Volume 2 Number 30
July 25, 2005

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TEXT VERSION

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22 CHARGED WITH HEALTH CARE FRAUD INVOLVING OVER $8 MILLION IN FALSE CLAIMS

22 individuals and entities, including chiropractors, massage therapists, and four medical clinics, have been indicted by a federal grand jury in a multi-million dollar health care fraud scheme, based on an investigation by the Department of Financial Services and several other agencies. The indictment charges the defendants with conspiracy to commit health care fraud, health care fraud, false statements relating to health care matters, and conspiracy to commit money laundering.

Florida CFO Tom Gallagher stated, "We are all victims of those who commit fraud. As consumers we pay for it every time we pay our insurance premiums. We will continue to fight insurance fraud to protect Floridians."

Other agencies involved were the Florida Department of Law Enforcement, the National Insurance Crime Bureau (NICB), and the Sunny Isles Beach Police Department.  Insurance companies involved in this investigation included Gainsco Company, Ocean Harbor Insurance, GEICO, State Farm, Liberty Mutual, MetLife, Direct, United Auto Insurance, and Federated Insurance.

Among those charged in the 33 count indictment were: Boris Royzen, his wife, Eva Royzen, Dmitry Rakovsky, Drs. Enrique Gonzalez-Pujol, Ambroise Forte, and Norma Roche, chiropractors, massage therapists and a receptionist who were owners and employees of the four defendant medical clinics. The clinics charged in the Indictment are Vista Mar Medical Rehab Corp., Plantation Medical Recovery Center, Inc., Romana Medical, Inc., and Dial Medical Rehab, Inc.

As set forth in the indictment, from November 2003 through July 2005 the defendants conspired to commit health care fraud by submitting fraudulent health insurance claim forms to private insurance companies for services that were not medically necessary and/or were not rendered.

The fraudulent claims were submitted under personal injury protection (PIP) provisions for alleged victims of automobile accidents. Boris Royzen and Dmitry Rakovsky paid runners to solicit victims and alleged victims of automobile accidents to become patients of the clinics.

In addition, Boris Royzen and Dmitry Rakovsky caused fraudulent applications to be filed with the State of Florida, falsely stating that the defendant clinics were 100% owned by licensed medical practitioners when, in fact, the medical practitioners named on the applications were employees of the clinics.

The indictment lists 30 private insurance companies, including State Farm, GEICO, Allstate, Ocean Harbor Insurance, Liberty Mutual, MetLife, Direct, Federated Insurance and United Auto Insurance, to which the defendants submitted fraudulent claims. The defendant medical clinics received over $8.5 million in insurance payments as a result of this fraudulent activity.

With regard to the money laundering charges, the indictment alleges that the defendant clinics employed management companies owned by Boris Royzen, Eva Royzen and Dmitry Rakovsky through which funds were channeled back to those defendants.

If convicted on the health care fraud conspiracy counts, the defendants face a maximum statutory term of five years imprisonment. If convicted of the related health care fraud counts, the defendants named in those counts face a maximum statutory sentence of 10 years. If convicted on the charge of making false statement relating to health care matters, those defendants will face a maximum statutory term of five years imprisonment. The money laundering conspiracy and its related substantive money laundering charges are all punishable by a maximum penalty of 20 years in prison.

Walton County was created in 1824, shortly after Florida became a territory of the United States. The courthouse is in the county seat of DeFuniak Springs.