Miami Criminal Defense Lawyer Blog

Five local residents were arrested for their involvement in a staged car accident scheme to defraud. The defendants were arrested in this county and will mostly likely be charged with insurance fraud, grand theft and staging an automobile accident. It is not known how many counts will be filed by the state attorney's office against the defendants. Anyone charged with these types of crimes should seek out experienced Miami criminal defense lawyers that have defended staged accident cases. The investigation in this case was led by the Florida Department of Financial Services Division of Insurance Fraud. This agency typically investigates insurance fraud throughout the state of Florida. The defendants purportedly contrived the fake accident and and put their plan into motion. The participants in the accident sought treatment at Doral Center Rehab and Justin Medical Services. The clinics allegedly billed $83,000 to several insurance companies for services that were not necessary or never performed.

For years, Florida has been battling insurance fraud and staged accident cases. The problem got so bad the Florida Legislature modified the laws involving staged accident cases. The Financial Services Division of Insurance Fraud is going after everyone involved in staged accident. Their main goal is to shut down clinics involved in fraud and to put the clinic owners in prison or jail. Doctors are also being prosecuted and typically required to forfeit their medical licenses in exchange for staying out of jail and rather receiving a probation plea. Prosecutors handling these cases in Miami are assigned to a specialized unit with sole purpose of prosecuting insurance fraud.
These prosecutors typically work from the bottom up pleading out the secretaries and receptionists in an effort to go after the people who reaped the most benefit from the fraud.

Insurance fraud is committed when a person presents, prepares written or oral statements in support of an insurance claim knowing that the statement contains false, incomplete or misleading information concerning any fact or thing medical to a claim. It is also unlawful for anyone to solicit others to become involved in a staged accidents with the intent and purpose of filing false motor vehicle tort claims. Anyone who plans and solicits others to participate in a staged accident with the intent to commit insurance fraud can be charged with a second degree felony and is also facing a two year minimum mandatory prison sentence. Anyone being investigated for insurance fraud for participating in staged accident schemes should speak with a qualified defense attorney as soon as possible.

There are a few things to remember when an individual is charged with insurance fraud. Obtain criminal representation as soon as possible. Never speak to criminal investigators. Under the constitution, everyone has the right to remain silent. Any statements can and will be used to prosecute someone. Never speak to your co-defendants, as they may agree to cooperate with the prosecution and those statements can be used in court as well. In general, staged accident and insurance fraud cases are created after lengthy investigation. Hundreds of documents and CD's will be provided to the defense at the beginning of the case. All of this information needs to be reviewed to determine the strength of the state's case. Only after a complete and thorough investigation of the case and the corresponding discovery can an informed opinion be made on how to defend the case.

Five PIP Fraud Arrests Made in Miami, PropertyCasualty360.com, October 26, 2011.

Federal authorities charged 20 individuals with mortgage fraud with losses alleged at $20 million. Of those indicted, many are professionals in the real estate industry. According to the indictment, the alleged fraud occurred between March 2006 and June 2008 when the defendants filed false loan applications and other documents to multiple banks to obtain $40 million in bank loans and lines of credit. The banks and lending institutions lost approximately $20 million as a result of the fraud. While the problem of mortgage fraud has been largely curtailed due to stricter banking policies, Miami criminal defense lawyers are still seeing indictments coming down the pike. Mortgage fraud investigations take months if not years, as well as, the subsequent arrests. Trhis leads us to believe that more indictments will follow.

The 25 count indictment includes real estate professional such as mortgage brokers, title agents, realtors, and real estate property appraisers. The defendants are charged with federal crimes such as bank fraud, receiving gifts for procuring loans and providing gifts for procuring loans. The indictment also seeks the forfeiture of money and property derived from the transactions. The U.S. Attorney for the Southern District of Florida issued a statement saying that he had never seen an indictment involving so many real estate professionals. He claimed that his office will continue to vigorously stamp out mortgage fraud and prosecute straw buyers, sellers, corrupt mortgage brokers and bank officials. If the defendants are convicted they face up to 30 years in prison on each count and substantial monetary fines.

As in most mortgage fraud cases, some of the defendants submitted false mortgage and line of equity applications on behalf of unqualified real estate buyers and borrowers. Bank employees assisted in getting the fraudulent loans approved. To cover up the scheme, other defendants failed to record or falsely recorded mortgage deeds and documentation. To secure the loans many of the straw buyers claimed to be doctors, dentists, engineers or other high paid professionals. The investigation into this large scale mortgage fraud scheme was conducted by the Financial Fraud Enforcement Task Force. The task force was solely created to investigate and prosecute large scale organized scheme to defraud.

