“Those arrested included clinic owners,

managers and other employees, and

participants in staged crashes.”

Volume 1 - Issue 12

June 2011

Following a five month undercover investigation into staged accidents and insurance fraud, the Hillsborough County Sheriff’s Office conducted an arrest sweep and executed search warrants at accident clinics in Tampa.

―Operation No Pain No Gain‖ resulted in arrest warrants for 53 people, and search

warrants at four accident clinics in Hillsborough County. Those arrested included clinic

owners, managers and other employees, and participants in staged crashes. The clinics

searched were Doctor Florida Rehabilitation; Healing Touch; Injury Health Care

Therapy; and Recovery Rehabilitation Services.

Healing Touch had arrest warrants issued for manager Ruben Borrego Izquierdo, two

clinic employees and 33 others. Healing Touch was incorporated in September 2009,

and received an exemption from the Agency for Health Care Administration (AHCA).

Neither manager Ruben Borrego Izquierdo nor the former manager are licensed in any

capacity with the Department of Health (DOH), while Chiropractor Gregory Santos

Rodriguez was removed from the corporation in February 2011. One of the troubling

aspects of this investigation was that seven of the subjects charged for their participation

in staged accidents involved at least nine children in their crashes.

Recovery Rehabilitation Services had arrest warrants issued for owner Liza Pereyra, two

employees and organizer Angel Leon. Recovery Rehabilitation Services is licensed with

AHCA and was incorporated in February 2009. Earlier this year, owner Pereyra had

appeared before the Hillsborough County Commission to speak on an ordinance that

would tighten regulation of accident clinics, arguing the cost of the new rules would

create problems for small businesses such as hers.

Doctor Florida Rehabilitation had arrest warrants issued for eight people, including its

owner, Alejandro Ruiz, manager Yordan Ruiz, two employees and organizer Wershon

Cameiro. Doctor Florida Rehabilitation was incorporated in March 2004, and is not

licensed by AHCA. Owner Alejandro Ruiz Calzadilla is not licensed by DOH in any

capacity. The clinic was formerly known as United Gables Medical Center.

Injury Health Care Therapy had arrest warrants issued for five subjects, including two

clinic employees and organizer Heriberto Larriuz. Injury Health Care Therapy was

incorporated in August 2003, and is licensed by AHCA.

Please see No Pain No Gain on page 2

INSIDE THIS ISSUE

1 HCSO Arrests 53

2 PIP Clinic Busts in

Orlando and Tampa

3 PIP Fraud in the

News

4 A Conversation

with Ron Poindexter

5 Statewide Arrests

7 Statewide Contacts

HEADER HERE Hillsborough County Sheriff’s Office Seeks To

Arrest 53 For PIP Fraud at Four Clinics

June 2011 Page 2

DIF Busts PIP Clinics in Orlando and Tampa

In Orlando, the Division of Insurance Fraud arrested three employees of Bethel Health & Rehab Center for insurance fraud. The manager, Jean Fritz Petiote, was also arrested for organizing a staged accident. DIF began their investigation after a patient reported that the clinic allegedly fabricated documentation related to her treatment to submit to her insurance company.

Two massage therapists who previously worked at Bethel admitted that Petiote, and two other employees, Oliver Steven Zidor and Myrlene Saint Preux, pressured them to sign and fabricate treatment forms to submit to insurance companies.

Petiote also allegedly organized a staged accident offering participants $1,000 if they went to his clinic. Patricia Placek, a massage therapist at a different clinic, and Alejandro Estrada, were charged as participants in the staged crash.

―These arrests represent the kind of manipulation and fraud that takes place in accident clinics throughout our state and drive up auto insurance costs for all Floridians,‖ said CFO Jeff Atwater. ―I am committed to cracking down on PIP fraud, putting these thieves behind bars and finding new ways to combat this pervasive crime.‖

Petiote his brother, Zidor, Saint Preux and Placek have been arrested. DIF is seeking Estrada. Among the charges are staging an accident, insurance fraud, grand theft, patient brokering and organized scheme to defraud. Possible sentences, if convicted, range from two years for those charged with staging an accident to up to 30 years in prison for organized scheme to defraud.

