The city of Miami, Miami-Dade County public schools and several
companies lost millions of dollars in health insurance payments as a
result of being scammed by crooked clinics that submitted bogus claims
for pain injections, according to newly filed indictments.
Federal
agents arrested 14 suspects Wednesday on charges of scheming to bilk
more than $130 million from the public entities, private companies and
major insurers, namely Blue Cross Blue Shield, United Healthcare and
Cigna.
Four other suspects — including the accused ringleader,
Reynaldo Castillo — were also charged but have not yet been apprehended.
One of those, Danny Jacomino Bordon, who ran a Miami rehab clinic as
well as a film production business called Ouija Studios, is expected to
surrender to FBI agents on Thursday.
All together, the various
entities and their insurers paid out about $15 million to the healthcare
network, which operated about 35 clinics in Hialeah, Doral and Miami
between 2012 and 2015, according to the indictments.
Among the
bilked entities: Pepsi Co., Macy’s, RadioShack, BJ’s Wholesale Club,
Lincoln Property Company, Nextera Energy and Southeast Frozen Foods
Company.
Most of those, as well as the city of Miami and
Miami-Dade school system, are self-insured with healthcare plans managed
by the big insurers — so the fraudulent healthcare payments came
directly out of their pockets.
Assistant U.S. Attorney Christopher
Clark said that he will seek to detain almost all of the defendants
because they are considered flight risks — possibly to Cuba. He is also
seeking to recover millions of dollars paid out to the defendants and to
seize at least five buildings that some purchased to house their
clinics.
Their bond hearings and arraignments are scheduled for next Wednesday.
The
case is unusual because typically the U.S. attorney’s office prosecutes
healthcare fraud offenders who try to fleece the taxpayer-funded
Medicare program.
But, according to the indictments, the clinics
used familiar ploys to carry out the racket: stealing the names of
employees to file false claims, paying kickbacks to patient recruiters,
and misappropriating the licensing information of physicians. Most of
the claims were for injections to treat purported knee and back pain.
Almost
all of the clinics — including 1st Class Medical Centers, A Woman
Health Center and Absolute Rehabilitation Center — were owned and
operated by Reynaldo Castillo, Hendris Castillo Morales, Lisbet Castillo
Batista and Maite Garcia, according to the indictments.
Another
defendant, Alejandro Biart, is accused of being a patient recruiter who
accepted kickbacks from the co-conspirators in return for referring
Cigna beneficiaries to their clinics.
Most of the rest of the
defendants, in exchange for a fee, allowed their names to be used to
incorporate the clinics, open bank accounts and cash checks received
from Cigna, Blue Cross Blue Shield and United Healthcare, the
indictments said.
Source: MiamiHerald
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