CFO Jimmy Patronis Announces Three Arrests in $39,000 Miami PIP Fraud Scheme
10/2/2019
MIAMI – Chief Financial Officer (CFO) Jimmy Patronis announced the arrest of Alean Machado, Barbarito Leyva-Claro, and Yoandra Rodriguez-Pena for their role in an alleged personal injury protection (PIP) fraud scheme. The scheme was exposed during an undercover operation charging the three individuals with Insurance Fraud, Grand Theft, Patient Brokering and Organized Scheme to Defraud.
CFO Jimmy Patronis said, “Insurance fraud is a serious crime that is estimated to cost Americans more than $40 billion a year. Reports show that this translates to an estimated cost to the average U.S. family of between $400 and $700 a year in the form of higher premiums. This is unacceptable and that is why I launched my Fraud Free Florida initiative to further enhance investigative efforts to combat the rampant fraud in Florida. I encourage all Floridians to report fraud tips at FraudFreeFlorida.com to help our detectives track down these fraudsters and bring them to justice.”
State Attorney Katherine Fernandez Rundle said, “These types of clinics are the core elements of any ongoing PIP insurance fraud scam as they exist only to steal, not heal. Those individuals who hope to snatch some cash from the pockets of Miami-Dade’s insured motorists should know that the dedicated investigators from CFO Jimmy Patronis' Division of Insurance Fraud and my Insurance Fraud prosecutors are out to get you. Find a new line of business or prepare to go to jail.”
Between January 2019 and March 2019, CFO Patronis’ Bureau of Insurance Fraud conducted an undercover operation into Professional Medical Practice, a Miami physical therapy clinic. Investigators used two cooperating witnesses to pose as vehicle accident victims at which time, it was discovered that clinic owner Alean Machado, with the assistance of Barbarito Leyva-Claro acting as recruiter, allegedly offered to pay participants $2,500 for their involvement in fraudulent physical therapy treatments. Yoandra Rodriguez-Pena, a physical therapist, coached the cooperating participants on what to say if ever questioned by their insurance company about therapy treatments that were never provided. As result of the scheme, Machado fraudulently billed two insurance companies over $39,000 for numerous days of physical therapy treatments that never occurred.
Machado, Rodriguez-Pena and Leyva-Claro were arrested and booked into Turner Guilford Knight Correctional Center (TGK) on October 1. Charges include Insurance Fraud, Grand Theft, Patient Brokering and Organized Scheme to Defraud and if convicted on all charges, Machado and Rodriguez-Pena face up to 45 years in prison. Barbarito Leyva-Claro, if convicted on all charges, faces up to 50 years in prison. Individuals charged with a crime are presumed innocent until proven guilty.
This investigation was conducted in conjunction with the National Insurance Crime Bureau (NICB) and is being prosecuted by Miami-Dade State Attorney Katherine Rundle’s Office.
CFO Jimmy Patronis said, “Insurance fraud is a serious crime that is estimated to cost Americans more than $40 billion a year. Reports show that this translates to an estimated cost to the average U.S. family of between $400 and $700 a year in the form of higher premiums. This is unacceptable and that is why I launched my Fraud Free Florida initiative to further enhance investigative efforts to combat the rampant fraud in Florida. I encourage all Floridians to report fraud tips at FraudFreeFlorida.com to help our detectives track down these fraudsters and bring them to justice.”
State Attorney Katherine Fernandez Rundle said, “These types of clinics are the core elements of any ongoing PIP insurance fraud scam as they exist only to steal, not heal. Those individuals who hope to snatch some cash from the pockets of Miami-Dade’s insured motorists should know that the dedicated investigators from CFO Jimmy Patronis' Division of Insurance Fraud and my Insurance Fraud prosecutors are out to get you. Find a new line of business or prepare to go to jail.”
Between January 2019 and March 2019, CFO Patronis’ Bureau of Insurance Fraud conducted an undercover operation into Professional Medical Practice, a Miami physical therapy clinic. Investigators used two cooperating witnesses to pose as vehicle accident victims at which time, it was discovered that clinic owner Alean Machado, with the assistance of Barbarito Leyva-Claro acting as recruiter, allegedly offered to pay participants $2,500 for their involvement in fraudulent physical therapy treatments. Yoandra Rodriguez-Pena, a physical therapist, coached the cooperating participants on what to say if ever questioned by their insurance company about therapy treatments that were never provided. As result of the scheme, Machado fraudulently billed two insurance companies over $39,000 for numerous days of physical therapy treatments that never occurred.
Machado, Rodriguez-Pena and Leyva-Claro were arrested and booked into Turner Guilford Knight Correctional Center (TGK) on October 1. Charges include Insurance Fraud, Grand Theft, Patient Brokering and Organized Scheme to Defraud and if convicted on all charges, Machado and Rodriguez-Pena face up to 45 years in prison. Barbarito Leyva-Claro, if convicted on all charges, faces up to 50 years in prison. Individuals charged with a crime are presumed innocent until proven guilty.
This investigation was conducted in conjunction with the National Insurance Crime Bureau (NICB) and is being prosecuted by Miami-Dade State Attorney Katherine Rundle’s Office.