Mortgage fraud, although considered to be under control by the federal government, still subjects defendants charged with crime to serious terms of incarceration. The crime of bank fraud itself does not subject defendants to lengthy prison sentences, but the large amounts of losses suffered by the lending institution is what puts defendant behind bars for several years. In cases with numerous defendants, it is inevitable that some of the defendants will testify against others listed in the indictment. Cooperation with the federal government can allow for defendants facing lengthy periods of incarceration with significantly less time. The amount of the departure from the sentencing guidelines will depend on the quality and quantity of cooperation provided by the defendant turned government witness.

20 South Florida Residents Charged in $40 Million Mortgage Fraud Crime, LoanSafe.org, September 30, 2011.

Federal law enforcement authorities arrested 42 people alleged to have committed Medicare fraud throughout three counties in the South Florida area. Among those arrested were the owners of the Biscayne Milieu Health Center, a psychiatrist from Broward County, along with patient recruiters and assisted living facility landlords. Other defendants arrested in the case and accused of the fraud include home healthcare operators, HIV clinics owners and operators and medical equipment suppliers. In total, the purported criminal enterprise billed Medicare in excess of $160 million for medical services that were not necessary or in some instances never even provided to patients. Medicare paid out approximately $90 million. Broward and Miami criminal defense lawyers, either appointed by the court or privately retained will represent the defendants in the case.

According to government officials, this alleged Medicare fraud scheme was a bit different from those seen in the past. It is alleged that recruiters lured out-of-state patients to the South Florida and Miami area with the promise of giving them housing and a fresh start. Instead, the patients brought their Medicare cards with them and were placed in substandard assisted living facilities. The patients were also directed to attend mental health programs and group therapy sessions which would also be billed to Medicare. If the patients refused treatment they were kicked out of the ALF's and forced to live on the street.

The federal government continues to vigorously investigate and prosecute Medicare fraud cases in cities such as Miami, Brooklyn, Detroit and Los Angeles. Forty million people a year claim benefits, but the program has suffered billions of dollars in losses as a result of fraud, waste and abuse. With politicians and the federal government under the gun for losses incurred in the federal healthcare system, a new computer software program was initiated with the hope that the losses could be curtailed. The new program is said to be a proactive approach to defeating fraud, however, investigators claim the program is inadequate and that the federal government will continue to combat fraud after it has been committed.

Anyone being investigated for or having been arrested on these types of fraud charges must seek out legal counsel as soon as possible. Defendants charged in healthcare schemes to defraud are facing significant terms of incarceration because of the amount of losses suffered by Medicare. While fraud is a relatively low offense under the federal sentencing guidelines, the offense becomes much more severe when the losses accrue in excess of a million dollars. Owners and operators of clinics involved in illegal billing are also subject to multi-level increases if it determined that they were the leaders of organizers of the fraud. In any event, the feds continue to investigate and hunt down all those alleged to be involved in these types of criminal enterprises.

Medicare Fraud Case Nets Dozens of Arrest, Miami Herald.com, September 7, 2011.

A South Florida man previously convicted of cocaine trafficking and money laundering has been charged with committing Medicare fraud. The indictment alleges that Luis Alejandro Sanz, who had previously served a five year prison sentence, opened a healthcare clinic to purportedly treat diabetes patients. Court documents allege that he billed the federal healthcare provider $11 million of which he actually received $7 million. Because of his past criminal record, Sanz enrolled his wife as the sole proprietor of the clinic to avoid detection. Both defendants are scheduled to appear in court with their Miami criminal attorneys this week for their arraignment.

Earlier in the week Sanz and his wife were indicted on charges of healthcare fraud, money laundering and for paying kickbacks. The clinic operated from 2006 to 2009 obtaining clients through the use of patient recruiters. This is not the first instance where previously convicted felons have turned to healthcare fraud. Despite the law that precludes individuals with prior felony convictions from being Medicare providers, several have slipped through the cracks. While it is almost impossible for the federal healthcare agency to detect who put the money up to start and run the clinic, the Medicare program has dumped millions of dollars into its security system in an effort to prevent millions of dollars of fraud from occurring.

Congress awarded Medicare $350 million in the Affordable Care Act to develop software which allows for stricter screening of Medicare claims. Previously, Medicare used the "pay and chase" method for combating fraud. While many prosecutions and convictions resulted from this approach, the federal government could not recoup the money after the scams had already been completed. The new software being used by the healthcare program along with stricter screening for healthcare providers is intended to prevent the fraud and save the taxpayers millions of dollars. Time will tell if the new initiative will be more effective in combating fraud than its predecessor.
The upgrades in fraud prevention come as a result of millions of dollars in losses to the federal government. It is well documented that the majority of fraud is an was committed in Miami and throughout the South Florida area. Along with the fraud detection upgrades, the Medicare fraud task forces across the country are working in concert and sharing information.

