LAWFUEL – The Law News Network – R. Alexander Acosta, United States Attorney for the Southern District of Florida, and Michael S. Clemens, Special Agent in Charge, Federal Bureau of Investigation, Miami Field Office, announced today that twenty-two (22) individuals and entities, including chiropractors, massage therapists, and four (4) medical clinics were indicted by a federal grand jury in a multi-million dollar health care fraud scheme. The Indictment charges the defendants with conspiracy to commit health care fraud, health care fraud, false statements relating to health care matters, and conspiracy to commit money laundering. The case has been assigned to United States District Court Judge Marcia Cooke. The defendants made their initial appearance this afternoon before Magistrate Judge William Turnoff in Miami, Florida, at which time the Indictment was unsealed.
Among those charged in the thirty-three (33) count Indictment were: Boris Royzen, his wife, Eva Royzen, Dmitry Rakovsky, Drs. Enrique Gonzalez-Pujol, Ambroise Forte, and Norma Roche, chiropractors, massage therapists and a receptionist who were owners and employees of the four defendant medical clinics. The clinics charged in the Indictment are Vista Mar Medical Rehab Corp., Plantation Medical Recovery Center, Inc., Romana Medical, Inc., and Dial Medical Rehab, Inc.
As set forth in the Indictment, from November 2003 through July 2005, the defendants conspired to commit health care fraud by submitting fraudulent health insurance claim forms to private insurance companies for services that were not medically necessary and/or were not rendered. The fraudulent claims were submitted under personal injury protection (PIP) provisions for alleged victims of automobile accidents. Boris Royzen and Dmitry Rakovsky paid runners to solicit victims and alleged victims of automobile accidents to become patients of the clinics. In addition, Boris Royzen and Dmitry Rakovsky caused fraudulent applications to be filed with the State of Florida, which applications falsely stated that the defendant clinics were 100% owned by licensed medical practitioners when, in fact, the medical practitioners named on the applications were employees of the clinics. The Indictment lists thirty (30) private insurance companies, including State Farm, GEICO, AllState, Ocean Harbor Insurance, Liberty Mutual, MetLife, Direct, Federated Insurance and United Auto Insurance to which the defendants submitted fraudulent claims. The defendant medical clinics received over $8.5 million in insurance payments as a result of this fraudulent activity.
With regard to the money laundering charges, the indictment alleges that the defendant clinics employed management companies owned by Boris Royzen, Eva Royzen and Dmitry Rakovsky through which funds were channeled back to those defendants.
If convicted on the health care fraud conspiracy counts, the defendants face a maximum statutory term of five (5) years’ imprisonment. If convicted of the related health care fraud counts, the defendants named in those counts face a maximum statutory sentence of 10 years. If convicted on the charge of making false statement relating to health care matters, those defendants will face a maximum statutory term of five (5) years’ imprisonment. The money laundering conspiracy and its related substantive money laundering charges are all punishable by a maximum penalty of twenty (20) years in prison.
United States Attorney Acosta stated, “Health care fraud is a federal crime, not a profitable business venture. Would-be fraudsters should know that this Office stands resolved to fight health care fraud – whether in the private or public health care systems.”
Mr. Acosta commended the investigative efforts of the Federal Bureau of Investigation and expressed appreciation for the assistance provided by the Florida Department of Law Enforcement, the National Insurance Crime Bureau (NICB), the Florida Department of Financial Services and the Sunny Isles Beach Police Department. In addition, Mr. Acosta commended the efforts and support of all of the insurance companies involved in this investigation, including Gainsco Company, Ocean Harbor Insurance, GEICO, State Farm, Liberty Mutual, MetLife, Direct, United Auto Insurance, and Federated Insurance. This case is being handled by Assistant United States Attorneys Jennifer Keene and Laurence Bardfeld.
A copy of this press release may be found on the website of the United States Attorney’s Office for the Southern District of Florida at www.usdoj.gov/usao/fls . Related court documents and information may be found on the website of the District Court for the Southern District of Florida at www.flsd.uscourts.gov or on .
