August 2014
Volume 5 - Issue 2
“To execute the
scheme, the true
owners of the
chiropractic clinics
recruited individuals
who had the medical
or chiropractic
licenses...to act as
nominee owners of the
clinics.”
INSIDE THIS ISSUE
1
Sledgehammer
2
PIP Fraud News
3
Most Wanted
4
Statewide Arrests
6
Statewide Contacts
HERE
Chiropractor HEADER
Lawrence
Schechtman
Sentenced in Operation Sledgehammer
Chiropractor Lawrence Schechtman, 45, and his office assistant Sircy Sacerio,
31, were sentenced this month by U.S. District Judge Kenneth A. Marra for their
participation in an automobile insurance fraud scheme involving staged
automobile accidents.
Schechtman was sentenced to 52 months in prison, to be followed by two years
of supervised release, and was ordered to pay nearly $2.5 million in restitution.
Sacerio was sentenced to 48 months in prison, to be followed by two years of
supervised release, and was ordered to pay more than $1 million in restitution.
According to court documents, between approximately October 2006 and
December 2012, the conspirators staged automobile accidents by recruiting
outside participants. Thereafter, the clinic owners were responsible for the filing
of false insurance claims through chiropractic clinics that were controlled by
members of the conspiracy. To execute the scheme, the true owners of the
chiropractic clinics recruited individuals who had the medical or chiropractic
licenses required by the state to open a clinic, including Schechtman, to act as
“nominee owners” of the clinics. The co-conspirators also hired complicit
licensed chiropractors, including Schechtman, who prescribed and billed for
unnecessary treatments and/or for services that had not been rendered.
Thereafter, complicit clinic employees, including Sacerio, prepared and
submitted claims to the automobile insurance companies for payment for these
unnecessary or non-rendered services. Twenty-one clinics participated in this
scheme.
Chiropractors Herman Diehl, 45, Kenneth Karow, 54, and Hal Mark Kreitman,
51, are scheduled to be sentenced in federal court on August 29, 2014.
Operation Sledgehammer was a collaborative investigation conducted by the
Federal Bureau of Investigation (FBI), Internal Revenue Service Criminal
Investigation (IRS-CI), the Division of Insurance Fraud (DIF), the National
Insurance Crime Bureau (NICB) and prosecuted by the United States Attorney’s
Office and the Office of the State Attorney for Palm Beach County.
See the full press release
PressReleases/140808-01.html.
at
http://www.justice.gov/usao/fls/
The PIP Source
Page 2
PIP FRAUD – In The News
Three Arrested in Miami for Organizing Staged Accident
Yansell C. Ugarde, 28, Roberto Gonzalez, 46, and Yudeisy Abreu Pena, 25, were arrested by the Division of Insurance
Fraud (DIF) for organizing a staged accident in October 2012, that resulted in more than $54,000 in fraudulent billings to
insurance carriers. Ugarde and Gonzalez were arrested in July, while Abreu was taken into custody in August.
Prior to the fake crash, Ugarde and Abreu inspected the vehicle and insurance coverage of several of the participants,
and then set up a meeting at El Palacio de los Jugos, a location commonly used by many to plan staged accidents,
where Gonzalez explained to all the participants how the accident would happen. Following the fake crash, several
participants were told to go to New Life Medical Center, a clinic in which Ugarde had a vested interest. Ugarde gave
them a stack of blank therapy forms to sign and paid them a total of $4,000. The participants were never treated at the
clinic.
Jacksonville Clinic Owner Charged With More Staged Accidents
The Division of Insurance Fraud (DIF) arrested Jacksonville clinic owner Oslay Acosta-Miguel, 36, on four new counts of
staged accidents.
Acosta, also known as El Guajiro, previously owned and operated a clinic in Tampa, local law enforcement caught on,
causing Acosta to relocate to Jacksonville. Investigation by DIF revealed that Acosta opened Baymeadows Injury
Center and Saint Jose Injury Center, both located in Jacksonville.
Between May 2011 and October 2012, Acosta participated in four intentional motor vehicle accidents for the purpose of
making or causing claims to be submitted for personal injury protection benefits to be paid to fraudulent clinics connected
to the fraudulent activity.
