Chiropractor Adams served as named

owner of the clinics, although the other defendants would maintain financial

control of the businesses.

Volume 3 - Issue 1 July 2012

Eleven defendants, including a licensed chiropractor and massage therapist, were charged in a multi-million dollar staged accident fraud scheme in Palm Beach County. In total, the U.S. Attorney’s Office has charged 26 defendants in less than 12 months as part of Operation Sledgehammer. Chiropractor Jennifer Adams, 38; massage therapist Moises Madrid, 40; Obelio Rodriguez, 43; Maria Molina, 41; Yuliet Tapanes, 25; Dagoberto Milian Lopez, 56; Amaurys Hernandez, 40; Gilda Garcia, 49; Javier De La Caridad Troncoso, 45; Ana Ovando, 42; and Janice Velez, 39, were each charged with one count of conspiracy to commit mail fraud. Defendant Rodriguez is at large and considered a fugitive. The defendants allegedly unlawfully profited by submitting fraudulent PIP claims for chiropractic and massage therapy treatments for individuals who had participated in staged automobile accidents. The defendants recruited individuals to participate, instructed them on how to conduct accidents and what to tell responding police officers, insurance company representatives and independent medical examination (IME) physicians. They also instructed them on how to collect police reports and what clinic to go to for treatment, even though the participants did not need treatment. Chiropractor Adams served as the named owner of the clinics, although the other defendants maintained financial control of the businesses. The clinics involved in the scheme were OVY Rehabilitation Medical Center, HHR Rehab Medical Center, Florida Chiropractic Center of Palm Beach Corp, Chiropractic Office of South Florida, Florida Mango Massage Therapy Center, New York Medical and Rehab Center and KCC. Wifredo A. Ferrer, United States Attorney for the Southern District of Florida, commended the investigative efforts of the FBI, IRS-CID, Defense Criminal Investigative Service, Florida Department of Financial Services Division of Insurance Fraud, and issued a special thanks to the National Insurance Crime Bureau (NICB) for its assistance in this investigation. The cases are being prosecuted by Assistant U.S. Attorney A. Marie Villafaña. Victim companies include 21st Century, Affirmative, Agency, AIG National, Allied Property & Casualty, Allstate, American Vehicle, Ameriprise, Apollo Casualty, Assurance America, Bristol West, Castlepoint, Corvel, Direct General, Esurance, Farmers, First Acceptance, Florida Farm Bureau, Geico, GMAC, Granada, Hallmark, Infinity, Infinity Indemnity, Kingsway Amigo, Liberty Mutual, Mapfre, Mendota, Mercury, Metlife, MGA, New Hampshire Indemnity, Occidental Fire & Casualty, Ocean Harbor, Peak Property & Casualty, PGCS, Praetorian, Progressive, Redland, Safeco, Security National, Seminole Casualty, Star Casualty, State Farm, Travelers, Unitrin, Victoria Fire & Casualty, and Windhaven. You can find the full press release at http://www.justice.gov/usao/fls/PressReleases/120618-01.html.

INSIDE THIS ISSUE

1 New Sledgehammer

Arrests

2 FHP Launches

Staged Crash Page

3 PIP Fraud News

4 FIFEC Awards

6 Statewide Arrests

7 Statewide Contacts

HEADER HERE Chiropractor Among Latest Arrests in Operation Sledgehammer Case

Page 2 July 2012

The Florida Highway Patrol launched a new webpage on its site called “Protect Yourself Against Staged Crashes.”

The new site provides information, videos and links from its partners the Florida Division of Insurance Fraud (DIF) and the National Insurance Crime Bureau (NICB) regarding staged accidents and insurance fraud. Included are brochures from both DIF and NICB and data forecast reports from NICB.

Included on the new page are three informative videos of caused crashes, including the swoop and squat, the panic stop and the drive down. The Florida Highway Patrol demonstrated these crashes during the PIP fraud legislative push earlier in the year. Check out these links to see more: http://www.putthebrakesonaccidentfraud.com/

http://www.wtsp.com/news/article/239043/19/Police-crash-cars-to-demonstrate-Floridas-growing-problem-with-accident-fraud

http://www.youtube.com/watch?v=UM0VVGCXiB8

http://www.youtube.com/watch?v=UyfxvUhF198

The new site also posts the hotline numbers for NICB (1-800-TEL-NICB) and DIF (1-800-378-0445). You may be eligible for a reward of up to $25,000 for reporting fraud to DIF.

