Volume 2 Number 35
August 29, 2005


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TAMPA BAY CLINIC OWNERS ARRESTED FOR ‘SELLING’ PATIENTS

Gallagher: Insurance Fraud Investigators Caught Them on Tape Taking Payoffs

Florida’s Chief Financial Officer Tom Gallagher announced the arrests of five Tampa-area clinic owners, and the issuance of a warrant for another, for “selling” patients, most of whom were accident victims, to diagnostic facilities that then billed auto insurers thousands of dollars.

“This crime costs Florida’s hardworking families every time they pay their insurance premiums,” Gallagher said.  “It also jeopardizes the care the patients get when they are sold to the highest bidder.”

Today’s arrests were the result of a joint investigation by the Department of Financial Services, Division of Insurance Fraud; the Florida Department of Law Enforcement; the Hillsborough County State Attorney’s Office, Economic Crimes Division; and the National Insurance Crime Bureau.  As CFO, Gallagher oversees the Department of Financial Services and the Division of Insurance Fraud.  In March, Gallagher went along as insurance fraud detectives arrested 13 individuals, including three Tampa clinic owners, on similar charges. 

In this latest investigation, insurance fraud detectives caught clinic owners on undercover audio and videotape taking payments from MRI facility owners for the referral of patients. The investigation revealed that some of the clinic owners engaged in this type of patient brokering scheme for several months, collecting thousands of dollars in referral fees.  Those arrested today were: 

Alan Felker, chiropractor and owner of Felker Clinic, for accepting a $1,000 payoff.

Sandra Kilpatrick, owner of University Medical Clinic, for accepting a $1,000 payoff.

Yussel Cabrera, owner of DMJ Clinic, for accepting a $500 payoff.

Elisa Valdez, owner of Cemar Clinic, for accepting an $800 payoff.

James Lee, owner of Bayside Clinic, for accepting a $2,000 payoff.

A warrant has been issued for Pedro Cabo, owner of Pro Med Clinic.

The investigation revealed that many diagnostic companies were paying the fee in order to get the business and the ability to bill the patients’ auto insurance carriers, under the Personal Injury Protection (PIP) coverage, anywhere from $800 to $1,000 per patient for the MRIs. Florida’s drivers are required by law to carry a minimum of $10,000 in PIP coverage.

The clinic owners arrested today could face up to five years in state prison if convicted on the patient brokering charge, a third-degree felony.  They all were booked into the Hillsborough County Jail. 

The department has made almost 1,000 PIP fraud-related arrests in the last five years, and those schemes billed insurers for more than $27 million.  That cost gets passed on to Florida consumers through higher premiums.

“We will continue to aggressively investigate and seek jail time for those who commit insurance fraud,” Gallagher said.  More arrests are anticipated in this case.

The Department of Financial Services, Division of Insurance Fraud, investigates various forms of fraud in insurance, including health, life, auto, property and workers' compensation insurance.  Anyone with information about this case or another possible fraud scheme should call the department's Anti-Fraud Hotline at 1-800-378-0445.  A reward of up to $25,000 may be offered for information leading to an arrest and conviction.

Night falls over the 1908 Lafayette County courthouse in Mayo, the county seat.  The two-story frame building across the street was an earlier courthouse. The county was formed in 1856 and named after the French marquis who assisted the colonies during the Revolutionary War.