The Chicago Syndicate: 4th Guilty Plea in #OperationFraudulentPain Investigation

Friday, May 20, 2016

4th Guilty Plea in #OperationFraudulentPain Investigation

United States Attorney A. Lee Bentley, III announces that Wisler Cyrius (35, Naples) pleaded guilty to conspiracy to commit mail fraud and conspiracy to commit money laundering. He faces a maximum penalty of 20 years in federal prison for each count. In addition, he has agreed to pay restitution to the victim automobile insurance companies and forfeit the proceeds of the offenses.

Cyrius is the fourth individual to plead guilty following the culmination of a two-year joint federal and state law enforcement investigation, dubbed “Operation Fraudulent Pain.” The investigation disrupted five unlicensed chiropractic clinics that had received more than $2 million in ill-gotten Personal Injury Protection (PIP) payments from automobile insurance companies. Anouce Toussaint (33, Naples) previously pleaded guilty to conspiracy to commit mail fraud and conspiracy to launder money.  Garry Joseph (37, Naples) and Maria Victoria Lopez (44, Moore Haven) previously pleaded guilty to conspiracy to commit mail fraud.

According to the plea agreements, Tamiami Pain and Rehab LLC, First Choice Pain and Rehab Inc., Parkway Medical and Rehab LLC, T&C Consultants d/b/a Collier Chiropractic Center, and Immokalee Pain & Rehab LLC were unlicensed chiropractic clinics operating in Naples and Immokalee. At each clinic, conspirators paid licensed health care practitioners who, in exchange for payments, allowed their names to be listed on official documents as though they were the true owners of the clinics. The conspirators controlled the finances and oversaw and managed the clinics' day-to-day business, including the insurance billing practices.

According to his plea agreement, Joseph conspired to defraud automobile insurance companies of approximately $2 million from October 2012 to February 2015. He and a co-conspirator were the true owners of Parkway Medical and Rehab and Collier Chiropractic Center. They caused automobile insurance companies to be billed for claims that violated Florida law because the clinics were not properly licensed. They also submitted claims for unnecessary treatments and/or services that had not actually been rendered.

From June 2013 to February 2015, Cyrius and Toussaint conspired with others to solicit individuals to participate in staged motor vehicle accidents in exchange for compensation. The conspirators also sent automobile insurance companies claims for unnecessary services rendered to purported accident victims who had been paid to participate in the staged accidents. The conspirators also submitted claims to automobile insurance companies that were unlawful under Florida law because the clinics submitting the claims were not properly licensed. Cyrius and Toussaint used a shell corporation to conduct financial transactions designed to conceal the proceeds and to avoid reporting requirements.

According to her plea agreement, between October and December 2014, Lopez conspired with others to defraud automobile insurance companies. She had worked in billing and customer service at more than one clinic operated by her co-conspirators. Lopez was coached to mislead others about the true ownership of clinics and knew that non-health practitioners were directing medical treatments in order to maximize claims for payment. In addition, knowing that a patient had participated in a staged accident, Lopez coached that patient to receive medically unnecessary treatment. She directed another patient not to tell his insurance company that he was being compensated for receiving unnecessary treatment.

Joseph is scheduled to be sentenced on June 27, 2016. Toussaint and Lopez are scheduled to be sentenced on July 11, 2016. Each faces a maximum penalty of 20 years in federal prison. The United States will also seek a forfeiture money judgment from each defendant equal to the amount of proceeds obtained as a result of each offense.

A fifth individual, Nesly Loute, was also charged in Operation Fraudulent Pain. He is scheduled for trial in July 2016.

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