Four extradited to Arizona to face charges in $1.8 million Obamacare scam

Jan. 26--Four suspects have been transferred from Florida to Arizona to face charges in what Arizona officials are calling one of the biggest health insurance fraud schemes they've seen.

The operation was straightforward and netted $1.8 million for nine people over two years, according to investigators with Arizona's Department of Insurance:

Nicholas Scaffidi, 35, bought health insurance policies on Affordable Care Act exchanges from Blue Cross Blue Shield of Arizona for himself, his wife Jolene, 28, and seven others.

Scaffidi then identified out-of-network hospitals where he and the others would visit with complaints of fake ailments, such as abdominal pain, fainting, and other fake ailments, the officials said. "In one instance, Scaffidi refused to leave an emergency room unless he received diagnostic testing," according to a news release.

Scaffidi, they said, knew that the insurance company would send payments for treatment directly to patients if the hospitals were not among the insurer's preferred providers. In such arrangements, patients are responsible for paying the hospitals. But hospitals victimized by Scaffidi's ring were never paid, Arizona insurance officials said.

Addresses the suspects provided to the hospitals often did not exist, while addresses they gave to Blue Cross Blue Shield of Arizona were post office boxes across the country set up in Scaffidi's name, the news release said. Officials later seized more than $97,000 from more than 20 bank accounts tied to the suspects.

Arizona state law requires "sending payments to members for out-of-network services under most insurance arrangements," Blue Cross Blue Shield of Arizona said in an email statement. That's not the case in Florida, where Blue Cross Blue Shield affiliate Florida Blue never sends payments directly to patients, a spokesman for that company said. None of the hospitals visited by the suspects were in Florida, investigators said.

Investigators in Arizona learned some of their suspects might be in Florida and reached out for help from counterparts in Florida's Department of Financial Services, they said.

"Arizona put together a very strong case," said department spokesman Jon Moore. "That allowed us to get search warrants."

The Arizona investigators compiled enough enough evidence to enable Florida officials to obtain a search warrant at 5953 Spanish River Road, Fort Pierce, where they believed the Scaffidis might be living, Moore said.

They found the Scaffidis and a third suspect -- Darrell Wade Johnson, Moore said. A fourth suspect, Jeffrey Glen Catren, was discovered in the Central Florida town of Chiefland and was arrested by members of the department's Orlando field office, Moore said.

The Scaffidis and Johnson were transferred to the Maricopa County, Ariz., jail and booked Sunday on multiple fraud charges, according to court records. Catren is awaiting extradition, according to Stephen Briggs, spokesman for the Arizona Department of Insurance.

Meanwhile, three other suspects -- Melissa Tavasci, Roy Brite and Seralda Johnson -- were arrested in New Mexico and are also awaiting to be transferred to Arizona, Briggs said.

Two additional suspects have been identified and further arrests are expected, Briggs said.

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