The bus drivers weren’t hurt in accidents, but you couldn’t tell that from the hundreds of insurance claims. The scam is over, halted by authorities who say they busted the scheme to defraud Miami-Dade County’s health insurance plan of tens of thousands of dollars.
The Miami-Dade public corruption bureau arrested six top executives of AZJ Medical Center in Miami and put out an arrest warrant for company president Elvis Garcia, who had left the building. The alleged perpetrators were charged with filing false insurance claims, grand theft, organized scheme to defraud, and patient-brokering.
This is standard stuff at the clinics that rip off insurance companies and drivers on Personal Injury Protection (PIP) claims. Organizers fabricate records of injuries and treatments and bill the insurer for the maximum amount. Sometimes, crews stage accidents to generate more claims.
At AZJ, operators recruited transit workers so the medical center could file phony claims with the insurance company administering the self-funded county plan. One bus driver generated billings for 135 visits and 758 treatments. But police say that the individual received only a handful of massages. Another worker signed blank medical forms that were turned into invoices.
One informant told investigators that she was paid more than $6,000 in cash to provide her name and insurance policy for fake claims and to recruit others to the scam. A clinic employee told police that he received $45 from the bosses each time he signed off on progress forms for patients he never treated. Another employee signed off on forms for patients seen by a massage therapist who pretended to be an occupational therapist.
Those are common practices at clinics that engage in PIP fraud. Injuries and treatments are invented and become insurance bills. At the AZJ clinic, authorities first arrested seven transit workers on charges they were part of an insurance swindle. A year later, police had enough evidence to go after the ringleaders.