4 Palm Beach County women charged in Aflac fraud scheme

(As originally published with bells and whistles, Mon, January 31st 2022, 12:14 PM EST)

WEST PALM BEACH, Fla. (CBS12) — Four women from Palm Beach County are accused of trying to rip off an insurance company, and three were even paid thousands of dollars before being arrested.

The Florida Department of Financial Services started looking into the cases – one going back more than four years – when special investigators for American Family Life Assurance, better known as Aflac, tipped them off.

According to the state, this was a web of teamwork and alleged deception involving “forged insurance billing forms and/or medical treatment/progress notes for hospital and doctor visits that never occurred” to illegally steal money from Aflac.

Three of the four defendants worked at the same local neurosurgery practice where claims were made, and investigators say doctors were exploited for records and prescriptions.

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COCYNTHIA HODGE

Detectives from the state say Cocynthia Hodge, 30, of South Bay, submitted an online claim “for an alleged hospital stay at Palms West Hospital,” detailing charges totaling $89,395.56 over nine days. But Hodge had not been a hospital patient. Her claim was denied but the form “was nearly identical to forms submitted by four other individuals under investigation.” She could’ve been paid more than $10,000.

Detectives say a year after her denial, Aflac noticed Hodge was among

“a group of claimants who submitted numerous claims from the same IP address.“

In addition, “services billed, billing totals, diagnosis codes, attending physicians, etc. were identical on” five other individuals’ claims, with only names, dates of birth, addresses, insurance information and dates of service different.

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Plus, in October of 2021, Hodge picked up a prescription for Diazepam. According to the report, “the prescription was allegedly written” by a neurosurgeon at Palm Beach Neurosurgery – where Hodge’s sister, Darneshia Hodge, works as a surgical coordinator and has access to the firm’s electronic medical records database as well as the doctor’s information. Cocynthia Hodge had never been seen there. The report said a, “related investigation has revealed that Darneshia Hodge used her position at the medical practice to forge medical records and prescribe herself controlled and non-controlled substances.”

Cocynthia Hodge is charged with insurance fraud of between $20,000 and $100,000.

CHASTITY BARRY

Chastity Barry, 45, of Loxahatchee, had Aflac policies for herself and her three children. Investigators found she “filed five fraudulent hospitalization claims listing herself as the patient, five fraudulent claims listing [her daughter] as the patient, four fraudulent claims listing [her son] as the patient, and six fraudulent claims listing [her other son] as the patient.” That’s 20 claims over a year – one listing Wellington Regional Medical Center and 19 listing Palms West Hospital – and she was paid $39,695 for the “alleged hospitalizations.”

The IP address Barry used to submit her claims belonged to a computer at Palm Beach Neurosurgery used by the Hodge sisters. That’s because she worked there

”for a brief period around the time she submitted her claims.”

The state’s investigator went on to write Barry picked up two Phentermine prescriptions that Darneshia Hodge “appears to have fraudulently obtained” using the name and DEA number of the doctor she serves as surgical coordinator for at the practice. Plus, bank records indicate Barry “received money from at least one other individual under investigation. These facts serve to show a level of familiarity and collaboration with the other individuals under investigation.”

Barry is charged with using fraud or swindling to obtain property worth between $20,000 and 50,000.

DARNESHIA HODGE

Darneshia Hodge, 34, of South Bay, had an Aflac policy for herself, her husband and two dependents. The state contends she filed 16 “fraudulent claims” – 11 in her own name, three in her husband’s, and one each using the dependents – and was paid $20,500. Two claims were submitted for bills she supposedly got from Lakeside Medical Center, two more from Palms West Hospital and all the rest from the neurosurgery practice where she works. The IP address used to file the claims is from Palm Beach Neurosurgery, and several of the claims from there list the doctor she works for as her attending physician.

Detectives wrote that a part-owner of the neurosurgery firm told an Aflac special investigator neither Hodge nor her husband were treated there. Then, Aflac sent Hodge a letter asking her to “pay back $20,230 for the benefits she fraudulently obtained” and realized “that a few of the claims Aflac believed were valid were actually invalid.” Hodge didn’t return the money.

“One of Darneshia Hodge’s billing forms “was nearly identical to forms submitted by four other individuals under investigation as part of this case,” according to investigators. Their

”services billed, billing totals, diagnosis codes, attending physicians, etc. were identical on each of the five individuals’ claims.”

Investigators pointed out that every record of Hodge at Palm Beach Neurosurgery was a “telephone encounter” with “progress notes,” and several with the electronic signature of the part-owner. That doctor told the state “telephone encounters do not produce notes like the ones Ms. Hodge included in her claims” and “he does not and has never used the format” the investigator showed him.

Next, the center’s practice manager explained to investigators “that according to the notes in her telephone encounters, it looked like Darneshia Hodge was ordering medications for herself” but without accompanying doctor’s notes for legitimately prescribed medications. That practice manager called investigators back the same day as her interview and emailed “screenshots and logs that show where Darneshia Hodge created and deleted the progress notes from [firm] that she submitted to Aflac.”

Furthermore, investigators searching “a law enforcement database for controlled substance prescriptions found Darneshia Hodge had 12 controlled substance prescriptions allegedly written by” the doctor she works directly for as his surgical coordinator. He works at Palm Beach Neurosurgery’s Wellington office, according to its website. The firm’s practice manager confirmed to investigators there was no record of the doctor writing the prescriptions and no records nor notes about a medical necessity.

Then, they talked to a pharmacy manager who confirmed there were prescriptions called in by the neurosurgery firm and “in each instance, the medication was picked up either by Darneshia Hodge herself or by another individual included in this investigation.”

Finally, the doctor Hodge works for had a lot to say, including that he didn’t prescribe any of the 12 controlled substances filled using his name as the provider.

There was:

• a drug “he never prescribes,”
• another he “said that he did not even know” what it was until the detective told him, and
• a third “he would have no reason to prescribe.”

Darneshia Hodge is charged with one count of using fraud or swindling to obtain property worth between $20,000 and 50,000, and four counts of obtaining controlled substances by fraud.

MARTINE CHARLES

Martine Charles, 34, of West Palm Beach, is fourth in what investigators called the “group of people who forged insurance billing forms,” and she works as a medical assistant at the same neurosurgery firm.

Aflac found Charles submitted an online claim for “an alleged stay at Palms West Hospital” and got $10,070 for the nine days she wrote she was there. Charles didn’t respond to an Aflac special investigator’s letter asking her to return the money. The IP address on the claim was from her workplace and her claim had the identical information seen on others.

The state’s investigator went on to write Charles picked up a Phentermine prescription that Darneshia Hodge “appears to have fraudulently obtained” and

”sent in one of Darneshia Hodge’s fraudulently obtained prescriptions.”

Charles is charged with insurance fraud of between $20,000 and $100,000.

All four women were booked on Friday. Darneshia Hodge is out of jail on $17,000 bond. The others are out of jail on $5,000 bond each.