You can visit the new website at http://www.flhsmv.gov/fhp/misc/StagedCrashes.htm.

FHP Launches New Webpage - “Protect Yourself Against Staged Crashes”

Page 3 The PIP Source

Massage Therapist Arrested as Straw Owner in Miami Clinic Fraud Case Maritza Ruano, 53, a licensed massage therapist, was arrested last month for her role in Operation Dark Horizon. Ruano allegedly posed as the owner of Coral Way Rehabilitation Services so the true owner, Daisy Sarmiento, did not have to obtain a clinic license from the Florida Agency for Health Care Administration (AHCA). Ruano, who has been licensed as a massage therapist in Florida since 2004, is also listed as an officer of at least three other clinics, including Maritza’s Healing Hands, LLC, M J Medical Center and 5757 Medical Rehabilitation, all in Miami-Dade County. Along with Coral Way Rehabilitation Services, MJ Medical Center and 5757 Medical Rehabilitation operated with an exemption from AHCA.

Ruano is the 28th defendant to be charged by the Miami-Dade State Attorney’s office in the Dark Horizon case.

PIP Fraud Kidnapping Case Update The second defendant in the previously reported (March and May 2012 issues of the PIP Source) kidnapping case entered a plea last month in a Miami-Dade court. Alberto Montalvan Rey, 25, was sentenced to 2 years in prison and 3 years probation for his role in the strong-arm tactics which resulted in both he and co-defendant Yasmani Marquez being shot by a staged accident participant. In the case, the participant from a May 2011 staged accident was taken to a clinic where he was allegedly threatened and accosted about money. When the participant could not satisfy the clinic’s demands, he was taken away in a car and was under the belief that the driver and accomplice were going to kill him. Instead, the participant pulled out his own handgun and shot Marquez and Montalvan Rey.

Co-defendant Marquez was previously sentenced to five years in state prison.

CFO Jeff Atwater Speaks at FIFEC in Orlando Florida Chief Financial Officer Jeff Atwater was the keynote speaker at the 2012 FIFEC Conference held last month in Orlando. CFO Atwater spoke about his efforts since taking office in 2011, highlighting the more than 1,700 arrests and $155 million in court-ordered restitution. “These are real results that continue to help stabilize Florida’s economy as a whole and increase consumer confidence throughout our state,” CFO Atwater said. “We could have no stronger team in the fight against fraud in Florida than the one we have.”

Inflated auto-insurance claims? Law firm denies allegations One of central Florida's best-known law firms and a prominent Brevard County surgeon may have had an "across-the-board agreement" in recent years to inflate by millions of dollars the charges for spinal surgeries in auto-accident claims, according to insurance-company allegations that have surfaced from a pair of routine personal-injury lawsuits.

Dan Newlin denied State Farm's allegation that Morgan & Morgan sent clients to surgeon Ara Deukmedjian in exchange for him agreeing in advance to accept less than the fees incorporated in the firm's lawsuits. He clarified that he had little knowledge of how lawsuits played out because his job had been to attract new clients, who were then assigned to other Morgan & Morgan lawyers.

Doctors routinely agree to reduce their medical fees during negotiations to settle cases based on the circumstances of each lawsuit. But lawyers are not allowed to intentionally overstate medical costs in lawsuits, said Amy Mashburn, a University of Florida legal-ethics professor who is not familiar with the Morgan & Morgan lawsuits. "That's fraud on the court, and it's a breach of the lawyer's professional ethics," Mashburn said.

Neither of the personal-injury lawsuits has gone smoothly. The federal judge, dissatisfied with Deukmedjian's responses during depositions, said the doctor was showing "a lack of respect for the authority of the court." As a result, in an extremely rare move, the judge has ordered that the next deposition be held in the courthouse, where he can preside if needed.

Capt. Steve Smith would not comment on whether an investigation is under way. He did say that excessive cooperation between doctors and lawyers generally has been a concern of the agency's. "Some of the problems we've had are doctors and lawyers probably working too closely together," Smith said. "They have a plan in place to go after the bowl of money ... where the priority is enriching themselves rather than taking care of the patient, who is secondary — or a means to the end."

To view the full article by Kevin Spear, please click here: http://articles.orlandosentinel.com/2012-05-27/business/os-auto-insurance-inflated-claims-20120527_1_state-farm-morgan-morgan-firm.

