JACKSONVILLE, Fla. — An insurance fraud scheme from two Jacksonville health care insurance employees netted them more than $1.1 million over five years, a release from the state Department of Financial Services said.
Rochell Green, 40, and Breana Ferguson, 34, both employees of the health care company Aetna, allegedly submitted at least 42 false insurance claims and uploaded false documentation to support their claims, Florida Chief Financial Officer Jimmy Patronis announced Friday. After warrants were issued Oct. 22, Green was arrested on Oct. 25 and Ferguson was arrested on Nov. 8.
The scheme took place from 2019 to 2023 and resulted in Green receiving more than $408,000 and Ferguson receiving more than $736,000 from false claims, the release said.
Investigators said both enrolled in insurance plans, presenting at least 42 false insurance claims and uploading fake documents in support of their claims. The supporting documents were "fake medical invoices and explanations of benefits for procedures that did not occur and patients that did not receive treatment," the release said.
The investigation began Feb. 9. The agency said Green started the scheme in 2019 and she involved Ferguson in 2021, "in return for half of Ferguson's claim payments," the agency said.