In these four new staged accidents, more than $155,000 in bills for fraudulent treatment at Baymeadows Injury Center,
Indian Rehabilitation Center and Saint Jose Injury Center were submitted to five insurance carriers; Direct, Geico,
Progressive, Sentry and USAA.
Acosta was previously charged in March 2014 for his role in staging five accidents between July and September, 2011
and bringing the participants to another clinic, One Touch Therapy Center, resulting in more than $176,000 being paid
for false claims filed against six insurance carriers; AGIC, Farmers, Gainsco, Geico, Kemper and Sentry.
Miami Paralegal Arrested in Fraudulent Lost Wages Claim
Marlene Ramirez, 50, was arrested by the Division of Insurance Fraud for filing a false claim. Ramirez allegedly created
a fictitious document in support of an injury claim to State Farm. Ramirez worked as a paralegal in the law offices of
Calejo and Associates, whom was representing the client for a February 2013 auto accident. In June 2013, attorney
Libio Calejo was suspended by the Florida Bar for one year, and Ramirez went to work for attorney David S. Kaufman,
who was taking over Calejo’s clients.
The document in question, a letter allegedly created by the client’s employer, stated that the client was unable to work
full-time after the accident and was fired shortly thereafter. When State Farm contacted the employer to verify the letter,
they learned that the employer had not created it, and that many of the statements it contained were false. The
employer told DIF that Ramirez had approached him with the letter but he refused to sign it because it was not true. The
client also told DIF that he did not provide the information that was in the letter, and that there was information in it that
was not true.
Ramirez and Kaufman stated that Ramirez created the letter, including a false letterhead, but claimed it was signed by
some one at the employer’s business and the information contained within was provided by the client.
Three More Arrested in Broward Staged Accident
Three more subjects were arrested by the Division of Insurance Fraud in July for their involvement in a staged accident
that resulted in false claims in excess of $80,000.
An investigation by the Department of Financial Services’ Division of Insurance Fraud discovered that a U-Haul truck that
allegedly crashed into a parked Dodge Caravan with eight passengers was, in fact, a staged accident. The occupants of
the caravan filed false claims for treatment at multiple clinics in Miami-Dade and Broward counties. Alfredo Romero,
Bessie Yamile Limas and Sharnice Hoy were charged with insurance fraud, bringing the total number of subjects
arrested in the case to six.
August 2014
Page 3
Most Wanted: Fugitive
Yuniet Rodriguez
Hispanic Male, 31 years old
5’06”, Green or Brown Eyes, Black, Brown or Partially Gray Hair
Warrant Information:
Warrant/Case #: 08CF23024
Felony Warrant Charge: Organized Fraud
Details:
The Florida Department of Financial Services, Division of Insurance
Fraud, is attempting to locate Yuniet Rodriguez. in reference to the
outstanding warrant.
Rodriguez has been a fugitive since November 2008 for organized fraud.
He was the owner of Dana Medical, a clinic located in Tampa, which
engaged in acts of patient brokering and insurance fraud.
If you know where Rodriguez 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/
Massage Therapist Arrested in Sarasota County
Massage therapist Marizol Salgado, 45, was arrested by the Division of Insurance Fraud in July for her involvement in
fraudulent billing by DMF Therapy & Rehabilitation Center, a clinic located in Sarasota.
Clinic surveillance was conducted and it revealed that a patient was not at the clinic on specific dates. DMF Therapy &
Rehabilitation Center later billed State Farm for treatment of the patient on dates that he was not there. When questioned, the patient stated that he had heard that the clinic would pay him money if he went there for treatment, and also
that he was paid a total of $1,300.
The patient also stated he was directed to sign blank therapy sheets for dates that he did not receive treatment at the
clinic. The patient indicated massage therapist Salgado was the one who told him to sign the sheets, which were then
used by the clinic to bill for treatment not provided.
Salgado denied telling the patient to sign blank forms and stated that she provided all the treatment that was billed for by
the clinic.
The investigation continues.
August 2014
Page 4
Statewide PIP Arrests – July 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.