PIP FRAUD – In The News

Page 4 July 2012

The 20th anniversary of FIFEC was a tremendous success. With nearly 740 attendees, the annual conference was abuzz with the latest information about insurance fraud in Florida. But one of the big stories this year was the award nominations. This year saw the addition of four new categories, and also a record number of 26 nominees. Here are the 2012 FIFEC award winners and nominees:

Insurance Investigator of the Year Jeff Phifer, Allstate, was this year’s winner. Other nominees included John Oral, Esurance; Randy Gibson, Geico; Carlos Torres, Infinity and Linda Hanley Armstrong, State Farm.

Law Enforcement Detective of the Year Raymond Gonzalez, Miami Police Department, was this year’s winner (not pictured due to his undercover status). Other nominees included Robert Batista, Dwight Murphy, John Savino, Miguel Mora, Rafael Delgado and Oscar Sigler, Division of Insurance Fraud and Victor Chica and Julie Medico, Cape Coral Police Department.

The Jerry Zappolo Distinguished Service Award Scott Dutton was this year’s winner. Also nominated were Blanca Aparicio, United Automobile and Kevin Beckner, Hillsborough County Commissioner.

The four new award categories for this year were:

Insurance Attorney of the Year Crystal Broughan, Allen, Dyer, Doppelt, Milbrath & Gilchrist, PA, was this year’s winner. Other nominees included Anthony Parrino, Reynolds Parrino Spano, PA; Steven Manno, Andrews & Manno, PA; Frank Goldstein, Goldstein Law Group; Scott Dutton, Dutton Law Group and Miguel Roura and Peter Nayrouz, Law Firm of Banker, Lopez & Gassler.

Insurance Analyst of the Year Wendy Sassman, United Automobile, was this year’s winner.

Law Enforcement Analyst of the Year Lori Rodabaugh, Division of Insurance Fraud, was this year’s winner. Other nominees included Lorie Wiese, also from the Division of Insurance Fraud.

Law Enforcement Prosecutor of the Year Juliana Millon, Miami-Dade State Attorney’s Office, was this year’s winner. Other nominees included Ann Marie Villafana, United States Attorney’s Office in Palm Beach County.

Special Recognition Award Commissioner Kevin Beckner, Hillsborough County Commission, was given special recognition for his leadership and support in getting the county ordinance passed last year in Hillsborough County to combat PIP fraud.

We congratulate all the winners and nominees for their dedication and efforts in the fight against insurance fraud.

2012 FIFEC Awards Announced in Orlando

Jeff Phifer

Crystal Broughan

Wendy Sassman

Lori Rodabaugh Kevin Beckner Juliana Millon and her co-workers at the Miami-Dade State Attorney’s Office

Scott Dutton

Page 5 The PIP Source

Check out the latest Most Wanted at http://www.myfloridacfo.com/PressOffice/MostWanted/.

Most Wanted: Fugitive

How You Can Help Fight Insurance Fraud in Florida Last year, the Florida Legislature created a fund to which anyone can contribute to the fight against insurance fraud by making a donation, gift or grant to the Insurance Regulatory Trust Fund. The proceeds will be used by the Division of Insurance Fraud to hire additional dedicated prosecutors and insurance fraud detectives, as well as fund anti-fraud programs around the state. This is an exciting program that we believe will have a substantial impact on insurance fraud in Florida.

Payments should be made payable to: The Department of Financial Services (Please write “Code 1201F” on the memo line of your check.) The mailing address is:

Department of Financial Services

Revenue Processing Section

P.O. Box 6100

Tallahassee, FL 32314-6100

The donor should include correspondence with the check indicating it is a grant or donation for the Division of Insurance Fraud. The letter should include his / her intent that the grant or donation be deposited to the Insurance Regulatory Trust Fund and used for anti-fraud efforts. Also include a statement that if the donation is to be used for any other purpose, the funding should be withdrawn.

If you have any questions, you can contact us at the PIP Source and we will get an answer. Thank you for your help.

Join the Fight. Be a part of the Solution. Make a Difference.

Vladimir Lopez Hispanic Male, 38 years old

6’00”, Brown Eyes, Brown Hair

Warrant Information: Warrant/Case Number: 209B-MM-113865

Monetary Structuring Transactions, Mail Fraud and Conspiracy to Commit Mail Fraud

Details:

The Florida Department of Financial Services, Division of Insurance Fraud is attempting to locate Vladimir Lopez in reference to the outstanding warrant.

