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Car Insurance Scam

Date: Mar 29, 2005
Contributor: Lance Kealey

Miami Doctors Convicted Of Fraud

Two Miami doctors and three others were convicted Thursday of health care fraud as part of a $5 million Medicare and car insurance scam.

Drs. Jose Garrido and Edgard Zamora, office manager Dalia Fernandez, and patient recruiters Antonio Pina and Deisy Aviles were each convicted of conspiracy to commit health care fraud and substantive health care fraud.

The doctors worked at Miami Health Medical Center and approved altered medical records and fraudulent prescriptions, prosecutors said.

Then a clinic, Exclusive Medical Supply, and supply company, Hope Medical Supplies, would charge the Medicare for items such as customized orthotic knee braces or breathing equipment.

Several patients told agents they were paid $50 apiece to accept knee braces. Others told agents they were paid monthly kickbacks to take respiratory and medical equipment. The group also defrauded private automobile insurers.

Some street recruiters were paid as much as $1,200 to $2,000 for each automobile accident victim they brought to the clinics, prosecutors said. The patients were coached to exaggerate symptoms and complain of multiple injuries to specific body parts.

The clinics then generated phony medical documents and prescriptions for unnecessary physical therapy that were paid by private personal injury auto insurance claims.

With the convictions, all 20 people indicted in the scam have been found guilty or issued guilty pleas, the state attorney's office said.

Each could be sentenced to 15 years in prison.

Fernandez was also convicted of money laundering, and could face another 20 years in prison.







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