While Medicare fraud itself is not a serious offense as far as punishment is concerned under the federal sentencing guidelines, the risk lies in the multi-level increases that are directly correlated to the amount of the loss suffered by Medicare. In South Florida, Defendants charged with Medicare fraud are facing 24 to 48 months if they enter guilty pleas and cooperate with government prosecutors and investigators. Defendant who go to trial and are convicted by a jury are looking anywhere form 10 to 20 years depending on their involvement in the fraud. At the present time, individuals charged with Medicare fraud are in the cross hairs of the United States Attorneys Office. Any charged with or being investigated for healthcare fraud, should retain a criminal lawyer with experience in defending these types of cases in federal court.

Former Miami Drug Trafficker Now an Accused Medicare Scammer, Miami Herald.com, July 27, 2011.

Federal officials finally launched the long awaited computer system to combat Medicare fraud. South Florida has been declared "ground zero" for Medicare fraud. A federal task force operating out of Miramar, Florida was the first to use the new program. For the last couple of years, the federal government has spent large sums of money and man hours to combat the crime. Numerous defendants have been sentenced to multi-year prison terms despite the efforts of the Miami criminal defense lawyers representing them. While in the past, the system used to detect and prosecute Medicare fraud has been mainly reactive, the new computer system definitely reflects a more pro-active approach to fighting the offense. While the use of the program began in South Florida, the system is being used nationwide to prevent the theft of millions of dollars from the federal healthcare program.

The new federal system is called "predictive modeling" and is designed to examine millions of Medicare claims filed on a daily basis. The program looks for suspicious claims to prevent fraudsters from using recruited patients or in the alternative using stolen Medicare identification numbers. According to Peter Budetti, the man leading the initiative, the new system will help identify similar scams occurring across the country. The new anti-fraud system is being used by all Medicare fraud task forces, some of which are set up in Miami, Detroit, Houston and Los Angeles. With all that being said, the federal government will continue to apply pressure to all those involved in healthcare schemes to defraud.

Federal investigators, last month, charged 21 defendants accused of stealing $21 million from the federal government. Six of the defendants are from the Miami area while the remainder were operating out of Michigan. Over the past year, South Florida prosecutors have charged in excess of 102 defendants with billing the federal government $441 million in fraudulent claims. Since 2007, the Medicare strike forces have been involved in the arrest in excess of 1,000 individuals responsible for filing $2.3 billion in fraudulent claims. South Florida led the way with $1.85 billion in fake claims. While it is not clear how much has been lost to fraud, estimates have reached as high as $60 billion. The new system of detection is designed to prevent the fraud from occurring while the old system was used to detect it after the fraud had already been committed.

Being investigated for or charged with Medicare fraud is a serious matter. The federal sentencing guidelines take into consideration the amount of loss in determining a potential sentence. The offense of fraud itself is only a level 6 offense. The problems lie with the multi-level increases that occur when substantial losses to federal healthcare system occurred. The cases prosecuted by the federal government are complex and indictments usually contain dozens of defendants. The defense of these types of cases should not be taken lightly and only qualified defense attorneys with experience in the arena should be retained to represent clients charged with this offense.

Medicare Anti-Fraud System Launched, Orlando Sentinal.com, July 11, 2011.

A federal judge sentenced a doctor to 20 years in prison for his involvement in a Medicare fraud scheme that cost the federal healthcare system millions of dollars. The defendant appeared with his Miami criminal attorney and attempted to avert a lengthy prison term by arguing that his client should not die in prison and that he suffers from a heart condition and diabetes. The federal court judge presiding over the sentencing hearing felt little sympathy for the defendant. On the record, the judge chastised him for violating his medical oath, billing the Medicare system and disgracing himself, his family and the community. The defendant was found guilty of charges involving his receipt in excess of a million dollars for writing fake prescriptions with the intent to defraud Medicare. The jury found that the doctor was involved in billing Medicare for HIV treatments that were unnecessary or never provided to patients.

The sentence handed down was the second harshest ever involving a medical doctor convicted of being involved in healthcare fraud. A Miami-Dade physician was charged with a similar Medicare fraud in 2008 and was sentenced to 30 years in prison. That sentence was upheld last year in appellate court with a former United States Supreme Court Justice sitting as a guest judge. She declared, "a doctor should be treated more severely than other participants because the doctor is breaching a position of trust and an ethical obligation to put the patient's interests first." The judge hearing the case yesterday repeated ths same sentiments. The defendant helped operate the scheme using two clinics to bill Medicare. The owner of one of the clinics suffered a far less fate as she cooperated with the government to prosecute other perpetrators.