Meanwhile, in Tampa, Luis Consuegra Borges, owner of American Relax Center, and massage therapist Solianid Rivera Lopresto, were arrested for patient brokering and insurance fraud.

This investigation began when detectives from the Florida Department of Financial Services’ Division of Insurance Fraud (DIF), obtained testimony from three witnesses that Borges and Lopresto were paying individuals to claim they were receiving treatment at the clinic and then submitting fraudulent billings to insurance companies. Undercover fraud detectives infiltrated the clinic and witnessed the signing of false treatment forms under the direction of Lopresto. These forms were later submitted to carriers for payments. PIP carriers USAA Insurance, Equity Insurance and United Auto Insurance assisted DIF in this case.

―This is a perfect example of the blatant fraud schemes that operate in our streets every day, driving insurance premiums up for all Floridians,‖ said CFO Atwater. ―We must continue to fight these fraud artists and put them behind bars.‖

Also arrested was Omar Lorenzo Aguero after he allegedly solicited undercover detectives to treat at Pain Solution, LLC, in Tampa, following a staged accident. Two clinic employees, massage therapist Neyvis Mendez and secretary Ania Horta, were also charged for allegedly fabricating documents for treatment in excess of $16,000, that was not provided, but billed to pip carriers 21st Century and GMAC. A search warrant was also executed at Pain Solution, which was issued an exemption by AHCA in 2010.

DIF was assisted in each of these investigations by NICB.

No Pain No Gain – from page 1

HCSO has been investigating this type of fraud since September 2009, and estimates that the potential loss to insurance companies in this case could be several million dollars.

Tampa leads the State of Florida in staged accident referrals, moving ahead of Miami as the fraudulent activity shifted to the Bay area.

In April 2010, HCSO arrested 55 people in connection with an ring that staged nearly three dozen crashes. Some were charged with setting up the collisions while others were accused of running two clinics.

HCSO was assisted in the investigation by DIF, NICB and the Hillsborough County Office of the State Attorney.

A complete list of persons charged in Operation No Pain No Gain is on page 6.

If you need further information regarding this case, go to the HCSO website at http://

www.hcso.tampa.fl.us/About-HCSO/Press-Releases/Releases/2011/May/11-156.aspx.

Chief Deputy Jose Docobo, left, with

NICB’s Ron Poindexter

Page 3 The PIP Source

Some PIP Reforms Survive Tough Legislative Session

CFO Jeff Atwater said legislative reforms help keep money in the pockets of Floridians by better protecting them from financial fraud and harm. Key reforms he pursued this Session include:

Resources to Fight Financial Fraud and Better Protect Consumers (provisions contained in HB 1087 and SB 1150):

Tougher Penalties: Reforms include civil penalties for crooks convicted of auto insurance fraud. The Legislature is also expected to act on a new requirement for police officers to list all passengers in accident reports to eliminate fraud perpetrators from later claiming passengers in order to fraudulently bill for medical treatments.

Additional Prosecutors: Additional funding was appropriated for fraud prosecutors in Tampa and Miami, which have been cited by the National Insurance Crime Bureau as two of the top five cities in the country for questionable medical claims associated with staged accidents. Lawmakers also granted authority to the CFO to pursue grants and donations to further bolster efforts to combat financial fraud.

―The costs of PIP fraud are passed down to all of us through increased auto insurance premiums,‖ said CFO Atwater. ―These costs are an unacceptable burden on the finances of Floridians who are already struggling. My office is committed to continuing to fight this and other types of fraud.‖

―PIP fraud has become an epidemic in the Tampa Bay area, and the additional resources provided by the Legislature will help us bring these criminals to justice,‖ said Hillsborough County State Attorney Mark Ober. ―I appreciate the efforts of CFO Atwater and the legislature in bringing these additional prosecutors to the Tampa Bay area.‖

―By providing prosecutors with greater staff and resources to focus on the almost invisible crime of insurance fraud, we can more effectively impact those criminals who are constantly reaching into the pockets of every citizen of the State of Florida. I want to thank our Chief Financial Officer, Jeff Atwater, for his leadership on this issue and our Legislature for their deep commitment to fighting this insidious crime,‖ said Miami-Dade State Attorney Katherine Fernandez Rundle.

