Florida Dental Fraud Case Unveils $11M Insurance Scheme

Multi-Million Dollar Fraud Operation Uncovered at South Florida Dental Practices

USA: A major dental insurance fraud investigation has revealed an $11 million scheme involving three dental office locations in South Florida, illegally owned and operated by non-dentist Evelyn Cruz and her husband Ysmel Cruz. The case, reported by WESH.com, has exposed systematic insurance fraud spanning over a decade.

Patient Testimonial Reveals Disturbing Treatment Practices

Former patient Jason Tuszynski shared his traumatic experiences at the Boynton Beach location. “There were countless times where I was sweating in that chair, and when they had to pull the tooth out back, the main dentist was older, so like, his knee was up on my arm braced with something like pliers, leaning all the way back trying to get this tooth cracked out of my mouth,” he recounted. Initially seeking treatment for a single cracked tooth, Tuszynski was told he needed 14 procedures totaling approximately $6,500.

Fraudulent Billing and Financial Implications

The investigation revealed that the practice was allegedly submitting inflated bills to insurance companies for procedures that were never performed. Law enforcement officials discovered more than $386,000 wrapped in trash bags during a raid of the Cruz’s residence, along with a $400,000 cashier’s check. The couple allegedly used approximately $500,000 of the fraudulently obtained funds toward the purchase of a $2 million waterfront property in Englewood.

Licensed Dentist’s Involvement

The investigation uncovered that 87-year-old Dr. Ivan Pelton allegedly allowed his dental license to be used by the Cruz couple to operate their illegal practices. According to investigators, Pelton received over $61,000 for his involvement and now faces serious charges.

Ongoing Investigation and Legal Consequences

The Cruzes currently remain in custody facing multiple charges of fraud and grand theft related to dozens of patients, with potential sentences spanning decades. Sources indicate that additional charges related to tax fraud may be forthcoming, as evidence suggests systematic embezzlement from their own businesses.

Impact on Patient Care

The human cost of the fraud scheme continues to affect former patients like Tuszynski, who still lacks proper dental restoration. “I didn’t necessarily have the money, all the work didn’t necessarily need to be done, and then the work that was supposed to be done wasn’t done. So yeah, I’d say nothing short of, like, a horrifying experience having to go through that,” he stated.