On Friday authorities arrested arrested Robbie N. Chamoun, 30, and Nazih Boulos Chamoun, 74, owners of Sky Imaging located in North Miami Beach for alleged PIP fraud. The two are accused of operating an unlicensed accident clinic and fraudulently billing more than $1.5 million in auto-related claims to insurance companies.
Specifically the owners of Sky Imaging lacked licensing from the Agency of Healthcare Administration (AHCA) and instead enlisted a medical doctor to sign paperwork and pose as the clinic owner to qualify to bill Florida PIP insurers.
The article from the SunSentinel is available here.
According to an Insurance Information Institute (III) report and an National Insurance Crime Bureau (NICB) study, questionable claims arising out of duplication billing rose 37% from 2010 to 2011. Also increasing over the same period were questionable claims arising out of excessive treatment which increased 24% over the same period. Also noted in the III report:
The III reported in December 2011 that widespread criminal activity and abuse of the state’s no-fault auto insurance system would result in an additional $658 million “fraud tax” on auto insurance costs in 2011, a 7 percent increase from 2010. On a per-vehicle basis, the $658 million works out to $58 for every vehicle in Florida. Since 2009 no-fault fraud has cost the state’s drivers and insurers nearly $1.3 billion.
The full report is available here.
According to Florida House sponsor Jim Boyd, R-Bradenton , and his Senate counterpart Joe Negron, R-Stuart, the new PIP law is expected to be signed by Governor Rick Scott tomorrow despite recent reports on the potential six month gap resulting from the July 1, 2012 and January 1, 2013 effective dates. Boyd and Negron report that any potential gap would be clarified through agency rulemaking or an executive order. “I think the legislative intent is clear,” Negron said.
According to the News Press report on the issue:
Jack McDermott, spokesman for the Florida Office of Insurance Regulation, said the agency expects few if any glitches in payments to providers.
Just in case, the Agency for Health Care Administration, which licenses health providers, is drafting language to clarify that payments to qualified providers will continue to flow. “The purpose of the bill was not to create a six month gap,” McDermott said. “AHCA has publicly said they are going to issue rules to clear this up. We’ve encouraged insurers privately that PIP providers should be paid.”
On reports that Governor Scott may not sign the bill due to the potential gap:, Florida House sponsor Boyd stated: “If it comes to that I think there will be an agency rule to make it clear what we’re doing, but I don’t think it is going to come to that.”
The full article is available here.
Reports indicate that three men working for Cardinal Chiropractic Clinic Center in Naples, Florida are responsible for over $100,000 in fraudulent PIP claims. Esmaeel Samaliazad, a licensed chiropractor in Fort Myers, is accused of being involved in more than $50,000 in fraudulent claims. The other two involved in the fruad, James Greenhut and Feghens Delva, were arrested in Palm Beach County and Orange County. All face felony charges. The Division of Insurance Fraud (DIF) reports that the investigation is ongoing, and far from over.
The full article from WZVN ABC is available here