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13 Charged in Scheme That Lured at Least 300 Patients


TALLAHASSEE -- Florida Treasurer and Insurance Commissioner Tom Gallagher and Statewide Prosecutor Melanie Ann Hines announced today that felony charges have been brought against 13 suspects in an ongoing investigation into a network of fraudulent heart monitoring service and billing companies. The companies based in Dade and Broward counties, lured more than 300 patients into a million-dollar billing scheme.

To date, seven suspects have been arrested -- three on Thursday and four last September. Four others are expected to surrender over the next few days. Se esperan más arrestos.

"This was an elaborate billing scheme designed to be virtually undetectable," Gallagher said, noting several of the suspects are charged with racketeering or conspiracy to commit racketeering because of the organized nature involved in the scheme.

The network included five heart monitoring service companies, three medical companies, a medical billing company, a management company and an unlicensed physician placed in a busy Miami clinic. Department of Insurance fraud investigators said the group billed insurance companies at least $1 million for heart monitoring services never rendered, collecting more than $410,000 in payments since March 1998.

According to investigators, most of the proceeds were funneled to Maria Prieto, 43, of Ft. Lauderdale, who operated Pacificare Case Management Inc. from her 15756 S.W. 17th St., Ft. Lauderdale home. Maria Prieto, her 43-year-old husband Carlos Manuel Prieto, and Gabriel O. Sanchez, 38, of Miami – the man investigators said impersonated a physician – are believed to be on the run to avoid prosecution on charges filed against them last September. More charges were issued Thursday against Maria Prieto and Gabriel O. Sanchez.

Also facing additional charges is Heirol Yanko Tamayo, 25, of Miami, who was originally arrested last September.

Among Thursday's arrests were Maria Prieto's brother, Noel Gonzalez, and sister-in-law, Frances Gonzalez, both 35, of Pembroke Pines.

Dr. Fausto Castillo, owner of Physicians Association, located at 8420 W. Flagler St., Suite 214, Miami, told investigators he never suspected Sanchez was not a licensed doctor when he hired him more than two years ago. At the clinic, Sanchez allegedly lured hundreds of patients into his scheme to obtain their insurance billing information and fraudulently bill for heart monitoring services that were never rendered. In exchange, Sanchez allegedly offered patients a percentage of what the insurance companies paid.

Sanchez allegedly forwarded the patient information to the heart monitoring service companies, which created and filed the fraudulent health insurance claims, replete with forged doctors' signatures. Investigators said three of the medical companies were used primarily to launder the insurance proceeds. Further, a group of individuals opened various corporate bank accounts in the medical company names and another group withdrew the money by cashing corporate checks and funneled the cash back to Maria Prieto, who used it to pay her associates and buy patient information.

Investigators said Prieto's sister-in-law, Frances O. Gonzalez, owned Accurate Express Billing Inc., located at 13380 S.W. 131st St., Suite 114, in Miami, and allegedly assisted with billing for the heart monitoring service companies. Her husband, Noel, owned Nationwide Services Inc., one of the medical companies suspected of laundering proceeds. The others were Transworld Medical Services Inc., owned by Tamayo, and B.B. Medical Services Inc., owned by Ignacio J. Regueyra, 35, of Miami.

Investigators identified the heart monitoring service companies, the first of which was established in early 1998, as: W.E. Cardio Monitoring Services, Inc., 1140 W. 50th St., Suite 202, Hialeah; Cardio-Central Corp., 401 Lejeune Road, Suite 303, Coral Gables; R.S. Cardio Monitoring Services Inc. and Nations Heart Monitoring Services Inc., both located at 4800 S.W. 64th Ave., Suite 105B, Davie; and Aceart Cardio Monitoring Services Inc., located at the same Miami address as Accurate Express Billing Inc.

The investigation was conducted by the department's medical fraud squad within the Division of Insurance Fraud. Prosecution is being handled by the Office of Statewide Prosecution in Fort Lauderdale.

The Department of Insurance, Division of Insurance Fraud, investigates various forms of fraud in insurance, including health, life, auto, property and workers' compensation insurance. Cualquier persona con información acerca de este caso u otra posible confabulación de fraude debe llamar a la Línea de Ayuda al Consumidor del departamento de Fraude al 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.

Below is a list of the suspects and their charges.

Suspect List

Mario Prieto, 43 (DOB 10/27/57), 15756 S.W. 17th St., Ft. Lauderdale -- charged with racketeering, two counts of grand theft and four counts of money laundering.

Carlos Manuel Prieto, 43 (DOB 08/20/57), 15756 S.W. 17th St., Ft. Lauderdale, -- charged with conspiracy to commit racketeering and one count of money laundering.

Gabriel O Sanchez, 38 (DOB 02/28/62), 7210 S.W. 126th Court, Miami – charged with racketeering and one count of grand theft.

Heirol Yanko Tamayo, 25 (DOB 12/10/75), 8511 N.W. 8th St., Apt #202, Miami – charged with five counts of money laundering, additionally charged with conspiracy to commit racketeering and one count of money laundering in September 2000.

Ignacio J. Regueyra, 35 (DOB 11/30/65), 1420 S.W. 90th Ave., Miami – charged with conspiracy to commit racketeering and one count of money laundering.

Alexis M. Avello, 34 (DOB 11/12/66), 3022 S.W. 134th Place, Miami – charged with racketeering or conspiracy to commit racketeering, one count of grand theft and three counts of money laundering.

Leonard Vidal, 28 (DOB 1/11/73), 14954 S.W. 58th St., Miami – charged with one count of grand theft.
Jason Olivera, 23 (DOB 2/26/77), 8500 S.W. 133rd Ave., Bldg. 3, #415, Miami – charged with conspiracy to commit racketeering.

Noel Gonzalez, 35 (DOB 10/30/65), 1501 N.W. 159th Ave., Pembroke Pines – charged with conspiracy to commit racketeering and three counts of money laundering.

Frances O. Gonzalez, 35 (DOB 3/31/64), 1501 N.W. 159th Ave., Pembroke Pines – charged with conspiracy to commit racketeering.

The following were charged, along with Tamayo, last September:
Gabriel Sinclair, 26 (DOB 11/28/74), 620 N.W. 109th Ave., Apt. #3, Miami – one count of money laundering.
Mark Andrew Artiles, 28 (DOB 11/24/73), 3251 W 77th Place, Hialeah -- one count of grand theft.
Alain Fernandez, 28 (DOB 12/18/73), 4954 S.W. 58th St., Miami -- one count of grand theft.