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As a result of a joint investigation by the Miami-Dade State Attorney`s Office and the Miami-Dade Schools Police Department, 55 year old Violeta Otero, theowner and operator of the Sunshine Wellness Clinic and 52 year old Ida Mercado Rico, a patient broker, were charged in an insurance fraud scheme which targeted the Miami-Dade School System by defrauding its self-insurance plan.

 

Utilizing forms previously completed at the Sunshine Wellness Clinic, insurance accounts of a number of Miami-Dade School District patients were filed for medical treatments and injections which never occurred. Many of these patients were initially recruited to come to the clinic by Ida Mercado Rico and were often paid in cash by Ida Mercado Rico.
Violeta Otero has been charged with:

1 count Organized Scheme to Defraud 1st Degree Felony
166 counts Grand Theft 3rd Degree Felony
166 counts False and Fraudulent Insurance Claims 3rd Degree Felony

Ida Mercado Rico has been charged with:

1 count Organized Scheme to Defraud 1st Degree Felony
77 counts Grand Theft 3rd Degree Felony
77 counts False and Fraudulent Insurance Claims 3rd Degree Felony
4 counts Patient Brokering 3rd Degree Felony

Insurance fraud is an attack on every individual on every person who pays an insurance premium, commented Miami-Dade State Attorney Katherine Fernandez Rundle Insurance fraud scams that steal from our public school system take dollars intended to make our schools function, dollars that can educate our children, and put those dollars into the pockets of thieves. I applaud this partnership which allows my prosecutors and theMiami-Dade Schools Police to effectively shut down such swindlers.

 

Protecting the interest of Miami-Dade County Public Schools, our students, and employees is paramount, said Superintendent of Schools Alberto M. Carvalho. Today`s arrest of individuals who sought to defraud our school district is a direct result of first-class investigative work by Miami-Dade Schools Police and the Miami-Dade State Attorney`s office. The genesis of this indispensable partnership began in 2014 with the creation of the Fraud Prevention Task Force to help curb abuse of employee health care benefits.


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