Case VIII: Chapter 7: With a Little Help from My Friends


Chapter 7: With a Little Help from My Friends

Lt. Frank Garcia spent the next several days poring over the files contained on the flash drive he had received “anonymously”.  He had figured out that most, if not all, of the lower-level operations were engaged in collecting detailed personal and financial information. But, it didn’t appear that they were doing anything else.  The records of their operations contained only typical office-related expenses like rent, telephone, internet, etc.  He began to concentrate on the items contained in the upper levels of the “pyramid”.

He skipped to a level in the middle of the pyramid.  There were about a dozen entities listed here and again, each one led to a separate file.  These businesses seemed to be suppliers. Some handled medical devices, simple items like crutches, canes, wheelchairs, etc.  Others were focused on more sophisticated devices, like sleep apnea breathing systems, in-home heart and lung monitoring devices.  Another company handled prescription medications, including insulin injections.  One even provided home security systems that claimed to be inter-linked with a local Emergency Response Team. It appeared that each company in this level specialized in one particular aspect of the overall healthcare field, from the most simple to the very sophisticated.

The picture was becoming clear to Garcia, but he was still unsure how everything fit together and why Marco had chosen to display everything as a pyramid. Then he remembered his initial reaction; it was a large-scale pyramid scheme! He sat back and tried to put all the pieces together in his mind.  He decided to go back to the beginning and examine the list of files on the flash drive.  Near the bottom of the list was another text file named Wiring Diagram. At first he assumed that it was one of those files that came with the drive that prompted you to sign up for Updates and other advertisements.  Frank!  You dummy! Marco was being clever again. It was like Marco to assume no one was as clever or as devious as he was.  He had included this file to show how everything was connected, or wired together.

When he opened the file, it was all there in front of him.  It was indeed a pyramid scheme and a very sophisticated one at that.  Frank got a clean sheet of paper from his desk drawer and began to draw his own picture.  The lowest level organizations were simply collecting information from people. This information was passed to a separate set of clearing house-like organizations which processed the raw data to select and prioritize individual accounts.  Another set of companies then placed orders for various health-related products from a series of manufacturers’ representatives or re-sellers, each specializing in only a few products or product lines.  They would buy direct from the manufacturer and then offer these products for sale with a substantial mark-up. The products would then be sold, typically to an individual and their insurance company would be charged the inflated amount.  A final step was to send a second invoice to Medicare or the insurance company of the original person whose identity had been used to start the process.  It was an example of death by a thousand cuts.  None of the individual invoices was large enough to cause concern, maybe just some grumbling and complaining.  But, by processing thousands of transactions, an enormous amount revenue and profit was generated.  A final look at Marco’s pyramid indicated that all of the diverse and discrete organizations eventually flowed (up) to a single holding company.  Garcia assumed that each organization and each level operated with little or no knowledge of any other part of the scheme.  Some may even have considered themselves legitimate.

Frank sat back, pleased with himself for figuring out this complex scheme. OK, so maybe Marco had left a series of bread crumbs for him to follow.  Now, there was only one problem.  All of this information had been obtained illegally and Garcia certainly could not acknowledge that it was in his possession.  “There goes my lily-white reputation”, he thought.  And, unless it could be shown that these individual organizations were inter-connected, they would appear completely legitimate.

Frank was exhausted and decided to go home for the evening. Frank did not enjoy watching television; he found most of it tedious; he preferred to read. But, tonight he didn’t think he could concentrate, so he opted for what he called the mindless activity of staring at the TV until it was time to go to bed.  It would be a few minutes before the Garcia family sat down for dinner together and the local news was on.  The local news anchor on Channel 9 was about to begin with the lead story which was typically some sensationalized version of a minor event in the City. Frank assumed that it was all the make-up the anchor wore that allowed him to keep a serious face when reading such drivel.

“Our Local Nine News Investigative Team has uncovered a major identity theft ring operating here in Albuquerque. The details are still coming in and our sources tell us that there will be major revelations in the coming days.  For this case, we’re working with an undercover operative from the Albuquerque Journal. Tune in for details at Ten!”