Martha Garcia, 56 - staged acct 07/02/13 (passenger) $48,607 - Best Rehab Team / New Health Rehabilitation (Esurance / State
Farm / United Auto) M
Karel Cantillo Martinez, 36 - staged acct 02/26/08 (passenger) $37,666 - Flagler Family Rehabilitation Chiropractor / S & B Medical
Center (Mercury / State Farm) M
Dawn Shaw Sims, 45 - false injury - $923 (Liberty Mutual) J
Shiquita Charelle Morris, 22 - fake ins card (Occidental Fire & Casualty) O
Marizol Salgado, 45 - massage therapist / false documents - $13,510 - DMF Therapy & Rehabilitation Center (State Farm) T
Katia Candelario Castelao, 42 - staged acct 07/02/13 (recruiter) $48,607 - Best Rehab Team / New Health Rehabilitation (Esurance /
State Farm / United Auto) M
Carlos Jermaine Solomon, 41 - sale of fake ins card (Assurance American) T
Tamarra Lastarr Jones, 31 – application fraud (Progressive) P
Armando Jose Herrera, 38 - paper acct 07/20/13 (passenger) $18,838 - Universal Medical Services Corp (Windhaven) M
Armando Jose Herrera, 38 - paper acct 09/19/13 (passenger) $24,313 - ReMed Medical & Rehab Center (Windhaven) M
Marlene E Reveron, 42 - paper acct 09/19/13 (driver) $24,313 - ReMed Medical & Rehab Center (Windhaven) M
Indira Ramirez, 27 - paper acct 07/20/13 (driver) $18,838 - Universal Medical Services Corp (Windhaven) M
Julia Ricano Fernandez, 38 - staged acct 10/05/11 (passenger) $94,716 - Clarke Medical Services / Emoge Medical Services / New
Life Rehab Services (Allstate / United Auto) M
Tomas Alvarez Martinez, 47 - staged acct 10/05/11 (driver) $94,716 - Clarke Medical Services / Emoge Medical Services / New Life
Rehab Services (Allstate / United Auto) M
Eric Martis McCree, 41 - fake ins card (Occidental Fire & Casualty) O
Yeney Gonzalez, 25 - staged acct 05/06/11 (passenger) $50,000 - Baymeadows Injury Center, LLC (Geico / Progressive) J
Isael Gonzalez-Cordova, 27 - staged acct 05/06/11 (driver) $50,000 - Baymeadows Injury Center, LLC (Geico / Progressive) J
Alfredo Romero, 65 - staged acct 08/07/12 (passenger) $80,000 - Synergy Medical Wellness / Total Rehab & Wellness Center
(United Auto) B
Franck Assouman, 51 - jump-in 03/27/13 - $24,220 - Modern Medicine (State Farm / Windhaven) W
Marlene Ramirez, 50 - paralegal / false claim - $26,000 - (State Farm) M
Bessy Yamile Limas, 33 - staged acct 08/07/12 (passenger) $80,000 - Synergy Medical Wellness / Total Rehab & Wellness Center
(United Auto) B
Nicole Ann Willoughby, 25 - jump-in 07/11/13 - $7,611 - Cooper Chiropractic & Neurological Diagnostic Center (State Farm /
Windhaven) O
Sharnice Hoy, 29 - staged acct 08/07/12 (passenger) $80,000 - Synergy Medical Wellness / Total Rehab & Wellness Center (United
Auto) B
Santiago Enrique Prado-Torres, 26 - staged acct 05/06/11 (passenger) $50,000 - Baymeadows Injury Center, LLC (Geico /
Progressive) J
Yansell C Ugarde, 27 - clinic owner staged acct 10/13/12 (recruiter) $54,093 - LMG Medical / New Life Medical Center (Geico / State
Farm) M
Roberto Gonzalez, 46 - staged acct 10/13/12 (recruiter) $54,093 - LMG Medical / New Life Medical Center (Geico / State Farm) M
Todd M Norton, 38 – application fraud (Allstate) 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 5
Statewide PIP Arrests – July 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.
