Drug treatment CEO accused of fraudulent insurance claims

The head of a sober household and drug abuse remedy facility in Palm Seaside County is accused of publishing over $500,000 in fraudulent insurance statements, in accordance to court information.

Xiomara Colon, 44, was arrested Thursday on rates of false and fraudulent insurance policies statements above $100,000, operating a compound abuse facility without having a license and illegal actions relating to personnel, between other people, county courtroom information present.

As CEO of Rise to Restoration, a drug procedure facility in West Palm Seashore that also ran a sober property in Lake Truly worth Seashore, Colon fraudulently billed a few insurance policy companies for providers from June to September 2021, when the facility was not licensed to treat everyone, a possible result in affidavit reported.

Compound abuse systems are expected by state law to be licensed in get to monthly bill insurance promises. If the companies experienced acknowledged Colon’s facility was not licensed, they would not have paid the statements, the affidavit stated.

As the Palm Seashore County Point out Attorney’s Office’s Sober Homes Activity Force investigated Increase to Restoration, they learned Colon had also submitted fraudulent files throughout the licensure software process and ran the application with unauthorized personnel, the affidavit reported.

The Florida Section of Little ones and Family members officers told Colon in June 2021 that Increase to Recovery’s license had expired and that Colon did not apply for renewal in time, the affidavit mentioned.

Colon attempted to utilize for a further license in late June 2021 given that the window experienced closed for her to implement for renewal, the affidavit mentioned, but DCF denied that application about a thirty day period afterwards, in aspect, because the application incorporated a fraudulent fireplace inspection report. The report claimed to be completed by an inspector who experienced retired around a yr prior to the facility submitted the report.

Investigators interviewed two people who had been in treatment method considering that July and lived at the sober household in Lake Worth Beach front in late September 2021, the affidavit reported. DCF officers advised investigators Rise to Recovery did not disclose managing a sober dwelling and that the home was not qualified by the vital condition company, the Florida Affiliation of Restoration Residences.

Both of those inhabitants advised investigators that their treatment sessions had been held in the kitchen of the sober home. The female they experienced classes with was not a clinically or medically certified therapist, the affidavit stated, violating the insurance companies’ insurance policies. They said Increase to Recovery workers “pushed massages and chiropractic products and services on them, even if they did not will need them,” the affidavit explained.

“They stated the chiropractor will do something for a couple of minutes or significantly less and then monthly bill insurance coverage,” the affidavit stated.

A whole of $559,219.03 statements were being submitted to Blue Cross Blue Protect, Aetna and Optum between June 24, 2021, and Sept. 15, 2021, when Increase to Restoration was not properly licensed, the affidavit claimed.

Colon’s lover Mark Sanchez, 44, was previously arrested and identified guilty of patient brokering linked to Rise to Recovery, the affidavit claimed. Court records present Sanchez was arrested in March 2021 and sentenced to 18 months in point out prison. Sanchez will be released in June.

Investigators spoke to Rise to Recovery’s medical director, who was hired by Sanchez in March 2020, who said she was unaware the facility’s license had expired and was informed by Colon that they ended up functioning less than a provisional license, the affidavit said. The medical director was also unaware that her identify was applied as the referring medical professional on the insurance policy statements.

The lady who furnished remedy to the sober house inhabitants explained to investigators she is not a accredited qualified but led group and personal sessions, which had been billed below the clinical director’s identify, the affidavit explained.

Colon’s legal professional did not answer to an e-mail looking for comment Friday night.

Colon posted bond Friday morning, court documents exhibit.