct 12/03/13 (passenger) $27,018 - Broward Manual Rehab (Geico) B
Maicon Velasquez, 22 - fake ins card (Gainsco) W
Shakieya Monique Williams, 32 - fake ins card (Seminole Casualty) T
Patrick Phillip Mowry, 38 - application fraud (Esurance) P
Sady Gomez Garcia, 42 - staged acct 09/14/12 (driver) $29,993 - Brilliant Medical Center (Knight Management Insurance Services /
United Auto) M
Gregory St Fleur, 50 - staged acct 12/30/12 (driver) $12,619 - North Beach Pain Health Center (Geico / RepWest) M
Luis Rosa, 40 - false claim - $1,633 - L & K Transmission (USAA) J
Raymond Harold Delong, Jr, 46 - false claim - $1,633 - L & K Transmission (USAA) J
Michel Monterno de la Cruz, 26 - staged acct 10/14/12 (recruiter) $17,215 - K & J Medical Center (Ocean Harbor) M
Michel Monterno de la Cruz, 26 - staged acct 09/19/12 (driver) $29,005 - Med Life Medical Services / TGC Services (USAA) M
Noel de Jesus Moreno, 25 - staged acct 08/04/12 (passenger) $84,917 - Doral Health Center / Faillo Care Therapy Center / YH
Imaging (Geico / United Auto / Windhaven) M
Jeffery Wayne Smith, 49 - staged acct 07/22/12 (passenger) $31,101 - One Touch Therapy Center (Direct General / Esurance /
Geico) J
Willie Lee Thomas, 57 - staged acct 07/22/12 (driver) $31,101 - One Touch Therapy Center (Direct General / Esurance / Geico) J
Adam Matthew Strouse, 38 - chiropractor / straw owner unlicensed clinic - $711,948 - Sunnaco Health Center (21st Century /
Allstate / Bristol West / Direct / Esurance / Geico / Infinity / MGA / Metropolitan / Mercury / Progressive / State Farm / USAA /
Windhaven) B
Jean Louis Bernard Celestin, 60 - unlicensed clinic - $711,948 - Sunnaco Health Center (21st Century / Allstate / Bristol West /
Direct / Esurance / Geico / Infinity / MGA / Metropolitan / Mercury / Progressive / State Farm / USAA / Windhaven) B
Mario Cesar Saez Ferrer, 40 - staged acct 09/19/11 (driver) $69,904 – B & A Diagnostics / Doctors Professional Medical Center /
M & N Rehabilitation Center / (Geico / RepWest / United Auto) M
Wilfredo Romero, 39 - staged acct 11/10/11 (driver) $13,488 - Emed Primary Care & Walk In Clinic / Physicians Medical Centers /
Saint Jose Injury Center (Gainsco) J
Maykel Rodriguez, 34 - fugitive / staged acct 02/20/07 (recruiter / passenger) $2,040 - Complete Care Rehabilitation (Geico) M
Yusney Rodriguez, 38 - PIP patient - $7,250 - Columbus Rehabilitation Center (Allstate / Geico) T
Carlos Rodriguez Martinez, 56 - staged acct 08/04/12 (passenger) $84,917 - Doral Health Center / Faillo Care Therapy Center / YH
Imaging (Geico / United Auto / Windhaven) M
Mayken Perez Menendez, 35 - staged acct 08/04/12 (driver) $84,917 - Doral Health Center / Faillo Care Therapy Center / YH
Imaging (Geico / United Auto / Windhaven) M
Alexis Sanchez Venero, 25 - staged acct 10/09/10 (passenger) $19,241 – Angels Diagnostic Center / Millennium Medical Center
(Progressive / RepWest) M
Osvaldo L Arocha, 46 - fake ins card (Geico) T
Sonyalice Soliveras-Alicea, 38 - staged acct 05/08/12 (driver) $41,037 - Gate Parkway Diagnostic Center (Direct General / Geico /
State Farm) 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)
The PIP Source
Page 5
Statewide PIP Contacts
PANHANDLE REGION
Counties: Bay, Calhoun, Escambia, Franklin, Gadsden, Gulf,
Holmes, Jackson, Jefferson, Lafayette, Leon, Liberty,
Madison, Okaloosa, Santa Rosa, Taylor, Wakulla, Walton,
Washington
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, DeSoto, Hardee, Hernando, Hillsborough,
Lake, Manatee, Orange, Osceola, Pasco, Pinellas, Polk,
Sarasota, Seminole, Volusia
Tampa Field Office - 813.972.8602
Major Michael BYRNE
Lt. Carlos ROSARIO
Orlando Field Office - 407.835.4402
Capt. Evangelina BROOKS
Lt. Laquanda GREEN
Lt. John SAVINO
Copy goes her.
Editor’s
Corner
On page 1, we cover the arrests of a clinic
owner and a chiropractor in Broward County.
On page 2, 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.
We wish everyone a Happy New Year and look
forward to good things in 2015.
SOUTH CENTRAL REGION
Counties: Broward, Charlotte, Collier, Glades, Hendry,
Highlands, Indian River, Lee, Martin, Okeechobee,
Palm Beach, St. Lucie
Plantation Field Office - 954.958.5402
Capt. Rafael DELGAGO
Lt. Bill LEE
West Palm Beach Field Office - 561.837.5601
Major Glen HUGHES
Lt. Vacant
Ft. Myers Field Office - 239.278.7527
Lt. Mark FRITZ
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