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Under the No-Fault Law, patients can assign their right to reimbursement from an insurance company to others, including medical clinics that provide treatment for their injuries.
Two Clinic Owners Plead Guilty For Their Roles In Massive No-Fault Insurance Fraud Scheme
Three Medical Professionals, Including One Licensed Doctor, Have Also Pled Guilty
February 15, 2013
Preet Bharara, the United States Attorney for the Southern District of New York, announced today that five defendants have pled guilty for their roles in a systematic scheme to defraud private insurance companies of more than $400 million under New York’s no-fault automobile insurance law. The case is the largest single no-fault automobile insurance fraud scheme ever charged. Earlier today, Andrey Anikeyev, an owner and controller of various acupuncture clinics, pled guilty before U.S. District Judge J. Paul Oetken to conspiracy to commit mail fraud and health care fraud. Yesterday, Dmitry Slobodyansky, who owned and controlled chiropractic clinics, also pled guilty before Judge Oetken to conspiracy to commit mail fraud and health care fraud. Sergey Gabinsky, a medical doctor, pled guilty before Judge Oetken earlier this month, and Pavel Poznansky, an acupuncturist, and Constantine Voytenko, a chiropractor, pled guilty before Judge Oetken in December 2012. All five were arrested in February 2012 with 31 other defendants, some of whom were also charged with racketeering and money laundering. The 36 defendants include 10 doctors and three attorneys.
Manhattan U.S. Attorney Preet Bharara said, “These five defendants piled up fraud to the tune of $400 million in a scheme to exploit New York’s no-fault auto insurance laws. We remain committed to ensuring that all their alleged co-conspirators, including the corrupt medical and legal professionals charged with using their professional licenses and training to facilitate this brazen fraud, see justice.”
According to the indictment, superseding informations, and other publicly filed information in the case:
Under New York State law, every vehicle registered in New York State is required to have no-fault automobile insurance, which enables the driver and passengers of a registered and insured vehicle to obtain benefits of up to $50,000 per person for injuries sustained in an automobile accident, regardless of fault (the “No-Fault Law”). The No-Fault Law requires prompt payment for medical treatment, thereby obviating the need for claimants to file personal injury lawsuits in order to be reimbursed. Under the No-Fault Law, patients can assign their right to reimbursement from an insurance company to others, including medical clinics that provide treatment for their injuries. New York State law also requires that all medical clinics in thesState be incorporated, owned, operated, and/or controlled by a licensed medical practitioner in order to be eligible for reimbursement under the No-Fault Law. Insurance companies will not honor claims for medical treatments from a medical clinic that is not actually owned, operated, and controlled by a licensed medical practitioner.
In order to mislead New York authorities and private insurers, some of the defendants in this case who were the true owners of these medical clinics (“No-Fault Clinic Controllers”) paid licensed medical practitioners, including doctors, to use the practitioners’ licenses to incorporate the professional corporations through which the medical clinics billed the private insurers for the bogus medical treatments. Gabinsky was one such doctor who admitted in open court to prescribing unnecessary medical treatments and to allowing co-conspirators to use his medical license to unlawfully open medical clinics in order to defraud insurance companies. Poznansky and Voytenko were medical practitioners who billed insurance companies for treatments to patients that were unnecessary.
The No-Fault Clinic Controllers also instructed the clinic doctors to prescribe excessive and unwarranted referrals for various “modality treatments” for nearly every patient they saw. The treatments included physical therapy, acupuncture, and chiropractic treatments—as much as five times per week for each—and treatments for psychology, neurology, orthopedics, and audiology. Clinic doctors also prescribed unnecessary MRIs, X-rays, orthopedics, and medical supplies. The No-Fault Clinic Controllers received thousands of dollars in kickbacks for patient referrals from the owners of the modality clinics (“modality controllers”). Anikeyev and Slobodyansky were two such Modality Controllers who admitted to billing insurance companies for treatments that patients did not need.
Anikeyev, 38, of Fort Lee, New Jersey; Slobodyansky, 42, of Brooklyn, New York; Gabinsky, 55, of Brooklyn, New York; Poznansky, 53, of Brooklyn, New York; and Voytenko, 41, of Brooklyn, New York, each face a maximum penalty of five years’ imprisonment, a maximum fine of $250,000, a maximum term of supervised release of three years, and a mandatory special assessment of $100. Poznansky, Voytenko, Gabinsky, Anikeyev, and Slobodyansky are scheduled to be sentenced by Judge Oetken on April 23, 2013; April 24, 2013; June 12, 2013; June 28, 2013; and June 13, 2013, respectively.
U.S. Attorney Preet Bharara thanked the Federal Bureau of Investigation and the New York City Police Department for their continued outstanding work in this investigation.
The case is being prosecuted by the Office’s Organized Crime Unit. Assistant U.S. Attorneys Daniel S. Goldman, Nicholas L. McQuaid, Carolina A. Fornos, and Daniel Noble are in charge of the prosecution. Assistant U.S. Attorneys Jason L. Cowley and Martin Bell of the Office’s Asset Forfeiture Unit are responsible for the forfeiture of assets.
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