Five Tampa-area clinic owners have been arrested and a warrant issued for the arrest of a sixth owner for “selling” patients, most of whom were accident victims, to diagnostic facilities that then billed auto insurers thousands of dollars in claims.
The arrests were announced by Tom Gallagher, Florida’s CFO, who indicated they were the result of a joint investigation by the Department of Financial Services, Division of Insurance Fraud; the Florida Department of Law Enforcement; the Hillsborough County State Attorney’s Office, Economic Crimes Division; and the National Insurance Crime Bureau.
In March, Gallagher went along as insurance fraud detectives arrested 13 individuals, including three Tampa clinic owners, on similar charges. In this latest investigation, insurance fraud detectives caught clinic owners on undercover audio and videotape taking payments from MRI facility owners for the referral of patients. The investigation revealed that some of the clinic owners engaged in this type of patient brokering scheme for several months, collecting thousands of dollars in referral fees. Those arrested were:
Alan Felker, chiropractor and owner of Felker Clinic, for accepting a $1,000 payoff.
Sandra Kilpatrick, owner of University Medical Clinic, for accepting a $1,000 payoff.
Yussel Cabrera, owner of DMJ Clinic, for accepting a $500 payoff.
Elisa Valdez, owner of Cemar Clinic, for accepting an $800 payoff.
James Lee, owner of Bayside Clinic, for accepting a $2,000 payoff.
A warrant has been issued for Pedro Cabo, owner of Pro Med Clinic.
The investigation revealed that many diagnostic companies were paying the fee to get the business and the ability to bill the patients’ auto insurance carriers, under the Personal Injury Protection coverage, anywhere from $800 to $1,000 per patient for the MRIs. Florida’s drivers are required by law to carry a minimum of $10,000 in PIP coverage.
The clinic owners arrested could face up to five years in state prison if convicted on the patient brokering charge, a third-degree felony. They all were booked into the Hillsborough County Jail.
The department has made almost 1,000 PIP fraud-related arrests in the last five years, and those schemes billed insurers for more than $27 million. That cost gets passed on to Florida consumers through higher premiums.
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