Boca Raton Back Doc Busted For Fraud

BOCA RATON, FL (BocaNewsNow.com) — Boca Raton resident Jennifer Adams, a chiropractor, is facing 20 years in prison after pleading guilty to conspiracy to commit mail fraud after federal investigators accused her of taking part in “staged” accidents used to generate business and profit off of insurance claims.

Adams, who like other chiropractors called herself a “doctor,” admitted to using recruiters who taught would-be claimants how to stage an accident, file a police report, then make insurance claims.

From the US Attorney's Office:

Wifredo A. Ferrer, United States Attorney for the Southern District of Florida, Michael B. Steinbach, Acting Special Agent in Charge, Federal Bureau of Investigation (FBI), Miami Field Office, Jose A. Gonzalez, Special Agent in Charge, Internal Revenue Service, Criminal Investigation Division (IRS-CID), and Jeff Atwater, Florida Chief Financial Officer, announced that defendant Jennifer Adams, 39, of Boca Raton, a chiropractic doctor, pled guilty today to a one-count Information charging her with conspiring with others to commit mail fraud for her role in a staged accident fraud scheme.

Sentencing will occur at a later date before U.S. District Judge Daniel T. K. Hurley. At sentencing, Adams faces a maximum term of imprisonment of twenty (20) years, to be followed by a term of supervised release of not more than three (3) years, a fine up to $250,000, and mandatory restitution of $1,920,424.83.

According to court documents, to execute the fraud scheme, the recruiters sought out drivers and their friends/family members to participate in staged accidents. Under Florida’s “No Fault” insurance law, insurers are required to provide Personal Injury Protection (PIP) coverage of $10,000 per person. The recruiters referred to the individuals whom they recruited as the “Perro” and the “Perra.” The “Perro” was the person who “caused” the staged accident. The “Perra” was the person who was the “victim” of the staged accident and whose car was struck by the “Perro’s” car. Thus, if the recruiter found a Perro with a wife and two children and a Perra with two friends, for a total of seven (7) participants, the maximum PIP benefit was $70,000.

Once the recruiters found the participants, they coached the participants on how to perform the staged accident, what to say to the police officer who responded to the scene, and on how to claim that they had been injured. Thereafter, the accident was staged. After impact, a police officer was called, and a police report was filed. After the staged accident, the Perro and Perra filed false claims with their insurance companies, alleging that they and their family members were injured.

Court documents state that the accident participants were then directed by the recruiters to chiropractic clinics that were controlled by co-defendants. The staged accident participants completed paperwork falsely asserting that they suffered injuries during the staged accident. The co-conspirators advised the participants on how to fill out the paperwork and what to say if an insurance investigator interviewed them about their injuries or treatment. The staged accident participants were instructed to sign numerous blank treatment forms that would later be submitted indicating that they had visited the clinic on a number of separate occasions for treatment, although they may have visited the clinic only once or twice. During their visits, some staged accident participants received no treatment at all, or may have received only a short exam or treatment from the chiropractor or LMT but the paperwork completed by the LMTs and chiropractors, including Dr. Adams, indicated that a full and lengthy exam and treatment was given.

According to documents filed as part of today's hearing, Adams agreed to place her name on the corporate paperwork for two clinics, thus utilizing her status as a licensed Chiropractic Physician, to allow the clinics to bill insurance companies directly for PIP claims without obtaining additional licensure from the State of Florida. Those clinics were Ovy Rehabilitation Medical Center, Inc. (OVY) in West Palm Beach, Florida and Chiropractic Office of South Florida, LLC (COSF) in Palm Springs, Florida. Although Adams was named as the owner of the clinic on the corporate paperwork, the co-conspirators maintained control of the bank account and running the operations of the clinics.

Court documents state that Adams initially believed the clinics to be operating legitimately. Sometime thereafter, Adams became aware that her license and status as a Chiropractor was being used to fraudulently submit claims by U.S. Mail to insurance companies. Adams realized these patients did not require the medical treatment they sought. Adams continued to work at both clinics signing prescriptions for plans of treatment that she knew were not medically necessary and that she knew were being submitted for reimbursement to numerous insurance companies. According to court documents, from the time that Adams was told about the fraud until the clinics were closed by law enforcement, the clinics submitted fraudulent claims that resulted in more than ten insurance companies making total payments of $1,920,424.83. Defendant Adams received a salary for her work as a chiropractic physician paid from the COSF and OVY checking accounts. The bulk of the proceeds of the fraud were taken by co-conspirators.

Mr. Ferrer commended the investigative efforts of the FBI, IRS-CID, and the Florida Department of Insurance Fraud, and issued a special thanks to the National Insurance Crime Bureau (NICB) for its assistance in this investigation. Mr. Ferrer also thanked the members of the Greater Palm Beach Health Care Fraud Task Force. The case is being prosecuted by Assistant U.S. Attorney A. Marie Villafaña.

 

 

 

 

 

 

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  1 comment for “Boca Raton Back Doc Busted For Fraud

  1. November 8, 2012 6:18 pm at 6:18 PM

    It’s such a waste that doctors get involved with this type of thing. After all the hard work to go through school, pass the national and state boards, and then pass the Florida state exam. Most of the time you see people doing this that have little to lose. In this case, all that studying and everything that she worked for is flushed down the toilet. Such a waste…

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