School Bus Drivers Arrested for Fraud

According to the Miami-Dade County State Attorney’s Office, two employees of the Public Schools system have been arrested for their alleged involvement in an extensive insurance fraud scheme. Nearly 100 others are suspected of being involved as well.  This is the last thing a school district needs when so many are struggling to meet budget shortfalls.

As noted by a local news station, Cynthia DaSilva and Maria Mendez, who are both school bus drivers, are accused of working with about 100 other fellow bus drivers to act as “fake” patients. They would let a few clinics use their names and their insurance information to make fraudulent bills, then get paid to do so and refer the scam to others.

“Their name and their insurance claim number would be used for a whole bunch of services that were never performed,” said Miami-Dade State Attorney Katherine Fernandez-Rundle.

Prosecutors stated that DaSilva would convince other bus drivers to give their insurance information to a clinic in exchange for $400 in kickback money. The clinic would then allegedly bill the school system’s self-insured health policy for the services.

The mastermind of the scheme is said to be the owner of Opera Health Clinic and Leon Global Center, Yasiel Reyes-Gonzalez. According to prosecutors, he is the clinic owner who the bus drivers supposedly worked for.

The building manager at the Miami clinic stated that it has since closed.

Another clinic in northwest Miami-Dade County is also gone. Sharon Weiss, who owns a neighboring insurance billing company, said that this clinic closed up shop just days before the investigators arrived.

Prosecutors said an estimated $1 million was bilked from the school’s health insurance, and because the district self-insures, it came from taxpayers’ money. Insurance fraud is a crime any time, but that added insult to injury at a time when the district was short more than $100 million.

Miami-Dade Superintendent Alberto Carvalho noted that “engaging in a scheme that ensnares some of our employees victimizes our public school system. It is shameful. It is unacceptable.”

According to CBS News, the bond for Reyes-Gonzalez was first set at $250,000 and required him to surrender his passport. However, the bond was lowered to $100,000 after his attorney asked the judge for a reduction.

After posting bond, Reyes-Gonzalez will be required to wear a GPS monitor.

“If somebody, employee or not, is caught doing something like this, we’re not going to put you on administrative leave. We’re going to fire you. We’re going to fire you on the spot,” said Carvalho. “And we will spare no expense, in identifying every single person responsible for these deeds.”

Due to this fraud, the school system believes that they lost more than one million dollars.

“We fight like hell to balance our budget, and for this to happen is a complete slap in our face,” said Miami-Dade Schools Police Chief Charles Hurley.

DaSilva is charged with three counts of grand theft, three counts of insurance fraud, and three counts of patient brokering.

Reyes-Gonzalez is charged with seven counts of patient brokering, each count punishable by up to five years in prison.