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Hospital Worker, Clinic Owner Accused of Steering Accident Victims into Inappropriate PIP Treatment


TALLAHASSEE -- A Brandon hospital emergency room clerk and a clinic operator have been arrested for collaborating to steer at least a dozen auto accident victims into unauthorized soft-tissue injury treatments that did not address their real injuries, including in one case head trauma and in another a broken leg, Florida Treasurer and Insurance Commissioner Tom Gallagher announced today.

Barbara Massa-Smith, 39, a Brandon Regional Hospital clerk, and Sharon Piatt, 51, owner of Montclair Clinic located at 110 N. Montclair Ave., were arrested Tuesday by Department of Insurance fraud investigators and were booked into the Hillsborough County Jail. Massa-Smith and Piatt are each charged with racketeering, organized fraud and eight counts of insurance fraud, and face up to 85 years in prison each if convicted. Further, Montclair Clinic is charged with corporate racketeering and could face closure.

"The crime here goes beyond the fraudulent payments that these two may have received from the insurance companies," Gallagher said. "People's lives and health were put at risk when they were sent to a clinic for treatment unrelated to the critical care they needed."

Investigators said Piatt offered last fall to pay Massa-Smith $300 for each accident victim she could get into Montclair Clinic for treatment that could be billed to the patients' Personal Injury Protection (PIP) portion of their automobile insurance coverage. Florida drivers are required to carry a minimum of $10,000 PIP coverage in addition to $10,000 property damage liability coverage.

Montclair Clinic staff included a travelling medical doctor, a chiropractor and a massage therapist. Most of the patients steered to the clinic immediately became suspicious and left without getting any treatment at Montclair, including a woman with a broken leg who said she was told that the clinic could not help with the swelling inside her cast and a woman whose husband had vomited all night from a head injury that the clinic couldn't diagnose.

Piatt allegedly used the personal information that Massa-Smith collected in the emergency room - as the victims were brought in for initial treatment - to later contact them and advise that the hospital had identified injuries that needed treatment at Montclair Clinic.

Brandon Regional Hospital officials contacted fraud investigators after hearing from patients complaining that the hospital was sending them to the clinic, which the hospital told investigators never happened. Investigators said Massa-Smith believes she may have referred as many as 80 patients to Montclair since last November.

Investigators have not yet determined just how much the pair may have billed or collected, but said claims were billed to insurance companies including Atlanta Casualty/Windsor Insurance Group Company, Allstate, State Farm, and AIG.

The Department of Insurance, Division of Insurance Fraud, investigates various forms of fraud in insurance, including health, life, auto, property and workers' compensation insurance. Anyone with information about this case or any possible fraud scheme should call the Department's Fraud Hotline at 1-800-378-0445. Se ofrece una recompensa de hasta $25,000 a cambio de información que conduzca a una condena en casos de fraude de seguros.