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Insurance Commissioner, Miami-Dade State Attorney Announce 16 Arrests in ‘operation Medical Deception’

4/10/2002

MIAMI - Seven doctors, three clinic owners and six clinic workers have been arrested in an ongoing Department of Insurance investigation in which dozens of auto accident victims said their insurance companies were billed nearly $1 million for clinic visits they did not make, Florida Treasurer and Insurance Commissioner Tom Gallagher and Miami-Dade State Attorney Katherine Fernandez Rundle announced today.

Gallagher said numerous accident clinics seem to be doing the same thing independently of each other - fraudulently billing the personal injury protection (PIP) portion of accident victims' auto insurance policies. State investigators said those arrested so far in Operation Medical Deception, or Operation M.D., worked for 10 clinics in Miami-Dade County and fraudulently billed nearly two dozen insurance companies. More arrests are expected.

"Those who commit or contribute to this kind of fraud are facing prosecution," Gallagher said. "This crime is taking millions of dollars out of Florida's economy every year, but consumers can help. The Department of Insurance offers a reward of up to $25,000 for information on insurance fraud."

The Department of Insurance, Division of Insurance Fraud, has made 264 PIP-fraud related arrests since January of 1999, the year a statewide grand jury was impaneled to study PIP insurance fraud.

"Personal injury insurance fraud has become the new crime of choice for many white collar criminals including medical professionals who feel it is an easy way to make a quick buck," said State Attorney Katherine Fernandez Rundle. "Investigations and arrests like these prove that if you commit personal injury insurance fraud in Florida, you will be arrested and you will go to jail."

It has been estimated that auto insurance fraud adds about $240 to the cost of the average Florida family's premiums. Policyholders are urged to closely review the Explanation of Benefits (EOBs) that insurance companies issue when a claim has been filed or paid. Any inaccurate or questionable claim should be corrected immediately.

The doctors arrested as part of Operation M.D. allegedly signed medical reports for patients they did not see or for patients who were seen by unlicensed medical personnel, who told investigators that they also fabricated patient reports when the patients did not return for visits. One patient's insurer was billed while he was incarcerated. The clinic owners allegedly directed the billing activities.

The insurance companies that were billed include Ocean Harbor Insurance, Progressive, Twin City Fire, U.S. Security, Underwriters Guaranty, American Skyhawk, Fortune, MGA, Union American, State Farm, Habor Specialty and Connecticut Indemnity.

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


OPERATION M.D. ARRESTS

Arrested today were:

Fernando Barquero, M.D., 57, of 1110 Pizzaro St., Coral Gables. A doctor at Human Care Medical, 8080 W. Flagler St., #2E, Miami, between October 2000 and August 2001, Barquero is charged with two counts of insurance fraud and two counts of third-degree grand theft.


Manuel Galguera, M.D., 39, of 3200 Collins Ave., #123, Miami Beach. A doctor at LeJeune Physical Therapy Center, 219 E. Lejeune Rd., Hialeah, between January 1999 and April 2000, Galguera is charged with organized scheme to defraud and 10 counts each of insurance fraud and third-degree grand theft. Lejeune Physical Therapy has since closed.


Algirdas Krisciunas, M.D., 69, of 465 Ocean Drive, #915, Miami Beach. A doctor at G&M Medical Care, 4184 W. 12th Ave., in Hialeah between July 1999 and March 2000, Krisciunas is charged with organized scheme to defraud and 10 counts each of insurance fraud and third-degree grand theft. G& M Medical Care has since closed.


Marco T. Molinares, M.D., 67, of 5660 SW 149th Ave., Miami. A doctor at G&M Medical Care between October 1998 and June 1999, Molinares is charged with organized scheme to defraud and 10 counts each of insurance fraud and third-degree grand theft.


Jorge Llovet, M.D., 42, of 2230 SW 79th St., Miami. A doctor at Health & Care Center, 85 Grand Canal Dr., #300, Miami, from June to November of 2000, Llovet is charged with two counts each of insurance fraud and third-degree grand theft.


Federico Labrador-Quintero, P.A., 54, of 1873 SW 138th Ave., Miami. A physician's assistant at Zigma Medical Care in Miami-Dade County from February to August of 2000, Labrador-Quintero is charged with two counts of insurance fraud and third-degree grand theft. Michel Huarte, the owner of Zigma Medical Care, was arrested last August for his alleged involvement.


Juan A. Santos-Diaz, P.A., 55, of 7980 NW 197th St., Miami. A physician's assistant at General Medical Center & Rehabilitation, 2500 S.W. 107th Ave., #36, Miami, from March 2000 to July 2001, Santos-Diaz is charged with two counts of insurance fraud and third-degree grand theft. General Medical Center has since closed.


Alan Trimpin, 26, of 6225 Kendale Lakes Circle, #D-156, Miami. The owner of Human Care Medical in Miami is charged with six counts each of insurance fraud and third-degree grand theft.


The following were previously arrested during Operation M.D.:


Armando Hernandez-Perez, M.D., 68, of 8856 SW 59th Lane, Miami, a doctor at Cohen Medical Institute, formerly located at 2501 S.W. 8th St., Miami, was arrested in March on one count of insurance fraud.


Lazaro T. Moran, M.D., 69, of 7500 S Waterway Drive, Miami, a doctor at Flagler Polyclinic in Miami, was arrested in March on two counts of insurance fraud and one count of grand theft.

Jose A. Coutin, 23, and Milagros Mantilla, 24, both of 925 SW 82nd Ave., #212, Miami, were arrested in February and charged with one count each of insurance fraud for their involvement in alleged fraudulent billings at their clinic, Queens Medical Corporation. The clinic, formerly located at 4655 W. Flagler St., Miami, is no longer operating.


Belkis Formoso, 35, of 915 SW 74th Circle, Miami, a former X-ray technician at Manhattan Medical Center, was arrested in January on one count of insurance fraud. Manhattan Medical Center, formerly located at 3900 W. Flagler St., Miami, is no longer operating.


Lazaro Gonzalez, 52, of 2745 NW 8th Lane, Miami, an X-ray technician at Cohen Medical Institute, was arrested in January on one count of insurance fraud. Cohen Medical Institute was located at 2501 S.W. 8th St., Miami.


Efren Menendez, 58, of 2175 SW 78th Place, Miami, a medical assistant at Galloway Health Services, was arrested in January on one count of insurance fraud. The clinic was located at 8756 S.W. 8th St., Miami.


Luis Richardson, 45, of 8918 W Flagler St., #5, Miami, a medical assistant at G&M Medical Care, was arrested in January on one count of insurance fraud.