INSURANCE FRAUD BUREAU
or MASSACHUSETTS
August 1, 2024
The Clerk of the House of Representatives
State House
Boston, MA 02130
To the Clerk of the House of Representatives:
Pursuant to Massachusetts St. 1990, c.338; St. 1991, c.398, §99; St. 1996, c.427, §13; and-St.
2002, c.279, §5, on behalf of the Insurance Fraud Bureau of Massachusetts {IFB), I hereby
submit the IFB Semi-Annual Report to the Clerk of the House of Representatives. Enclosed is
a copy of the IFB June 2024 e-focusFraud. The IFB e-focusFraud includes court activity
resulting from IFB investigation and case referrals to prosecution to fulfill semi-annual
statutory reporting requirements.
This report should be forwarded to the Joint Committee on Insurance and the Joint
Committee on Labor and Workforce Development. In summary, as of June 30, 2024, the IFB
has received 96,666 referrals involving auto fraud, workers' compensation fraud and other
insurance fraud since its inception. As a result of these referrals (many of which involve the
same suspects), 23,548 case investigations were created and 4,684 cases have been
referred to the Attorney General, District Attorney or United States Attorney for
prosecution.
In all, 716 individuals have been indicted and complaints have been filed against 3,923 other
individuals. Court action has therefore been initiated against 4,639 separate individuals. To
date, as a result of IFB investigation, 1,063 people have been convicted of insurance fraud
crimes with an additional 1,320 individual's prosecutions continued without a finding. IFB
staff have aggressively pursued publicity through both print and electronic media to
educate the public regarding Bureau progress.
Cordially, /ti
/JJPo!viDiPaolo
Executive Director
c: Attorney General Andrea Campbell
Senate Chair, Joint Committee on Labor & Workforce Development
House Chair, Joint Committee on Labor & Workforce Development
Senate Chair, Committee on Financial Services
House Chair, Committee on Financial Services
Kevin Beagan, Acting Commissioner of Insurance
101 Arch Street• Boston, Massachusetts 02110-1131
Telephone (617) 439-0439 • Fax (617) 439-0404 • Internet http://www.ifb.org
 INSURANCE FRAUD BUREAU OF MASSACHUSETTS
101 Arch Street
Boston, MA 02110-1131
(617) 439-0439
Fax (617) 439-0404
IFB Fraud Hotline
1-800-32FRAUD
IFB Website
https://www.ifb.org
IN THIS ISSUE: Anthony M. DiPaolo
AGENT FRAUD………………………Pages 1-2 Executive Director
HEALTH CARE FRAUD…………………… Pages 2-3
PROVIDER FRAUD………………………Pages 3-4 Laura A. Kessler
WORKERS’ COMPENSATION FRAUD…..Pages 5-8 Vice President/General Counsel
AUTOMOBILE INSURANCE FRAUD….Pages 8-9
OTHER TYPES OF INSURANCE FRAUD……Page 9 M. Katherine Mulligan
Vice President/Chief
of Investigations
Cassandra Abdulla
Editor
Administrative Manager
cabdulla@ifb.org
Details contained in charging documents are allegations.
Defendants are presumed innocent unless and until proven
guilty beyond a reasonable doubt in a court of law.
e-focusFraud is published periodically throughout the year.
News flashes on current press releases and news articles and
updates on prosecution court activity are posted frequently
on the IFB website.
https://www.ifb.org
 e-focusFraud
Volume 30, Number 1 June 2024
Agent Fraud
Connecticut Insurance Agent Indicted in Identity Fraud Scheme
Boston - A Connecticut man was indicted on March 25, 2024 on charges of larceny and identity fraud. It
is alleged that between April 14, 2018, and November 22, 2019, the Connecticut man, a former insurance
agent, fraudulently created at least 33 group accounts with 68 policyholders involving 272 policies in
violation of his agreement with Aflac.
Investigation revealed discrepancies related to the group accounts. The business address for most group
accounts was modified soon after the account was created and many of the policyholders had the same
address. The Connecticut man’s bank account is alleged to have been used for most of these group
accounts. Some policyholders held policies under multiple groups simultaneously. Further investigation
revealed that the IP addresses associated with the Connecticut man were used to create the accounts.
Many of the named policyholders associated with these group accounts logged into their accounts from
the same IP addresses, using the same devices and identical hashed passwords. In addition, group
accounts were accredited via telephone, and the Connecticut man was believed to be impersonating
company representatives.
The Connecticut man is also alleged to have electronically signed the policy applications without the
policyholder's authorization. As a result of this fraudulent scheme, Aflac paid the Connecticut man over
$45,000 in advanced commissions and $8,700 in cash awards.
