Florida leading the pack
Healthcare fraud losses reach an all-time high so far this year, DFS arrests 16 individuals involved in unlicensed contracting and workers’ comp insurance fraud, and staged automobile accidents are back in the news in, you guessed it, Miami. It’s all in this week’s Fraud News.
Healthcare Fraud Rising: The Coalition Against Insurance Fraud is sounding the alarm about a growing trend. The Federal Trade Commission (FTC) received 16,396 healthcare fraud complaints in the first quarter of 2024, according to a Healthnews report. About 53% of the reports indicated victims lost money, with an average loss of $258. Most victims were contacted through phone calls and used credit cards as a payment method. The state with the single-largest number of complaints was Florida, with 1,562 reports. The “medical treatments and cures frauds” category accounted for $12 million in losses, a steep increase from $1 Million reported during the same period last year. Common scams in this category include supplements to treat opioid dependence and withdrawal, dementia, anti-aging treatments, and cancer-fighting products, such as pills or devices. Another $3 million was lost in scams related to diet products, plans, and centers. The FTC warns that any product promising rapid, permanent weight loss without watching what you eat is a scam.
Workers’ Compensation Fraud Sting: The Florida Department of Financial Services (DFS) announced the arrest of 16 individuals involved in a workers’ compensation fraud scheme at the end of April in a joint operation by the Florida Department of Business and Professional Regulation (DBPR) and the Manatee County Sheriff’s Office (MSCO). The group of 16 was arrested for making agreements to perform work without the necessary licensing and without any worker’s comp coverage. Such schemes often involve unsafe construction methods, leaving both the workers and homeowners without any coverage should disaster strike. “Our detectives conduct these stings with the victims of unsafe construction practices and the poor workmanship of unlicensed contractors in mind… unsuspecting customers are the ones who suffer the most,” said Manatee County Sheriff Rick Wells. “We hope that this latest operation will serve as an example to those who choose to ignore state law requirements and take shortcuts.” To report suspected contractor fraud, call the state hotline at 1-800-378-0445 or report it online at MyFloridaCFO.com.
Miami Staged Accident: Further south in Miami, DFS also announced the arrests of four people involved in a staged accident scheme. Abel Vera, Nancy Mercedes Pena, Yuniesky Betancourt, and Maura Perez are all accused of staging an automobile accident and falsely documenting the crash with police. Authorities say the group intended to exploit personal injury and protection (PIP) benefits for financial gain. A formal investigation conducted by the DFS Division of Investigative and Forensic Services’ Miami Field Office showed that the four individuals staged the crash on December 6, 2022, and billed Kemper over $61,000 for fraudulent physical therapy for injuries not actually sustained. Each of those arrested could face up to 10 years in prison if found guilty on all charges.
LMA Newsletter of 5-13-24