In federal court, defendants that cooperate with government receive significantly reduced prison sentences than those who go to trial and are convicted by a jury. While cooperating with the government against people you know and used to work with is definitely a difficult situation, it is far better than receiving a double digit prison sentence. Every defendant in federal court should seek qualified representation before deciding to accept or reject a plea. While this decision is always difficult, the case and the evidence supporting it must be critically analyzed to support this decision. The benefit of accepting a plea results in significant level reductions under the sentencing guidelines and of course the benefit of a large sentence reduction that comes with a 5K supported by federal prosecutors.

Federal prosecutors continue to focus on Medicare fraud cases involving HIV treatments, as clinics, mostly in the Miami-Dade area, have billed in excess of $2.2 billion worth of infusion bills. Clinics in the South Florida are have billed for 72% of all HIV Medicare claims despite the fact that only 8% of the population with HIV reside in the same area. While the defense lawyer representing the doctor attempted to appeal to the softer side of the judge, government prosecutors convinced her that the defendant deserved no sympathy and should be sentenced to 30 years in prison. Both the government and the judge focused on the fact that the defendant was a doctor and should be sentenced accordingly for this breach of trust.

Medicare Fraud Nets 20-Year Prison Sentence for Miami Physician, Miami Herald.com, June 27, 2011.

A South Florida woman entered a guilty plea in the Southern District of Florida for her involvement in the largest Medicare fraud case in the nations's history. Margarita Acevedo appeared with her Miami criminal defense attorney in federal court. She is facing between 12 and 15 years in prison for her role in the $200 million healthcare fraud. The indictment alleges that Ascevedo recruited senior citizens with mental health issues residing at assisted living facilities (ALF's) and halfway houses. The proprietors of these establishments would send hundreds if not thousands of patients to seven mental healthcare facilities operating under the name of American Therapeutic.

Acevedo was one of 24 individuals indicted for their involvement in the multi-million Medicare fraud scheme. She and the other defendants are facing long prison sentences. The lengthy prison sentences are not attributable to the crime itself, but the federal sentencing guidelines take into account the amount of loss to the victim when calculating a sentence. Medicare fraud along with other offenses such as larceny, forgery or theft start at a base level offense at 7. Levels will be added depending on the amount of the loss to the government, financial institution, or individual. Other level increases exist depending on the actions of the defendant and the type of victim involved in the case. Anyone interested in looking at the guidelines for these types of offense should check section 2B1.1 in the sentencing guidelines.

Despite the lengthy sentence Acevedo is facing on paper under the federal sentencing guidelines, she will likely on serve a third or even a half of the time she was facing as a result of her cooperation with federal prosecutors and law enforcement investigators. The government will expect many things from her in order for her to receive a significant sentence reduction. First, she will be required to speak with law enforcement and describe in detail the inner workings of the operation. She will also be required to point the finger at the owners and operators of the clinics who provided the fraudulent treatment. She will be required to lay out for the government which individuals at the ALF's and halfway houses were referring over patients and receiving kickbacks. Finally, she may be required to testify against any and all of these individuals at trial.

Acevedo and other individuals at American Therapeutic recruited the living facilities to send patients in exchange for kickbacks. Personnel at the facility would receive $30 for every patient referred over to the clinics. As usual, Medicare did not discover the fraud despite the unusually high number of claims being filed by American Therapeutic. The fraud was only discovered after clinic employees complained that the patients being sent over were beyond help. The owners of the clinics have also been charged and relayed their intent to plead guilty once the amount of loss has been fairly calculated. As stated earlier, the amount of loss is critical in determining the amount of time someone is facing for fraud related charges in federal court.

First Miami Defendant in Nation's Biggest Health Fraud Case Pleads Guilty, Miami Herald.com, April 8, 2011.

The feds are at it again and made 16 arrests for individuals allegedly involved in Medicare fraud. The arrests come as part of what has been dubbed by the government as the largest fraud in Medicare's history, to the tune of about $200 million. Residents of Miami-Dade and Broward Counties were the subjects of the arrests. The case will be prosecuted locally which means that the majority of the defendants will be represented by Broward and Miami criminal defense lawyers. The defendants include doctors, health care administrators and other employees that worked for a company called American Therapeutic.

The defendants are going to appear today in federal court for there first appearance. Several things occur at the first appearance. The defendants have the right to have a private criminal attorney appear on their behalf or request a short continuance in order to retain counsel. If a defendant is comfortable with his or her counsel, the lawyer can file an appearance and address the matter of the bond. The judge or magistrate presiding over the case will determine the amount of the bond based on two simple factors which are the safety of the general public and a defendant's ties to the community which will assure the magistrate that the defendant will appear for all court hearings. In considering the safety of the general public, the magistrate will consider the type of crime for which a defendant was arrested and the defendant's prior criminal history.