In related legislation, the Legislature passed tighter licensing requirements for insurance agents, wherein persons who have committed a felony related to the financial services business will be permanently barred from obtaining an insurance agent, adjuster or agency license. ―Florida has the largest senior population in the nation, and with that comes a responsibility to protect them, and other hard-working Floridians, from financial harm,‖ said CFO Atwater.

More dedicated prosecutors is great news for Florida citizens; bad news for the fraudsters.

DIF Arrests Massage Therapists in Accident Clinic Fraud Schemes

The Division of Insurance Fraud arrested massage therapist Olinda Rodriguez for her alleged involvement in a fraudulent scheme at Universal Rehab Med Group, located in Lake Worth, which totaled nearly $98,000 in bills to Allstate. In last month’s PIP Source, we reported on Operation Look Out, in which eight patients of the clinic were arrested for their participation in the scheme. Rodriguez is the first clinic employee to be charged.

Also arrested was massage therapist Tania Puron for her involvement in a fraudulent scheme at Bayshore Chiropractic in Naples, in which she allegedly fabricated documentation for treatment of a patient who was out of the country. Bristol West was billed $1,526 for treatment that was not provided.

Dennis Russo Named To Lead NICB’s Central Florida Major Medical Fraud Task Force

We congratulate Supervisory Special Agent Dennis Russo, who was promoted in May to lead the National Insurance Crime Bureau’s Central Florida Major Medical Fraud Task Force, located in Tampa. It focuses its investigative resources in Tampa, St. Petersburg, and Orlando. This includes the beach communities on the west coast of Florida, in Pinellas and Pasco Counties, through the communities east of Orlando to Cape Canaveral and Titusville, south of Jacksonville and north of Lake Okeechobee. NICB started the second Task Force in August 2010, in response to the increase in fraud in that region, with the goal of copying the achievements of the South Florida Medical Fraud Task Force that began in 2002.

Russo, who retired from Florida’s Department of Law Enforcement (FDLE), has been with NICB since 2008. SSA Fred Burkhardt, who had been pulling double duty supervising both task forces, offered these words of wisdom to Russo, ―Cancel all your time off as fraud never sleeps. Seriously, Communicate, Communicate, Communicate. To make a difference, you and your team must be a valuable resource to Member Companies and Law Enforcement‖.

We echo those sentiments, and wish Dennis Russo the best of luck in his new role.

PIP FRAUD – In The News

Page 4 June 2011

This month we introduce our newest feature, ―A Conversation With‖, in which we have a candid discussion with individuals involved in the fight against PIP fraud.

Our goal is to share information and viewpoints that we feel would be beneficial to those involved in fighting fraud. We have some very interesting topics in the works, and kick off this new column with a good friend as our first guest.

Ron Poindexter was appointed as Director of Operations for Area 5 of the National Insurance Crime Bureau (NICB) in June 2001. More than 1,000 insurance companies are members of the NICB, a not-for-profit organization whose mission is combating insurance fraud through information analysis, criminal investigation support, training and public awareness. Ron supervises approximately twenty five special agents and analysts in the Southeast United States and Puerto Rico.

In his area of supervision, Ron also oversees Medical Fraud Task Forces in both South and Central Florida. These highly successful task forces work with law enforcement and insurance companies to investigate organized rings that are fraudulently billing insurance companies through patient brokering, staged accidents, and other related insurance scams that take advantage of Florida’s automobile ―No-Fault‖ laws.

