The owner of a rehabilitation clinic in Miami and two of her employees, all of Cuban descent, were arrested this Tuesday. They face over twenty serious charges each, including organized crime and insurance fraud, according to authorities in the state of Florida.
An undercover operation by the Bureau of Insurance Fraud from the Florida Department of Financial Services uncovered and dismantled an insurance fraud scheme orchestrated from Ace Medical & Rehab Center, located at 3990 W. Flagler St. in the Flagami neighborhood, reported Local 10 News.
Police arrested the clinic's owner, Yanirma Toledo, 43; advanced registered nurse practitioner Maylett Leiva Santana, 42; and therapist Lensky José Hernández Santiago, 43. All three reside in the southwest of Miami-Dade.
According to the arrest report, Ace Medical & Rehab Center billed insurance companies $47,310 for multiple therapy sessions that never took place. The investigation began in January after authorities received "multiple tips" that the three defendants were "deceiving and defrauding insurance companies."
Police documents state that on January 30, investigators created a fake accident report and sent two operatives to the rehabilitation center. At the clinic, undercover witnesses were asked to fill out medical and therapy forms before being consulted by a doctor for routine exams and X-rays, but no actual therapy was conducted.
The arrest report notes that Hernández Santiago paid one of the witnesses to bring the other to the health center. Additionally, he instructed Leiva Santana—identified by police as the clinic’s "doctor"—to add a non-existent injury in one of the claims to "extract more money from insurance companies," according to the document accessed by Local 10 News.
Each defendant faces charges of organized crime, conspiracy to commit organized crime, and conspiracy to commit grand theft, two counts of organized scheme to defraud, and 23 counts of insurance fraud. Hernández Santiago is also charged with money laundering.
Following their arrest, the three were taken to the Turner Guilford Knight Correctional Center (TGK) in Miami-Dade.
Details on the Miami Insurance Fraud Case
This section answers some frequently asked questions about the recent insurance fraud case involving a Miami clinic owner and her employees.
Who are the main individuals involved in this case?
The main individuals involved are Yanirma Toledo, Maylett Leiva Santana, and Lensky José Hernández Santiago, all of Cuban descent residing in Miami-Dade.
What charges are they facing?
They are facing charges including organized crime, conspiracy to commit organized crime, conspiracy to commit grand theft, organized scheme to defraud, and insurance fraud. Hernández Santiago is also charged with money laundering.
How was the fraud uncovered?
The fraud was uncovered through an undercover operation by the Bureau of Insurance Fraud, which included creating a fake accident report and sending operatives to the clinic.