In determining whether the defendant's ties to the community merit a particular bond, the magistrate will consider the citizenship of a defendant, property ownership, and the locale where his family, in particular where his or her spouse and children reside. As part of the bond, the defendant or his family may be required to sign as personal guarantors for the bond or be required to put up real estate as collateral for the bond. Typically, a defendant will be required to surrender his or her passport as a condition of the release. At the bond hearing or first appearance, counsel may seek a bond reduction on behalf of his or her client. Once the first appearance portion of the case is completed, the case will be set for an arraignment. At the arraignment, a defense attorney will file a permanent notice of appearance on behalf of the client and will also become aware of the charges the client is facing. At the arraignment, a trial date will be set for the case.

In federal court, trial dates are set quickly and judges do not like to grant continuances. Continuances are generally granted based on the complexity of the charges and the number of defendants listed in the indictment. Because the current Medicare fraud case referred to earlier involves such a substantial loss and thousands of documents will be used as evidence to prove the case, along with 16 co-defendants, the case may stay open for about a year. During that time, defendants will most likely enter pleas to reduce their exposure. Some of the defendants will even enter into agreements with federal prosecutors to testify against other co-defendants. The potential sentences in this case will be extremely high, mostly because the federal sentencing guidelines factor in the amount of loss to the victim which in this case is the federal government and the Medicare program. The only real way to escape the guidelines to cooperate with the government or obtain an acquittal at trial.

Feds Make More Arrests in Major Medicare Fraud Case, Miami Herald.com, February 15, 2011.

A local man was arrested and charged with dozens of counts of credit card fraud and identity theft. He is being accused of being involved with a ring that engages in credit card theft throughout the State of Florida. According to police reports, at the time of the arrest, the defendant had in his possession 109 fraudulent credit cards. Juan Echemendia's bail has been set at $1.825 million. While the defendant is facing a large of number of charges and serious prison time, a good defense team may prevail in his case. Recently, two Miami criminal attorneys appeared in Hillsborough County and won a motion to suppress of behalf of three clients. The court granted the motion and dismissed the information containing in excess of 50 counts.

The defendant is being investigated in other counties by various law enforcement agencies which may lead to additional arrests for identity theft, credit card and possession of fraudulent credit cards. The allegations may be so wide spread that the Florida Department of Law Enforcement may be involved in the cases. Four other suspects have also allegedly been caught on camera with the defendant committing identical crimes. It is not clear if law enforcement will attempt to use the defendant to catch the other suspects, but his assistance could certainly help him secure his release.

Many of the credit card fraud cases are defensible as long as the suspect does not admit to the crimes. The first step is to attempt to get the bail requirement reduced at a bond hearing to secure one's release. Credit card fraud and identity theft cases are fairly complex with voluminous discovery. If a defendant can not make bail, he or she will sit in custody while the defense in the case is prepared. The next step is to evaluate the evidence in the case. If the fraudulent credit cards were used in a retail store, surveillance video of the transaction may exist and can be used by the prosecution at trial. Dozens of police reports are generated in large investigation and must be evaluated to determine where the credit cards were found, what names appeared on the credit cards and by what method the police seized the credit cards.

How the police seized the credit cards is extremely important. The recently won case in Tampa by way of a motion to suppress occurred as a result of an illegal stop ordered by the lead detective. The detective received information from another detective that a person residing in Tampa was involved in marijuana trafficking. The detective set up surveillance on the residence and observed an individual carry a black to garbage bag to the rear of the vehicle. The detective could not see or smell the marijuana. The detective ordered the vehicle stopped and its occupants searched. Two of the passengers possessed fraudulent credit cards. A search of the residence revealed a marijuana grow house and more stolen credit cards. Because the detective did not have reasonable suspicion to stop the vehicle, the judge suppressed the evidence and dismissed all of the charges. This is an example of how and experienced criminal lawyer can win a case even when there appears to be insurmountable evidence against a defendant.

Suspect in Statewide Credit Card Fraud Ring Arrested in Herando, The St. Petersurg Times.com, January 20, 2011.

The Chief Financial Officer for the State of Florida announced six recent arrests involving staged accidents and insurance fraud. Other than mortgage fraud and Medicare fraud, staged accident insurance fraud remains problematic for both politicians and law enforcement. Although Miami criminal attorneys have seen a decrease in the number of staged accident cases hitting the court dockets, arrests are still being made. According to reports, Florida led the nation in false insurance claims related to staged accidents, with New York and New Jersey close behind. The problem became so serious in South Florida, that the Miami-Dade County State Attorney's Office assigned the prosecution of these fraud crimes to a specialized unit. However, Florida tallied approximately 30 arrests last year which was down from previous years.