Case Update- Owner of Insurance Agency Sentenced in Relation to Embezzlement Scheme
Gloucester - A Gloucester woman pleaded guilty and was sentenced to three years probation on charges
of Larceny by Embezzlement Over $1,200 (8 counts), Forgery (2 counts), and Unlicensed Insurance
Practice (1 count). She was ordered to pay a $90 victim witness fee, a $110 DNA fee, and $19,875 in
restitution in connection with an embezzlement scheme that left client companies uninsured. Her
insurance agency pleaded guilty to charges of Larceny by Embezzlement Over $1,200 (8 counts) and
Unlicensed Insurance Practice (1 count).
The Gloucester woman embezzled over $39,000 from customers while working as an insurance producer
at her insurance agency between May 2017 and September 2018. After suspension of her insurance
broker’s license, she took one or more payments from eight individuals who paid her for their workers
compensation insurance. The Gloucester woman subsequently issued fraudulent certificates of insurance
to six of the eight affected businesses without binding coverage.
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As a result of a complaint by one of the customers, the Massachusetts Division of Insurance investigated
and revoked the insurance producer licenses for both the Gloucester woman and her insurance agency
on June 11, 2018, as part of a settlement agreement signed by the Gloucester woman. After the
settlement, the Gloucester woman informally transferred ownership of her insurance agency to a family
member and continued to work at the business for another 14 months. During that time, prosecutors
report that the Gloucester woman forged the signatures of customers on two separate occasions, binding
them to insurance premium financing agreements to cover up her previous embezzlement.
Health Care Fraud
Case Update- Dorchester Man Pleads Guilty in Relation to Insurance Scheme Regarding
Addiction Treatment Centers
Boston – A Dorchester man pleaded guilty on May 21, 2024 to nine counts of larceny over $250, nine
counts of filing a false health care claim, and four counts of conspiracy in connection with preying on
people with substance use disorder, sending them to treatment facilities in Florida, and signing them up
for false insurance policies in order to make a profit.
Investigation found that from March to June of 2016, the Dorchester man – a well-known individual in the
local recovery community – worked in partnership with detox and addiction treatment facilities in Florida,
where patients from Massachusetts were lured and, at times, left without care. The Dorchester man was
known as a “runner” and was paid a commission by the Florida facilities to produce patients. The
Dorchester man recruited patients at substance use disorder meetings in Massachusetts and conspired
with an insurance agent, to write up false and misleading insurance policies on their behalf. The facility
in Florida would then bill insurance companies for treatments. The insurance companies, Minuteman
Health and Harvard Pilgrim Health Care, paid out a total of approximately $730,000 in insurance claims as
a result of this scheme. Both companies conducted separate investigations following an influx of claims
from Florida treatment facilities for Massachusetts residents.
To obtain an insurance policy outside of the open enrollment period there must be a “qualifying event”
and moving from an out-of-state address into Massachusetts meets that requirement. The Dorchester
man would provide the insurance agent with a prior out-of-state address for the applicant and the
insurance agent, in his capacity, would push the policies through. Once the policies were issued, the
Dorchester man paid for the individual’s plane ticket to Florida and was responsible for paying the monthly
insurance premiums. Those premiums were not always paid, resulting in the insurance policies lapsing
and patients in Florida either being kicked out of their facilities or rushed through treatment to a sober
home. While some completed treatment in Florida and returned to Massachusetts, in many cases,
individuals who went to Florida ended up relapsing and were stranded with no way home. The victims
who were enrolled in these policies stated that they had never seen the applications with their purported
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signature, that the address change was untrue, and they were not aware they were enrolled in these
health insurance policies.
Provider Fraud
Case Update- Former PT Clinic Owner Sentenced for Health Care Fraud
Boston – The former owner of several physical therapy clinics in Greater Boston was sentenced on May
23, 2024 on two counts of health care fraud charges.
Chang Goo Yoon, a South Korean national residing in Queens, N.Y., was sentenced by U.S. District Court
Judge Indira Talwani to 27 months in prison and three years of supervised release. Following a seven-day
jury trial on two counts of healthcare fraud, Yoon was also ordered to pay $587,722 in restitution. Yoon
was arrested and charged in February 2021 and subsequently indicted by a federal grand jury in May
2021.
“Chang Goo Yoon orchestrated a brazen scheme, abusing his position of trust as a health care provider to
collect hundreds of thousands of dollars in payments for work he did not do. We thank the jury for its
swift and prudent verdict,” said Jodi Cohen, Special Agent in Charge of the Federal Bureau of Investigation,
Boston Division. “This conviction sends an unambiguous message that anyone who cheats our health care
system will not get away with it.”
“This is exactly why the Insurance Fraud Bureau of Massachusetts was created over thirty years ago to
combat insurance fraud and, specifically, this type of insurance fraud that increases the cost of insurance
premiums for consumers in the state of Massachusetts. This case was borne out of a collaborative effort
by our investigative partners. The perseverance and hard work done by all involved in this case is a
demonstration that insurance fraud will not be tolerated in Massachusetts,” said Anthony DiPaolo,
Executive Director of the Insurance Fraud Bureau.
