Miami clinic owner, nurse among 3 accused of racketeering, insurance fraud

www.local10.com, Chris Gothner, September 3, 2024

MIAMI – The owner of a Miami rehab clinic and two of her employees — a nurse practitioner and a therapist — are each facing more than two dozen felony charges, including counts of racketeering, after state authorities said they busted an insurance fraud scheme in an undercover sting.

Ace Medical & Rehab Center, located at 3990 W. Flagler St. in the Flagami neighborhood, was the focus of the Florida Department of Financial Services Bureau of Insurance Fraud investigation.

Authorities arrested clinic owner Yanirma Toledo, 42, advanced practice registered nurse Maylett Leiva-Santana, 42, and therapist Lensky Jose Hernandez-Santiago, 43, on Tuesday. All three live in southwest Miami-Dade; Leiva-Santana and Hernandez-Santiago share the same address on Southwest 229th Street in the Goulds area, according to arrest reports, which do not explain the nature of their relationship.

The reports state that investigators began their probe into the facility in January after receiving “several tips” that the trio were “misleading and defrauding insurance companies.”

Authorities said on Jan. 30, investigators created a fake crash report and had two cooperating witnesses go to the facility.

There, authorities said they were asked to fill out medical and therapy forms before seeing a doctor and received routine checkups and X-rays with no actual therapy being performed. Authorities said the clinic billed insurance companies for numerous therapy sessions that never occurred.

According to the arrest reports, Hernandez-Santiago paid one of the witnesses for bringing the other to the clinic.

Hernandez-Santiago also told Leiva-Santana, identified in the arrest reports as the clinic’s “doctor,” to add a nonexistent injury to a claim so “they could get more money from the insurance companies,” authorities said.

Authorities said the trio billed United Auto Insurance $47,310 for the non-existent injuries.

Each faces individual charges of racketeering, conspiracy to commit racketeering and conspiracy to commit grand theft, two charges of organized scheme to defraud and 23 counts of insurance fraud.

Additionally, Hernandez-Santiago faces a money laundering charge.

All were being held in the Turner Guilford Knight Correctional Center on varying bond amounts as of Tuesday afternoon.

News article: https://www.local10.com/news/local/2024/09/03/miami-clinic-owner-nurse-among-3-accused-of-racketeering-insurance-fraud/