Insurance fraud is covered under Florida Statute 817.234. Insurance fraud is defined as anyone who presents or causes to present a claim for payment to an insurance company knowing that the information provided was false, incomplete or misleading. Insurance fraud is a third felony punishable up to five years in prison. First-time offenders will often be offered a pre-trial intervention program as long as the person has no prior criminal history. However, the legislature changed the law in staged accident cases because of the large number of fraudulent activity reported.

The current state of the law specifically target individuals who organize, plan or knowingly participate in staged accidents. If individuals fall into these categories and motor vehicle insurance claims were made on behalf of the participants involved in the fraud, the offense is increased to a second degree felony, but more importantly the offense carries a two year minimum prison sentence. Even first-time offenders with no prior criminal record to speak of, still face a prison sentence. While the offense is serious, there are ways to defend these types of cases.

Criminal defense attorneys know that the strength of the prosecutor's cases generally lies with witnesses who have agreed to cooperate with the state in an effort to avoid a jail sentence. In many cases, the state only has testimony of charged and uncharged witnesses trying avoid being prosecuted. Knowing this, it is important to remember never to provide a statement to law enforcement or detectives. Any inculpatory statement will corroborate the testimony of the state witnesses and cause serious problems in defending the case. Anyone contacted by law enforcement regarding a staged accident should seek out and obtain advice from a criminal defense law firm with experience in defending insurance fraud cases.

Six Arrested in Miami for Allegedly Staging Accidents, Sun-Sentinal.com, January 17, 2010.

Another South Florida resident received a significant prison sentence for his alleged involvement in a Medicare fraud scheme. The owner of clinic located in Miami, Florida, received a 60 month prison sentence for fraudulently billing Medicare for home health care services that were either unnecessary or in some instances never provided. After entering a guilty plea, the defendant appeared with his Miami criminal defense lawyer at his sentencing hearing where he was also ordered to perform two years of supervised release and pay $9.8 million in restitution to the federal government. Other defendants were also charged as co-conspirators in the Medicare fraud case.

The defendant purportedly admitted to the Medicare fraud by telling federal law enforcement authorities that he operated the clinic which provided home health care services and billed for unnecessary prescriptions, healthcare plans and medical certifications. The defendant's company submitted fraudulent medical records in order to submit bills to Medicare. The clinic was billing for insulin for patients who allegedly suffered from diabetes. Court records indicated that 344 prescriptions were billed to Medicare for unnecessary treatments or for treatments that were never provided to patients.

The clinic through the defendant billed Medicare for $16.8 million for home health care services. Medicare issued payments back to the clinic in the amount close to $10 million. A co-owner of the clinic had previously received the same sentence for his involvement in the case. Nurses who worked at the clinic also received prison sentences. Two of the nurses received 30 months in prison at their sentencing hearing, while a two other nurses received two and four month prison sentences. These nurses cooperated with federal law enforcement to received the reduced sentences. All of the nurses were ordered to serve probation after their release and make restitution payments. The nurses admitted that they falsified records provided to Medicare that patients were receiving treatment and insulin injunctions, both of which never occurred.

The Medicare Fraud Strike Force conducted the investigation, while the case was prosecuted the U.S. Attorney's Office for the Southern District of Florida. Since inception of the strike force, they have been responsible for 825 indictments of defendants charged with fraudulently billing Medicare in excess of $2 billion. In effort to cut down on the fraud, the Health and Human Services Office of the Inspector General, the Human Health Care Centers of Medicare Services and the FBI are also investigating fraud claims. Medicare fraud is being taken seriously as the fraud eats into the country's budget. Any one being investigated or arrested for fraud related charges should immediately seek out a criminal defense law firm with experience in handling and defending these types of cases as the punishments and fines are severe.

Florida Clinic Owner Sentenced for Role in Medicare Fraud Scheme, 7th Space.com, December 21, 2010.

South Florida is becoming one the leading regions of credit card fraud in the country. Arrests for credit card fraud are occurring on a daily basis from Miami-Dade to Hillsborough County. Last week, detectives in Lee County stopped a vehicle in Fort Myers, Florida for speeding and various other traffic infractions. Police reports indicate that both occupants of the vehicle appeared nervous. The driver allegedly consented to the search of the vehicle. The search uncovered 15 fraudulent credit cards and two fake driver's licenses that matched the names on the fake credit cards. Once the credit cards were discovered, the driver began to struggle with the investigating officer and was placed under arrest. The driver was arrested for charges including trafficking in fraudulent credit cards, possession of counterfeit credit cards, possession of a fraudulent diver's license, identity theft, and resisting an officer without violence.