Lopez was indicted by the U.S. Attorney’s Office in July 2011 as part of Operation Sledgehammer for his involvement in a massive insurance fraud / staged accident ring operating in Palm Beach County.

If you know where Lopez can be located, please contact the Division of Insurance Fraud at 800-378-0445.

Page 6 July 2012

Statewide PIP Arrests – June 2012

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.

Jose Rodriguez, 29 - staged acct 02/01/10 (passenger) $122,351 – Pompano Family Chiropractic (Progressive / Security National) B

Iliana Londono, 40 - statement in support of jump-ins - $0 (Geico) B

Marcel S Holman, 22 - fake ins card (Geico / Ocean Harbor) W

Gardy Jeune, 54 - clinic owner – US Chiromatrix (Progressive) O

Lazaro Baldomero Almeida Pareda, 64 - massage therapist - $710 - Performance Health & Wellness (Allstate) W

Pascal Charite, 32 - PIP patient - $10,000 (Farmers) F

Charles A Parker, 31 - jump-in - $0 - PMC Deerfield (Allstate / Geico) W

Pedro Rodriguez, 53 - staged acct 04/16/09 (driver) $43,522 - Better Life Medical Center (State Farm) M

Ericka N West, 38 - fake ins card (MGA) W

George Thompson, 32 - false claim (Progressive) T

Yuliet Tapanes, 25 - clinic employee - Florida Mango / New York Medical and Rehab Center () W

Moises Madrid, 40 - massage therapist - New York Medical and Rehab Center () W

Amaurys Hernandez, 40 - staged acct (recruiter) - New York Medical and Rehab Center () W

Javier Troncoso, 45 - staged acct (recruiter) - New York Medical and Rehab Center () W

Ana Ovando, 42 - staged acct - New York Medical and Rehab Center () W

Janice Velez, 39 - staged acct - Chiropractic Office of South Florida / New York Medical and Rehab Center () W

Maria Molina, 41 - clinic straw owner—OVY Rehabilitation Medical Center / HHR Rehab Medical Center () W

Wilfredo Rodriguez Martinez, 47 - staged acct 02/11/09 (recruiter) $27,374 - E & B Rehabilitation Center (Allstate) M

Maitte Pluma Palma, 40 - staged acct 04/27/11 (recruiter) $80,584 - AZJ Medical / La Maison / YH Imaging / (Allstate / Geico / State Farm) M

Jennifer Adams, 38 - chiropractor - Chiropractic Office of South Florida / HHR Rehab Medical Center / OVY Rehabilitation Medical Center () W

Gilda Garcia, 49 - staged acct (recruiter) - Chiropractic Office of South Florida / New York Medical and Rehab Center () W

Marc Maxis, 42 - staged acct 01/07/09 (recruiter) $45,898 - Michigan Health & Rehab (Avis Budget / State Farm) O

Maritza Ruano, 53 - massage therapist / straw clinic owner – Coral Way Rehabilitation Services (Imperial Fire & Casualty) M

Esteban Grueiro Gonzalez, 42 - runner solicitation - Certified Pro Collision / (United Auto) M

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

Copy goes her. Editor’s Corner On page one, we cover the latest arrests in Palm Beach County in Operation Sledgehammer. To date, 26 defendants have been charged...with more to follow.

On page two, we spotlight a new website from the Florida Highway Patrol called “Protect Yourself Against Staged Crashes.”

On page four, we report on the 20th anniversary of FIFEC, and publish the names of this years award winners.

As always, we report on PIP Fraud in the News and the latest PIP-related arrests.

Finally, we proudly start our third year of the PIP Source. We are thankful for the support and the interest from our readers.

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

Tallahassee Field Office - 850.413.3115 Capt. Robert BRONGEL Pensacola Field Office - 850.453.7802 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 Capt. 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 Capt. 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 Capt. Glen HUGHES Lt. Evangelina BROOKS

Orlando Field Office - 407.835.4402 Lt. Jewel CAMERON Lt. Paul MEYERS

SOUTH REGION Counties: Broward, Dade, Monroe

Miami Field Office - 305.536.0302 Capt. 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 Director Southeast Region Dennis Russo 863.967.6904

Statewide PIP Contacts