West Palm Beach Resident Sentenced for Role in Staged Accident Scheme
|U.S. Attorney’s Office December 19, 2012|
Wifredo A. Ferrer, United States Attorney for the Southern District of Florida; Michael B. Steinbach, Special Agent in Charge, Federal Bureau of Investigation (FBI), Miami Field Office; José A. Gonzalez, Special Agent in Charge, Internal Revenue Service-Criminal Investigation Division (IRS-CID); and Jeff Atwater, Florida Chief Financial Officer, announced today’s sentencing of Maria Molina, a/k/a Cary, 41, of West Palm Beach, in connection with her participation in a staged accident fraud scheme. U.S. District Judge Kenneth A. Marra sentenced Molina to 48 months in prison, to be followed by two years of supervised release. Defendant Molina previously pled guilty to conspiring with others to commit mail fraud, in violation of Title 18, United States Code, Section 1341; all in violation of Title 18, United States Code, Section 1349.
According to court documents, under Florida’s “No Fault” insurance law, insurers must provide Personal Injury Protection (PIP) coverage of $10,000 per person. Defendant Molina and other co-conspirators unlawfully enriched themselves by submitting fraudulent PIP claims for chiropractic and massage therapy treatments for individuals who had participated in staged automobile accidents.
Court documents state that Molina worked as the receptionist, office manager, and billing specialist at OVY Rehabilitation Medical Center (OVY) and HHR Rehab Medical Center (HHR), both located on Congress Avenue, West Palm Beach, Florida. Molina and other co-conspirator employees and recruiters advised the staged accident participants on how to fill out the paperwork and what to say if an insurance investigator interviewed them about their injuries or treatment. The staged accident participants were instructed to sign numerous blank treatment forms that would later be submitted indicating that they had visited the clinic on a number of separate occasions for treatment, although they may have visited the clinic only once or twice. During their visits, some staged accident participants received no treatment at all or may have received only a short exam or treatment from the chiropractor or LMT, but the paperwork completed by the LMTs and chiropractors indicated that a full and lengthy exam and treatment was given.
According to court documents, Molina admitted that she was aware that patients would sign blank therapy forms for days when they did not receive treatment in order to justify the bills submitted to the insurance companies. Molina specifically admitted that the patients who came to OVY and HHR never remained longer than 15 minutes and that the patients did not receive the treatments that were billed to the insurance companies. Molina also admitted that she was the person responsible for compiling and mailing the claims to the insurance companies, although on some occasions she supervised others who assisted with this task.
Court documents state that during a series of controlled meetings between a co-conspirator and Molina, Molina advised the co-conspirator on how to set up a clinic to perform PIP fraud. Molina advised the co-conspirator that she would need $30,000 to pay the lease and to pay the patients. Molina also described how the patients would come from “pre-arranged accidents” and that the clinic would have to pay the patients upfront. Molina told the co-conspirator not to worry about the patients admitting that the accidents were staged because everything was illegal, and the accident participants would not risk problems by telling the truth. Molina stated the accident participants expected to be paid 20 percent of the amount to be received from the insurance company. Molina offered to do all the bookkeeping for the new clinic. When the co-conspirator asked how Molina would keep receipts for the cash payments to the “patients,” Molina responded that there would be nothing to show for those payments because “this is illegal, it is fraud, and this is what people are doing.”
Ms. Molina is the latest federal defendant to be sentenced in the investigation known as Operation Sledgehammer. To date, a total of 26 defendants have been charged, resulting in 22 federal convictions. Four defendants are fugitives who have fled the United States.
Mr. Ferrer commended the investigative efforts of the FBI, IRS-CID, and the Florida Department of Insurance Fraud, and issued a special thanks to the National Insurance Crime Bureau (NICB) for its assistance in this investigation. Mr. Ferrer also thanked the members of the Greater Palm Beach Health Care Fraud Task Force. The case is being prosecuted by Assistant U.S. Attorney A. Marie Villafaña.
A copy of this press release may be found on the website of the United States Attorney’s Office for the Southern District of Florida at http://www.usdoj.gov/usao/fls.