Frank was no longer drowsy and sat bolt upright in his seat.  Well, Marco had warned him that he would be sending information to the Journal.  But, Frank quickly realized that Marco had only provided the Journal with a fraction of the whole story.  It was his way of creating publicity to prompt the Police to open an investigation.  Brilliant!

Even though Garcia got to his office early the following morning, the Commissioner and District Attorney were already seated in his office. The Commissioner spoke first, before Garcia was completely in the door. “I suppose you saw the Channel 9 News and the headlines in this morning’s Journal.”  It really wasn’t a question.  “The Department doesn’t need any more negative publicity or implication that we’re not doing our job.  How quickly can you get up to speed on this identity theft business?”

The District Attorney added. “Look, Lieutenant, I spoke to Judge Wilson last evening and he’s prepared to issue whatever warrants you need. Just give me some names and some reasonable probable causes for search and I’ll have the paperwork in your hands in less than an hour.”

“Do you need any type of special experts to do some of the digging for you?” offered the Commissioner.  I will make whatever resources you need available; just let me know.”

Frank Garcia smiled quietly to himself.  On any other occasion, when he had asked for support from either the Police Commissioner or the DA, there had always been a host of reasons why his requests were unreasonable or that he would just have to be patient”.  But now, when their butts were hanging out, he was the one holding up the parade!  “Let me spend an hour or so thinking about the most efficient way to tackle this, Sir. I appreciate your support and believe we can act swiftly and decisively before the Press makes a total mess out of things.”

“That’s the spirit, Lieutenant.  I’ll be in my office waiting for your plan of action.”

“I have to be in court at 9, but will be in my office the remainder of the day.  I have Judge Wilson on speed-dial whenever you’re ready to move.”

Garcia decided he’d let this flurry of activity sink in while he enjoyed a cup of coffee and waited for the clock to reach 8 AM.

He was still savoring his coffee when his computer signaled an incoming e-mail from Matthew Dudley.

Lieutenant, during one of our projects with the La Vida Aureo Community Assist Program, we uncovered a number of organizations operating in the City that claim to be authorized agents to sign people up for health insurance.  We’ve concluded among ourselves that most of these are phony. I don’t know if this has anything to do with that article I this morning’s paper, but I thought I pass it along to you just in case.  I’ve attached a file that contains a list of the places we’ve identified.  Let me know if I can be of further assistance. Regards, Doc.”

When Garcia compared Dudley’s list with the names in the lowest level of Marco’s pyramid, he was not surprised to see a complete match.  Garcia now had a legitimate staring point of names and could begin his investigation in earnest.  He could easily incorporate additional names in the search warrants based on Marco’s information while asserting that everything he was doing stemmed from the Community Assist Team’s efforts. As he hurried down the hall to the Commissioner’s office, he knew that he needed to understand why the two lists of names were so similar.  But, that was a matter for a later and quite private discussion with Matthew Dudley.  Right now, he had work to do.

Because he knew exactly where to look for specific organizations and individuals, it did not take Garcia very long to execute a series of arrest warrants and seize large amount of records. For over a week, the local news aired video clips of people being led away in handcuffs and trucks being loaded with boxes and boxes of inventory reports, shipping manifestos, personnel files, etc., etc.  Eventually, Lt. Frank Garcia was able to pursue the top tier of the pyramid. He led the raid on the corporate offices of Tyler Enterprises and personally placed Madison Tyler in handcuffs.  Garcia knew that Mr. Tyler would be out on bail within a few hours and that this was just the beginning of a very long and involved legal process.   Nonetheless, the insurance fraud scheme had been exposed and would not be operating in Albuquerque, at least for a long time.


With a great sense of satisfaction, Frank Garcia knew there was still some unfinished business to attend to.  His first stop was at People’s Florist where he purchased a dozen long-stem red roses.  The barista at Humble Coffee expressed surprise when Garcia said the roses were just an expression of appreciation to Humble’s clientele. Garcia just smiled and left with his coffee.