Any Miami criminal defense attorney will tell you to never consent to the search of your vehicle. Just because a person is stopped for committing a traffic infraction, that does not mean that law enforcement has the right to search a vehicle. Every search and seizure requires a warrant with a few exceptions. Most notably are the consent to search and the automobile exception. For a consent to search to be valid, a person with standing must freely and voluntarily consent to a search. For the automobile exception to apply, the officer must have probable cause to believe that a vehicle contains unlawful contraband. In the event a person is stopped for a traffic infraction, police have two options when attempting to gain access to an automobile. In the event an officer cannot obtain consent, he or she can request a K-9 units to establish probable cause to search the vehicle. In drug possession cases, specially trained narcotics K-9 can be called to the scene of the stop. If the K-9 alerts to a vehicle, the officer will have the requisite PC to conduct a search. However, there is no way a K-9 can alert to fake or stolen credit cards, therefore, the only way an officer can obtain access to the vehicle is by consent. If the defendant in this case would have refused to consent to the search of the vehicle, the police would not have had a basis to conduct the search.

To prove the charge of fraudulent use of a credit card, the prosecutor must establish that a person with the intent to defraud an issuer possessed or retained a credit card with the knowledge that it is fraudulent. The charge itself is a third degree felony punishable up to five years in prison. A five year sentence will apply to each fraudulent card in a person's possession. Trafficking in fraudulent credit cards requires that a person knowingly possess 10 or more fraudulent credit cards. This offense is a second degree felony punishable up to 15 years in prison. Identity theft is the most serious offense that can be charged in cases dealing with fraudulent credit cards. Anyone who wilfully and without authorization fraudulently uses the personal identification of another person with out obtaining consent is guilty of a first degree felony punishable up to 30 years in prison. Anyone found guilty of identity theft involving more than 30 victims is facing a 10 year minimum mandatory prison sentence.

Prosecutors, both in the state in federal criminal justice systems take all forms of credit card fraud very seriously due to the victim impact. Anyone arrested for possession of fraudulent credit cards, trafficking in fraudulent credit cards, any fraudulent credit card offense or identity theft should immediately contact a criminal defense law firm to defend the charges as convictions for these types of offenses can end in long prison sentences and hefty fines.

Woman Arrested After Counterfeit Credit Cards Seized in I-75 Traffic Stop, News-Press.com, December 9, 2010.

A local man appeared in federal court and received a 57 month prison sentence for his involvement in a Medicare fraud scheme involving millions of dollars. Jose Garcia was sentenced for the alleged improprieties surrounding his Miami HIV clinic. The defendant appeared with his Miami criminal attorney at the sentencing hearing before a United States District judge. Initially, the defendant received a bond at his first appearance hearing, but soon absconded. He surrendered to the FBI earlier this year and remained in custody for violating the conditions of his pre-trial release.

The indictment alleged that the defendant committed large scale Medicare fraud with other co-conspirators. The group operated a clinic called Global Med-Care Corp., Inc., which like in so many South Florida cases billed Medicare for HIV treatments that were not medically necessary or that were never provided to patients. In order to procure patients, the clinic paid kickbacks to secure their presence for treatment or for a lack of treatment. According to court documents the clinic through the defendant billed Medicare in excess of $10.9 million.

Another co-defendant received a 30 month sentence after he pled guilty to one count of conspiracy to commit Medicare fraud. Three other defendants were also indicted for their involvement. The indictment alleged that these individuals fronted the money to open and staff the clinic. These defendants were charged in a different indictment and one has already pled guilty and been sentenced. The sentences he received was much harsher at 14 years because the fraud exceeded $100 million. These defendants were also charged with money laundering. Two of the defendants have fled and are fugitives. Once apprehended the federal government will seek an extradition back to Miami for trial.

Like in all recent Medicare fraud cases, the Strike Forces compiled by the federal government were responsible for the arrest. The Strike Force continues to operate in seven districts which are responsible for the most Medicare fraud in the United States. They are responsible for obtaining indictments on 825 individuals involved in Medicare and healthcare fraud in general. Anyone being arrested for or charged with Medicare fraud should consult with a criminal defense law firm experienced in defending these matters in federal court.

Operator of Miami HIV Clinic Sentenced to 57 Months in Prison for Role in Medicare Fraud Ring, The Cypress Times.com, November 19, 2010.

Federal law enforcement has charged four South Florida residents for their involvement in a multi-million dollar Medicare fraud scheme. According to the indictment, four healthcare operators attempted to bilk the federal healthcare program out of $200 million for medical services they did not perform. The indictment accuses four Miami-Dade County residents of being linked to American Therapeutic Corporation. The companies owner, chief executive officer and two other employees were taken into custody last week. American Therapeutic is the largest chain of clinics supported by the federal healthcare system. The defendants will make their initial appearance with their privately retained Miami criminal defense lawyers or attorneys from the federal public defender's office.

