3 Arrested in Miami in $39K PIP Fraud Scheme

October 4, 2019

Three people in Miami have been arrested in an alleged $39,000 personal injury protection (PIP) fraud scheme, according to a statement from the Florida Department of Financial Services.

Alean Machado, Barbarito Leyva-Claro, and Yoandra Rodriguez-Pena were charged with insurance fraud, grand theft, patient brokering and organized scheme to defraud for their role in the scheme that was exposed during an undercover operation.

DFS said between January 2019 and March 2019, the Bureau of Insurance Fraud conducted an undercover operation into Professional Medical Practice, a Miami physical therapy clinic. Investigators used two cooperating witnesses to pose as vehicle accident victims at which time, it was discovered that clinic owner Alean Machado, with the assistance of Barbarito Leyva-Claro acting as recruiter, allegedly offered to pay participants $2,500 for their involvement in fraudulent physical therapy treatments. Yoandra Rodriguez-Pena, a physical therapist, is alleged to have coached the cooperating participants on what to say if ever questioned by their insurance company about therapy treatments that were never provided.

As result of the scheme, Machado fraudulently billed two insurance companies over $39,000 for numerous days of physical therapy treatments that never occurred.

Machado, Rodriguez-Pena and Leyva-Claro were arrested and booked into Turner Guilford Knight Correctional Center (TGK) on October 1. If convicted on all charges, Machado and Rodriguez-Pena face up to 45 years in prison. Leyva-Claro, if convicted on all charges, faces up to 50 years in prison. Individuals charged with a crime are presumed innocent until proven guilty.

This investigation was conducted in conjunction with the National Insurance Crime Bureau (NICB) and is being prosecuted by Miami-Dade State Attorney Katherine Rundle’s Office.

“These types of clinics are the core elements of any ongoing PIP insurance fraud scam as they exist only to steal, not heal,” State Attorney Katherine Fernandez Rundle said.

Source: Florida Department of Financial Services

Topics Fraud

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