Under the pretense of paying a visit to Señora Angostura, Frank Garcia arrived at La Vida Aureo just as Matthew Dudley was finishing his morning ritual of coffee and the Wall Street Journal.  Dudley looked up from his paper. “Lieutenant, what a pleasant surprise.  I hardly expected to see you here. You’ve become quite a celebrity lately.”

“It’s nice to see you too, Doc.  Actually, I just stopped by to pay my respects to Señora Angostura.  It’s been a while since I’ve seen her and I didn’t want any more time to go by.  It would be disrespectful.”

“Well, Lieutenant, you just missed her.  She took two of ladies who live here on a shopping trip.  I understand the three of them are cooking up a special meal for Sunday.  I’ll be sure to tell her you were here and give her your regards.”

“Thanks, Doc. I would appreciate that.  You know, while I’m here, I wanted to ask you about that list of names you sent me a while ago.  I’m sure you realize that most of those organizations were somehow involved in the major insurance fraud operation that’s been in the news.  If you don’t mind my asking, just how did you come up with those names?”

“It wasn’t that complicated,” said Dudley modestly. “Some members of the Community Assist Team were hearing stories that didn’t make sense, so they decided to look into it a bit further.  That’s about it. It was Minot Atkinson, one of the Team, that actually compiled the list I sent you, based on her research.”

“Well, it obviously helped a great deal in our investigation.  Do you think it would be appropriate if I met with the Team, you know, just to say Thank You?’

“No problem. I’m sure they would appreciate it.  If you’re not busy, the Team is scheduled to meet in a few minutes.  Why don’t you come along?”


The Team was gathering in the Conference Room when Dudley approached with Lt. Garcia.  They were a bit surprised; Frank Garcia had become somewhat of a local celebrity and the main spokesman for the Police Department.  Everyone took a seat and Dudley introduced Garcia.

“I have known Mr. Dudley, or Doc, for only a short while but consider him a friend and valuable resource for the Police Department and particularly the Major Crime Unit where I work.  Today, I want to express the Department’s appreciation for the valuable work you folks are doing and for your help in uncovering this insurance fraud scheme.   As you continue to work out in the community, please feel free to alert me to any suspicious activities you may encounter.”

Lt. Garcia concluded his remarks to the Team and asked for questions.  There were none, but Beth Ford stood and spoke. “Lieutenant Garcia, we certainly appreciate the time you took to come and talk with our Team.  We are all too aware of the potential for fraud and deception in this large and rapidly expanding field; so many people are vulnerable.  We understand that you have many other responsibilities, but I would like to keep a line of communication open as we continue to explore our role in the community.”

“I heartily agree,” replied Lt. Garcia “and welcome your input.  You may not be aware of it, but I have a personal relationship with La Vida Aureo and am always glad to stop by to visit with Mr. Dudley or Señora Angostura.”

I should have known,” Beth mused to herself.  “Thank you again, Lieutenant.”


Frank Garcia had not been able to get the explicit answer to his question about the lists. He knew that Dudley had only told him part of the story.  Perhaps Dudley had told him everything he knew.  But Garcia’s policeman’s intuition told him that the details of the explanation somehow resided with one or more members of the Team.  He was confident that his presence at their meeting had delivered the Thank You message to the appropriate person.

Beth turned to face the Team and said, “Well, I think that’s enough for today.  We should be proud that we played at least some small part in uncovering this criminal activity.  Hopefully, we can get back to our other initiatives in the very near future.  Mr. Dudley, is there anything you’d like to say before we adjourn?”

“Not really, Beth. I think you’ve pretty well covered things.  I would just like to add my congratulations to the Team for all their fine work.”

As he looked around the room, he noticed that all of the Team members had a very pleased and satisfied look on their faces, particularly Minot Atkinson.  She was sitting very much at ease with her arms folded casually across her chest and a look on her face that Dudley could only describe as the cat that ate the canary”.

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