“Mr. Yoon repeatedly lied and billed for services he never provided. Actions which were fueled by nothing
more than his greed,” said Ketty Larco-Ward, Inspector in Charge of the U.S. Postal Inspection Service.
“We are pleased with the jury’s guilty verdict in this matter and thank them for their service. It is our
hope that this case serves as a warning to others who may use the U.S. Mail to further their criminal
activities.”
Yoon owned and operated several physical therapy clinics in Allston, Waltham, and Brookline between
2014 and 2018. Yoon billed patients for non-existent physical therapy appointments, including
approximately $150,000 in claims billed on dates when Yoon was traveling in South Korea, Los Angeles,
and Toronto. Yoon also billed $50,000 in claims on dates when he was gambling at casinos, including the
Golden Nugget in Atlantic City, N.J., MGM Springfield in Massachusetts, and Twin River Casino in Lincoln,
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R.I. Additionally, Yoon submitted approximately $30,000 in physical therapy claims for himself after three
automobile accidents. Most of those claims falsely listed one of Yoon’s employees as the servicing
physical therapist. The remaining claims listed Yoon as both the patient and the servicing physical
therapist.
The case is being prosecuted by the Office of Acting U.S. Attorney Levy. FBI SAC Cohen, IFB Chief DiPaolo
and USPIS INC Larco-Ward made the announcement. Assistant U.S. Attorneys Elysa Q. Wan and Patrick
M. Callahan of the Criminal Division are prosecuting the case.
Case Update- Natick Psychiatrist Sentenced for Billing for Services Never Rendered
Wellesley - Gustavo Kinrys was sentenced to 99 months in prison, followed by three years of supervised
release on seven counts of wire fraud, six counts of false statements relating to health care matters and
one count of obstructing a criminal health care investigation. Kinrys, a Natick psychiatrist, was sentenced
in connection with charges that he billed Medicare and private insurance companies for over $10 million
in treatments he did not provide and then obstructed justice in an attempt to conceal his crimes. Kinrys
was a licensed psychiatrist who owned and operated Advanced TMS Associates. Among other services,
Kinrys offered transcranial magnetic stimulation (TMS) therapy and psychotherapy to patients suffering
from depression. TMS therapy is a noninvasive method of brain stimulation that uses rapidly alternating
or pulsed magnetic fields to induce electrical currents directed at a patient’s cerebral cortex. Between
January 2015 and December 2018, Kinrys engaged in a variety of fraudulent billing schemes in which he
sought and received reimbursement for services he did not render. For example, Kinrys billed Medicare
and private insurers over $10 million for thousands of TMS sessions he never provided, including over
8,000 sessions he claimed were provided to 75 patients who, in fact, never received a single session of
the therapy.
Kinrys also billed Medicare and private insurers for hundreds of thousands of dollars’ worth of
psychotherapy sessions he never provided, including over 1,000 face-to-face sessions he falsely claimed
he provided while he or his patients were in fact out of the country. On hundreds of occasions, Kinrys
billed Medicare and private insurers for having provided more than 24 hours of psychotherapy services in
a single day, including one day in 2017 when he claimed he had provided hour-long psychotherapy
sessions to 79 different patients. Further, Kinrys made numerous false statements to his patients, the
billing company with which he worked and the insurers to whom he submitted claims seeking
reimbursement. When Medicare, private insurers, and the Department of Health and Human Services
(HHS) sought records from Kinrys pertaining to certain of his claims, he took steps to conceal his fraudulent
conduct by making false representations and creating false documentation purporting to show that he
had provided thousands of treatments he had billed for, but never rendered. For example, in response to
a July 2018 subpoena from the HHS’s Office of Inspector General seeking medical records for ten of his
patients, Kinrys created documents – and ordered his office workers to create documents falsely stating
that those patients had received dozens of treatments that had not been provided.
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Workers’ Compensation Fraud
Boxford Man Sentenced in Relation to Mail Fraud Scheme
Chelsea - The former owner and operator of APC, a transportation and delivery company based in
Chelsea, was sentenced on January 16, 2024, for his involvement in a mail fraud scheme.
Anthony Catalano, formerly of Boxford, now living in Winthrop, was sentenced by Chief United States
District Court Judge F. Dennis Saylor IV to six months in prison, followed by three years of supervised
release and restitution in the amount of $541,000 to The Travelers Insurance Company. Catalano was
also ordered to cooperate with the Internal Revenue Service regarding personal and corporate taxes
due and owing. Catalano pleaded guilty in October 2023 to two counts of failing to collect, report and
pay over employment taxes and one count of mail fraud in connection with cash wages he paid to
company employees.
From 2017 to 2020, Catalano cashed over $8 million in customer APC checks and failed to report the
company income to the IRS. Catalano pleaded guilty to using the bulk of the cash funds to pay
employees “under-the-table” cash wages, which APC was also required to report to the IRS. As a result,
neither the company nor the employees paid employment or income taxes on the cash wages, resulting
in a tax loss of more than $1 million to the IRS. Catalano also pl