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Dr. Angel Amado Lazo, Arlene Hernandez Garcia, and Clara R. Segura of Miami, Florida Arrested Fraudulent Insurance Claims and Third-Degree Grand Theft

Arlene Hernandez Garcia and Clara SeguraDr. Angel Amado Lazo, 79, the owner of Brothers Medical Center; Clara R. Segura, 43, a therapist; and Arlene Hernandez Garcia, 32, a receptionist, were arrested in Miami, Florida on Monday. The trio was brought in by the Staged Accident Detail, a federal task force of the Miami Police Department that combats medical insurance fraud.

Lazo, Segura, and Garcia face charges for grand theft, organizing a scheme to defraud, and false health insurance claims. It is unclear whether bond has been set for any of the three or if they’ve acquired the services of an attorney.

According to the police report, the arrests were the culmination of an investigation that started in September of last year. An undercover officer working with the Staged Accident Detail posed as an accident victim to help investigators gather enough evidence to make the arrests. Details of the case are still not available to the public.

Miami is a hotbed for crimes involving health care fraud, and several arrests have been made over the past month in an effort to crackdown on the practice. A spokesperson for Miami police said in a statement with regards to the case that “if you are stealing from insurance companies, everyone is going to have to pay for that theft.”

Last Friday, Gabriela Alegria of Miami, Florida was arrested for performing illegal Botox injections while awaiting sentencing for her involvement in a Medicare fraud case. Alegria, 43, is believed to have defrauded the government of more than $700,000. She pleaded guilty and was released on bond, only to be arrested again last week for performing illegal cosmetic procedures.

In another recent case, the owners and office managers of two clinics were arrested last week for allegedly stealing $2.7 million from the Miami-Dade school district through a healthcare insurance scam. Osvaldo Garca, Osmani Gonzalez, Ailyn Cuervo and Daymi Crespo, were arrested in Miami and face charges for health care fraud.

But perhaps the biggest health care fraud case reported this month is the $1-billion Medicare fraud scheme involving Philip Esformes, Odette Barcha, and Arnaldo Carmouze. The U.S. Justice Department is calling the case the “largest single criminal health-care fraud case to ever be brought against individuals.” It appears the Esformes case has lead to a severe crackdown on South Florida clinics that defraud government-run health programs that are primarily meant to help the elderly and the poor.

Esformes and his co-conspirators were arrested late last month and are being held without bond pending a detention hearing. Barcha and Esformes face charges of conspiracy, money laundering, health care fraud, and obstruction of justice; Carmouze is only facing the first three charges.

According to court records, Esformes is the owner of 30 nursing homes in the Miami-Dade area. He allegedly worked with his co-conspirators to provide expensive and unnecessary medical services to his patients. These services were allegedly illegally billed to Medicaid and Medicare. Esformes is also accused of “preying” on his patients by getting them addicted on narcotics so they would remain in his facilities, allowing him and his co-conspirators to continue with their alleged fraud scheme.

Source: 8.8.16 Lazo, Garcia, Segura Healthcare Insurance Fraud, Grand Theft.pdf