Therapist, Nurse Practitioner, and Clinic Owner Busted in $47,000 Miami Insurance Fraud Scheme

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Florida Chief Financial Officer (CFO) Jimmy Patronis announced yesterday the arrests of Yanirma Toledo, Lensky Jose Hernandez-Santiago, and Maylett Leiva-Santana, a therapist, a nurse practitioner, and a clinic owner, for their alleged involvement in a $47,000 personal injury protection (PIP) fraud scheme. These individuals exploited their professional roles to defraud United Auto Insurance Company by submitting fraudulent therapy claims for treatments that were never provided.

The investigation, led by the Criminal Investigations Division, Bureau of Insurance Fraud, revealed that Hernandez, Leiva-Santana, and Toledo, operating out of Ace Medical and Rehab Center in Miami, falsified physical therapy forms and billed insurance companies for services never rendered. Over a period from January to March 2024, the trio allegedly forged documents and filed fraudulent insurance claims, collecting over $47,000 in PIP benefits.

“It’s amazing the lengths fraudsters will go simply to make a quick buck and this is exactly the kind of fraud that drives up car insurance rates for every Floridian on our roadways," said CFO Jimmy Patronis in the press release.

During the investigation, cooperating witnesses attended the clinic under surveillance by detectives. Instead of receiving legitimate treatment, witnesses were handed blank therapy forms to sign. Therapist Hernandez, who never attended to the witnesses, signed off on the fraudulent forms, as did Nurse Practitioner Leiva-Santana. Clinic owner Yanirma Toledo played a key role in facilitating the scheme, managing the submission of the fraudulent claims to United Auto Insurance.

The individuals voluntarily surrendered at the Turner Guilford Knight Correctional Center on September 3, 2024. They are charged with RICO/Racketeering, Insurance Fraud, and Grand Theft. According to the release, if convicted, they could face up to 20 years in prison.