TPS - What do you feel is the greatest success for NICB in Florida? RP - The establishment of the two Major Medi-cal Fraud task forces, first in 2002 in South Florida and then in 2010 in Central Florida. This allows the collective resources of the Division of Insurance Fraud, NICB, Insurance SIU’s, and other law enforcement agencies to combat PIP fraud.

TPS - Do you think the general public knows enough about insurance fraud, and what can NICB and law enforcement do to advance public awareness? RP - Generally the public is mostly unaware of insurance fraud, how-ever by continuing to use media outlets to send our anti-fraud message out we may see a future return on our investment in reduce / prevent this type of crime. NICB and the insurance industry have stepped up the efforts to broaden public awareness in the last several years. These efforts include billboards, radio spots, print media, bus shelter posters and television.

TPS - You have been working in some capacity involving insurance fraud for 15 years now. What do you be-lieve is the greatest challenge going forward in the fight against PIP fraud? RP - Learning how to use all the data and information that is available with technology to provide information that contains actionable evidence to the insurance companies so that they may make informed claims decisions prior to the claims being paid and the crime reaching epidemic levels. Information is the key for the future and is our greatest challenge on how to use it.

TPS - What has been your greatest accomplishment in the fight against insurance fraud? RP - The Public Awareness and media exposure I have brought to light on the issues surrounding PIP and insurance crimes and how it affects all insurance consumers.

Prior to joining the NICB, Ron Poindexter served as Director of the Florida Department of Insurance’s Division of Insurance Fraud (DIF) from May 1996 until June 2001. At that time the Fraud Division had a staff of 171, of which 121 were sworn law enforcement investigators, located throughout Florida. During his tenure, the Division led the nation in fraud prosecutions and criminal convictions according to a study by the Coalition Against Insurance Fraud.

Ron served twenty-seven years with the Hillsborough County Sheriff’s Office in Tampa, Florida. He rose to the rank of Colonel, Chief of Law Enforcement Operations, and retired in March 1996. He served three years in the United States Army as an Intelligence Analyst. Ron is also a graduate of the FBI National Academy.

We thank Ron Poindexter for his continuing leadership at NICB in the fight against fraud, for his many years of dedicated law enforcement service to the State of Florida, and his participation in our first installment of ―A Conversation With.‖

A Conversation With – Ron Poindexter

Page 5 The PIP Source

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 Captain Smith.

Luis Consuegra Borges, 38 – clinic owner / patient brokering - $15,000 – American Relax Center (USAA) T

Solianid Lopresto, 32 – clinic employee - $15,000 – American Relax Center (USAA) T

Efrain Vizcaya-Cartgena, 38 – PIP patient fake injury (pedestrian) $9.930 – Hess Spine & Medical Centers of Brandon

(State Farm) T

Patricia Placek, 50 – staged acct 02/14/10 (passenger) $36,360 – Bethel Health & Rehab Center (Direct General) O

Satirinov Stanislov, 32 – staged acct 01/19/02 $15,077 (State Farm) T

Myrlene Saint Preux, 34 – clinic employee $27,548 – Bethel Health & Rehab Center (Direct General) O

Luz Maria Hernandez Aguila, 36 – staged acct 07/20/10 (driver) $57,773 – Psychologist Technology / V & R Medical

(Allstate / Progressive) M

Agnes Morris, 53 – false injury claim - $330,000 (Geico) J

Luther Crispin, 34 – clinic employee / patient brokering - $27,771 - Wellness Center of Tampa (Sentry) T

Glenn Moore, 30 – clinic employee / insurance fraud - $660 - Whitfield Chiropractic & Massage Clinic (Bristol West) T

Maniacline Francois, 23 – clinic employee - $9,335 - Whitfield Chiropractic & Massage Clinic () T???

