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Florida CFO Jeff Atwater Announces Arrests of Licensed Massage Therapist and Clinic Employees for PIP Fraud

3/6/2012

Contact: Alexis Lambert
(850) 413-2842

TALLAHASSEE—Florida Chief Financial Officer Jeff Atwater announced today the arrests of three Tampa clinic employees on charges of insurance fraud and patient brokering stemming from a personal injury protection (PIP) fraud scheme.  Danilo Ardian Gonzalez-Alfonso, 37, the clinic manager; Lydia Merlo-Fernandez, 23, a licensed massage therapist; and Yennier Gutierez Obregon, 23, an employee—all employees of CPS Medical Clinic—allegedly solicited a confidential source to participate in a scheme to file fraudulent claims for services never provided. 

“These fraud clinics have become an albatross around the neck of Florida’s consumers—driving up insurance rates across Florida and lining their pockets with the hard-earned dollars of honest Floridians,” CFO Atwater said. “My office will remain diligent in the fight against accident fraud while continuing to seek legislative reforms in the final days of the 2012 Legislative Session to curb this costly crime.”

During an investigation by the Florida Department of Financial Services’ Division of Insurance Fraud, a confidential source met with Obregon and went with him to CPS Medical Center located at 4023 N. Armenia Ave. During multiple visits, Gonzalez-Alfonso and Merlo-Fernandez instructed the source to sign blank therapy sheets and leave the clinic without receiving any treatment.

All three suspects were booked into the Hillsborough County Jail today and are awaiting bond.  If convicted on the charges, they each face up to 10 years in prison. 

CFO Atwater has been advocating for reforms this legislative session that target staged accident fraud, strengthen billing practices so appropriate services are provided to those who need care, tighten requirements for clinic ownership and ultimately result in rate relief for Florida’s consumers.  Based on a report by the Insurance Consumer Advocate, the number of Florida drivers has remained stable, and the frequency of crashes declined between 2006 to 2010 while the number of PIP claims opened or recorded during the same time increased 28 percent. In addition, the payment on PIP claims increased 66 percent during the same period.

“PIP fraud creates a $1 billion annual tax on Floridians, and that is a burden we cannot and should not tolerate,” CFO Atwater said. 

This case is part of a continuing crackdown by CFO Atwater’s Division of Insurance Fraud in the fight against auto insurance fraud in Florida.  Nationwide Insurance provided assistance in this investigation. This case will be prosecuted in the 13th Judicial Circuit under the direction of Hillsborough State Attorney Mark Ober.

Anyone with information regarding suspected insurance fraud is asked to call 1-800-378-0445. Individuals who provide tips can remain anonymous and are eligible for a reward of up to $25,000 for information that directly leads to an arrest and conviction in an insurance fraud scheme.  The Department of Financial Services to date has awarded almost $250,000 to approximately 40 citizens as part of its Anti-Fraud Reward Program.

Chief Financial Officer Jeff Atwater, a statewide elected official and officer of the Florida Cabinet, oversees the Department of Financial Services.  CFO Atwater’s priorities include fighting financial fraud, abuse and waste in government, reducing government spending and regulatory burdens that chase away businesses, and providing transparency and accountability in spending.