Automobile Insurance Fraud Scheme Leads To Federal Health Care And Mail Fraud Charges

U.S. Attorney’s Office
Western District of Michigan
20 April 2016

FOR IMMEDIATE RELEASE

GRAND RAPIDS, MICHIGAN — U.S. Attorney Patrick A. Miles, Jr., announced today that four individuals were arrested on federal health care fraud and mail fraud charges related to their roles in an automobile insurance fraud conspiracy: Yoisler Herrera-Enriquez, age 30, and Dolis Rojas-Lopez, age 30, both of Wyoming, Michigan; Gustavo Ramiro Acuna-Rosa, Age 28, of Versailles, Kentucky; and, Antonio Ramon Martinez-Lopez, Age 34, of Port Richey, Florida.

All four defendants are currently in custody pending hearings on bond.

"Serial insurance fraud schemes undermine the fairness of the rates everyone has to pay. These schemes are and will continue to be a high priority for federal prosecution," U.S. Attorney Miles explained.

According to the indictment, Herrera-Enriquez, Acuna-Rosa and Martinez-Lopez operated physical therapy clinics in Wyoming and Lansing, Michigan, under the names "H&H Rehab Center," "Revive Therapy Center," and "Renue Therapy Center." These clinics utilized patient recruiters, including Rojas-Lopez, to find individuals who had either been involved in automobile accidents but who were not yet receiving medical treatment, or who were willing to participate in staged automobile accidents. The conspiracy then paid these automobile accident participants to claim injuries related to these automobile accidents and to become patients of the clinics. The clinics then falsely billed various automobile insurance carriers for physical therapy or other health care services that were not in fact provided. According to the indictment, two confidential government informants never received any physical therapy or other health care services of any kind at either H&H Rehab Center or Renue Therapy Center, yet those clinics billed an automobile insurance carrier for treatment allegedly provided to the confidential informants and were paid in excess of $50,000.00 between January 2014 and May 2015.

The mail fraud and conspiracy charges carry a statutory penalty of up to 20 years’ imprisonment and mandatory restitution. The health care fraud charge carries a penalty of up to 10 years’ imprisonment and mandatory restitution. The investigation is being handled by the Department of Homeland Security, U.S. Immigration and Customs Enforcement, Homeland Security Investigations, and the Federal Bureau of Investigation. Assistant U.S. Attorney Ronald M. Stella is assigned to the prosecution.

The charges in an indictment are merely accusations, and the defendants are presumed innocent until and unless proven guilty in a court of law.