Carlos Rodriguez, 35 – fake ins card (Shelly Middlebrooks & O’Leary) W

Ileana Calvo, 46 – clinic owner / unlicensed clinic - $45,534 – All Star Rehabilitation Center (Allstate / State Farm / United Auto) M

Omar Lorenzo Aguero, 65 – staged acct 12/10/10 (recruiter) $16,868 – Pain Solutions, LLC (21st Century / GMAC) T

Neyvis Mendez, 25 – clinic employee - $16,868 – Pain Solutions, LLC (21st Century / GMAC) T

Ania Horta, 38 – clinic employee - $16,868 – Pain Solutions, LLC (21st Century / GMAC) T

Sanford Marcus, 72 – crash reports – Pines Total Health Center M

Joseph Chrispin, 54 – crash reports – Pines Total Health Center M

Olinda Rodriguez, 37 – clinic employee - $6,020 – Universal Rehab Medical Group (Allstate) W

Djeneira Williams, 35 – staged acct 02/20/10 (driver) $45,045 – Palm Beach Chiropractic Wellness & Rehab (Geico) W

Michael Aristide, 31 – staged acct 02/20/10 (recruiter) $45,045 – Palm Beach Chiropractic Wellness & Rehab (Geico) W

Michael Aristide, 31 – staged acct 11/24/10 (recruiter) $31,789 – Good Care Chiropractic Center / Palm Beach

Chiropractic Wellness & Rehab (Assurance America / Geico / Republic Western) W

Farah Pierre, 25 – staged acct 05/03/10 (driver) $0 – (RepWest) W

Djeneira Williams, 35 – staged acct 11/24/10 (passenger) $29,000 - Palm Beach Chiropractic Wellness & Rehab (Geico) W

Jean Gerald Roc, 42 – staged acct 05/03/10 (recruiter / passenger) $8,587 - McClellan Chiropractic (RepWest) W

Albert Benson, 25 – staged acct 08/22/09 (driver) $3,421 - Dr Gregory Moses (Republic Western) W

Christopher Bell, 38 – staged acct 02/20/10 (recruiter) $45,045 – Palm Beach Chiropractic Wellness & Rehab (Geico) W

Tania Puron, 36 – clinic employee = $1,526 – Bayshore Chiropractic (Bristol West) F

Tekeira Jones, 21 – staged acct 11/24/10 (driver) $31,789 - (Republic Western) W

Wadson Benjamin, 29 – staged acct 08/22/09 (passenger) $6,445 - Dr Gregory Moses (Republic Western) W

Joseph Valentin, 40 – staged acct 05/03/10 (recruiter / driver) $28,333 - West Palm Beach Wellness and Rehabilitation

Center (RepWest) W

Jose Fernando Ruiz, 35 – staged acct 01/03/10 (driver) $8,405 – Quality Therapy Center (Omni) T

Christopher Crenshaw, 30 – staged acct 08/22/09 (passenger) $4,140 - Dr Gregory Moses (Republic Western) W

Office Code –B (Broward) F (Ft Myers) J (Jacksonville) M (Miami) O (Orlando) TL (Tallahassee) T (Tampa/St Pete) W (West Palm Beach)

Statewide PIP Arrests – May 2011

Page 6 June 2011

Listed below are the names of the suspects who were arrested and/or had warrants issued against them as part of Operation No Pain No Gain by the Hillsborough County Sheriff’s Office. If you need additional details on any of these arrests, please contact HCSO.