The indictment alleges that the company and the defendants charged Medicare on behalf of Alzheimer's patients for treatments that were not necessary or in most circumstances for treatments that were not even provided. Most of the purported healthcare recipients were referred to American Therapeutic by assisted living facilities (ALFs) in exchange for monetary kickbacks, The Medicare fraud case cost losses in excess of $163 million to the federal healthcare system and is one of the largest fraud cases on record. Like the other large fraud cases in recent history, The Medicare Frauds Strike Force was at the heart of the investigation.

Despite the media attention that the offenses of Medicare fraud and healthcare fraud, in general, have gathered due the long list of arrests and convictions have not dissuaded individuals from continuing a criminal course of conduct. The Justice Department holds press conferences after every major bust, but despite the dissemination of the information, Medicare fraud continues to exist. According the newest press release, the federal government will continue to fight the ongoing fraud at all costs. Last month, President Obama signed a new law requiring Medicare requiring the use new technology to flag suspicious activity rather than just paying out the billing requests. Until the recent law was passed, Medicare paid out bills without verifying whether or not the bills were fraudulent or not.

The federal healthcare system has been required to place a watch on many Miami-Dade clinics, as well as, clinics located in New York and Los Angeles where the majority of the fraud cases originate. Why is Miami a target of healthcare fraud? Last year alone, more than 100 clinics, the majority of which are located in Miami-Dade County submitted in excess of $425 million dollars in bills to Medicare. Fifty-six percent of all payments from Medicare were made to South Florida clinics, with the majority being in Miami, Broward and Palm Beach Counties. Anyone being investigated for or that has been arrested for Medicare fraud, should immediately retain a Miami criminal defense law firm specializing in defending healthcare fraud cases in federal court.

Federal Agents Round Up Ring of Mental Health Operators in Alleged $200 Million Medicare Fraud Case, The Miami Herald.com, October 21, 2010.

Police out of Tampa arrested eight people for being involved in an insurance fraud scheme involving staged accidents. Tampa has taken over the top spot from Miami regarding these types of offenses. Hillsborough County has become acutely aware of the problem it faces regarding insurance fraud of this kind and intends to use significant assets to quash it. From 2008 to 2009, Hillsborough County experienced a 290% increase in staged accident claims rising from 232 to 487. Included in the in the figures are Tampa, St. Petersburg and Clearwater. The Hillsborough police says they uncovered a new type of scam where U-Haul trucks are used in the accidents because renters can secure a $1 million dollar policy for $100.00. As a Miami criminal attorney, I can tell you that the use of rental trucks due to high insurance coverage have been used in dozens of cases in South Florida.

For years, Miami had been considered the staged accident capital of Florida, but stricter laws and specialized insurance fraud units made life increasing difficult for those who were involved in staged accidents for the purpose of attending sham clinics and billing insurance companies for non-existent injuries. Miami was able to curb the problem form the bottom up Drivers and passengers of vehicles involved in staged accidents were arrested and facing significant jail time as a result of changes in the legislature. The law changed to read that any person that organizes, plans or participates in an intentional motor vehicle accident with the intent of filing personal injury claims is guilty of committing a second degree felony. More importantly, the offense carries a two year minimum prison sentence.

Because drivers and passengers were facing such dire consequences and most of the defendants were first-time offenders, they were offered the opportunity not to be arrested or receive significantly reduced sentences for their cooperation in prosecuting the accident planners, clinic owners and doctors involved in the elaborate schemes. Eventually, the majority of the drivers and passengers had provided enough information where the individuals responsible for the majority of the losses to the insurance companies were taken out of circulation. Dozens of clinic owners, doctors and others involved in the day to day operations of the clinic were arrested and the clinics closed. Over the past year, the number of arrests in Miami for staged accident insurance fraud cases have been significantly reduced, although the state court criminal docket remains replete with these types of cases. The cases stay open do to the swelling number of cases in the Miami-Dade County criminal justice system.

The overloaded docket and the overwhelmed prosecutors at the state attorney's office often provide the best defense to a stage accident insurance fraud case. An defense attorney will tell you that the longer a cases remains open the better the result will likely be for the defendant. The strength of these insurance fraud cases lies with flip witnesses or in other words with co-defendants who have been promised deals to testify against the ringleaders of the operations. Seldom is there any physical evidence and the prosecution relies solely on testimonial evidence. As long as a defendant did not make an incriminating statement to law enforcement, a solid cross-examination of the state witnesses will more often than not lead to an acquittal on the charges. Even if a case is weak, insurance fraud investigators leave little discretion to plead case out with the prosecutors. That being the case, anyone arrested for staged accident insurance fraud should prepare themselves for trial, at least in Miami-Dade County.

Hillsborough Deputies Arrest Suspects in Staged Car Crashes, TampaBay.com, October 9, 2010.