Alleged Florida Insurance Fraud Scammers Still On the Run

Inside Subprime: March 19, 2019

By Grace Austin

A former doctor and his sister alleged to have stolen tens of millions in an insurance fraud scheme throughout Florida are still on the run after most of their suspected co-conspirators were arrested by state authorities.

The fraud scheme, which netted almost $10 million before being shut down, was allegedly based out of more than a dozen fake eye doctor clinics and storefronts located throughout the state.

A former Miami doctor and his associates are accused of stealing other physicians’ identities, illegally acquiring insurance information and billing $43 million in medical services that never took place.

The suspects allegedly billed large insurance groups like United Healthcare and Florida Blue for eye treatments.

Authorities say the 14 suspects filed more than 23,000 false claims for procedures never done from 2015 to 2018. The suspect and his associates are also accused of stealing the identities of more than 20 different doctors.The suspect even boasted about it on social media, according to one news outlet.

The scam set up “phantom” clinics in Fort Myers, Tampa, Lake Worth, Boca Raton and Miami. The “clinics” were essentially places to drop off the insurance payments.

The Florida Department of Financial Services announced that fraud scheme and the subsequent arrest of several individuals in February 2019. Authorities called the scam bust “Operation Eye See You.”

The investigation has led to felony charges of scheme to defraud, money laundering, insurance fraud, fraudulent use of identification, and racketeering against all suspects involved. They range in age from 27 to 61 years old.

Now, the Department of Financial Services is still looking for the former doctor, the reported leader of the operation, along with his sister who allegedly helped in the scam. Twelve other people were also charged in February and are now in custody.

It’s not the first time the former doctor has got into trouble with the law — he was previously indicted and served time in prison for health care fraud.

At a February press conference, the chief financial officer of Florida said it wasn’t “a victimless crime,” since insurance fraud “drives up insurance costs for every Floridian.”

“This organized crime scheme cost health insurance companies millions and stretched from Hillsborough to Miami Dade County,” she said. “Insurance fraud is a serious crime that forces higher premiums on all rate payers.”

Florida CFO Jimmy Patronis said other Floridians helped catch the suspects by calling into consumer fraud hotlines and reporting potentially fraudulent activity on their insurance statements.

For more information on payday loans, scams, and cash advances and check out our city and state financial guides including, Florida, Jacksonville, Miami, Tampa and more.