Healing Touch, LLC Recovery Rehabilitation Services

Ruben Borrego, 36 – Office Manager Liza Pereyra, 28 – owner

Lollet Perez, 25 - Billing Clerk Jorge Alonso, 41 – therapist

Diana Vaga, 20 – Receptionist Ciara Salgado-Alvarado, 26 – receptionist

Michael Clothen, Jr, 56—patient Angel Leon, 35 – organizer

Tremeka Porter, 33—patient

Guillermina Lugo, 35—patient Doctor Florida Rehabilitation

Rose Rodriguez, 43—patient Alejandro Ruiz, 37 – owner

Flordelles Santiago, 40—patient Yordan Ruiz, 26 – manager

Ana Rodriguez, 31—patient Wershon Cameiro, 37 – organizer

Teresa Canals, 41—patient Dayana Marrero, 26 – receptionist

Jonathan Philogene, 18 - patient Rafael Frias, 30 – therapist

Marien Garcia, 38 - patient Katia Lippincott, 31 – suspect

Rafael Fee, 39 - patient Halandra Correa, 30 – suspect

Leidy Vigoa, 18 - patient Alesandro Oliveira, 31 – patient

Arcides Valdez, 66 - patient

Jose A Diaz, 21 – patient Injury Health Care Therapy

Yunior Diaz, 33 - patient Jay Morillo, 24 – therapist

Maricela Taboada, 57 - patient Yamilys Carbo, 39 - receptionist

Orlando Noda, 38 – patient Heriberto Larriuz, 37 – organizer

Manuel Vigoa, 34 – patient Juan Rivera, 37 – suspect

George Lopez, 47 – patient Luis Santiago, 40 – suspect

Miguel A Medina, 26 – patient

Yenia Dominguez, 21 – patient

Ivette Salvador, 59 – patient

Eric Diaz, 30 – patient

Marcos A Diaz, 39 – patient

Yoandra Rodriguez, 39 – patient

Elena C Zayas, 65 – patient

Amarelyes Del Sol, 21 – patient

Nieves Naranjo, 47 – patient

Nicole Lopez-Matos, 22 – patient

Leonardo Rimblas, 22 – patient

Frank Garcia, 29 – patient

Dayana Cabrera, 23 – patient

Jennifer Serrano, 29 – patient

Rosendo Hernandez, 26 – patient

Statewide PIP Arrests – May 2011

Copy goes her. Editor’s Corner

This month’s cover story involves a case that we

hope will have a big impact on fraud in the Tampa

Bay area. Good job HCSO!

We also introduce a new feature, “A Conversation

With”, and our first guest is NICB’s Ron Poindexter.

Check it out on page 4.

We want to thank the Coalition Against Insurance

Fraud, Florida Insurance Council (FIC), the Fraud

Alert Team of Tampa Bay, the Latin American

Association of Insurance Agencies (LAAIA), the

National Insurance Crime Bureau (NICB), the

Sunshine Alliance to Erase Fraud, and especially

DFS’ own Ashley Mayer, who worked so hard on

PIP legislation in Florida this year. Unfortunately,

we did not get all that we believe was necessary to

advance the fight against PIP fraud, but we will try

again next year.

Page 7 The PIP Source

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 Captain Buddy HAND

Lt. Joseph HOLOKAN

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 Captain Brian McCOY

Lt. Kevin JONES

WEST CENTRAL REGION

Counties: Charlotte, Collier, DeSoto, Glades, Hardee, Hendry, Hernando, Highlands, Hillsborough, Lee, Manatee, Pasco, Pinellas, Polk, Sarasota

Tampa Field Office - 813.972.8602 Captain Michael BYRNE Lt. Carlos ROSARIO

Lt. Darrell WILSON

Fort Myers Field Office - 239.278.7527

Lt. Mark FRITZ

EAST CENTRAL REGION

Counties: Brevard, Indian River, Lake, Martin, Okeechobee, Orange, Osceola, Palm Beach, Seminole, St. Lucie, Volusia

West Palm Beach Field Office - 561.837.5601 Major Simon BLANK Captain Glen HUGHES

Lt. Evangelina BROOKS

Orlando Field Office - 407.835.4402

Lt. Jewel CAMERON

SOUTH REGION

Counties: Broward, Dade, Monroe

Miami Field Office - 305.536.0302 Captain Steven SMITH Lt. Violeta SERRANO Lt. John DYGON

Lt. Stanley JEAN-FELIX

Plantation Field Office - 954.321.2902

Lt. Bill LEE

South Florida Major Medical Fraud Task Force Supervisory Special Agent Fred Burkhardt 954-329-7427

Central Florida Major Medical Fraud Task Force Supervisory Special Agent Dennis Russo 863-967-6904

A good place for a photo or graphic

Statewide PIP Contacts