Oslay Acosta-Miguel, 37 - clinic owner / four staged accidents - $155,429 - Baymeadows Injury Center / Indian Rehabilitation
Center / Saint Jose Injury Center (Direct / Geico / Progressive / Sentry / USAA) J
Wales Alexis, 48 - false damage to vehicle / false injury - $10,502 - DISA Med (Direct General / Enterprise) O
Brian Andrew Wells, 26 - staged acct 10/2/13 (driver) $9,932 - Accident & Injury Clinic (State Farm) O
Patricia C Reis, 26 – application fraud (USAA) J
Lisvan Zayas, 34 - staged acct 09/19/11 (recruiter) $69,904 - B & A Diagnostics / Doctors Professional Medical Center / M & N
Rehabilitation Center (Geico / United Auto) M
Lisvan Zayas, 34 - staged acct 08/23/11 (recruiter) $17,366 - B & A Diagnostics / Clarke Medical Services / RER Medical (United
Auto) M
Kelvin Ortiz, 23 - staged acct 09/18/12 (driver) $32,738 - D & J Rehabilitation Center / Health and Wellness Services / Med Rehab of
Florida / YH Imaging (Esurance / Geico) M
Alexander Vasallo, 39 - staged acct 02/20/10 (driver) $49,287 (National Indemnity / Progressive) M
Emmauel Lundi, 34 – solicitation – Accumed Wellness and Rehab (Allstate) B
Emmauel Lundi, 34 – solicitation – Accumed Wellness and Rehab (Allstate) B
Leando Mortimer Dexter Payne, 42 - staged acct 07/21/11 (recruiter) $6,875 – Sunrise Medical Clinic (Enterprise Hertz /
Progressive) B
Jennifer Arlene Santiago Arias, 28 - staged acct 05/06/11 (driver) $50,000 - Baymeadows Injury Center, LLC (Geico / Progressive) J
Arrested in Apr 2012
Albert Potel, 72 - runner solicitation – Medical Center of the Palm Beaches (Gainsco) W
Arrested in Feb 2013
Joseph Demetrius Smith, 42 - sale of fake ins cards (Direct General / Seminole Casualty) T
Joseph McDuffy Smith, 42 – sale of fake ins card (Seminole Casualty) T
Demetric Marcus Smith, 23 – sale of fake ins card (Seminole Casualty) T
Arrested in Mar 2013
Josue Fernandez, 40 - staged acct 07/01/10 (recruiter) $26,636 - Care Resources Group (Progressive / Republic Western) M
Ydumy Perez, 34 - staged acct 07/01/10 (clinic employee) $26,637 - Care Resource Group, LLC (Progressive / Republic Western) M
Arrested in Apr 2013
Junel Basile, 35 - staged acct 11/06/11 (recruiter) $25,273 - Metro Chiropractic and Wellness Center (Geico) O
Arrested in May 2013
Alberto R Correa, 40 – staged acct 05/14/10 (driver) $32,492 - Care Resources Group (State Farm / Western Republic) M
Arrested in June 2013
Ydumy Perez, 34 – staged acct 05/14/10 (recruiter) $32,492 - Care Resources Group, LLC (State Farm / Western Republic) M
Arrested in June 2014
Kevin Shane Godwin, 34 - application fraud (Progressive) TL
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 2014
Page 6
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
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
WEST CENTRAL REGION
Counties: Charlotte, Collier, DeSoto, Glades, Hardee, Hendry,
Hernando, Hillsborough, Lee, Manatee, Pasco, Pinellas, Polk,
Sarasota
Tampa Field Office - 813.972.8602
Capt. Michael BYRNE
Lt. Carlos ROSARIO
Fort Myers Field Office - 239.278.7527
Lt. Mark FRITZ
Copy goes her.
Editor’s
Corner
On page 1, another chiropractor is convicted
in Operation Sledgehammer and sentenced to
federal prison.
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.
EAST CENTRAL REGION
Counties: Brevard, Lake, Orange, Osceola, Seminole, Volusia
Orlando Field Office - 407.835.4402
Capt. Glen HUGHES
Lt. Laquanda GREEN
Lt. John SAVINO
SOUTH CENTRAL REGION
Counties: Broward, Highlands, Indian River, 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
Lt. Evangelina BROOKS
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