Saturday, July 19, 2008

Ten individuals associated with a Brooklyn-based medical clinic ...charges of conspiracy to commit health care and mail fraud.

NEW YORK—Ten individuals associated with a Brooklyn-based medical clinic — including the clinic’s owners and several of its medical practitioners – have been arrested on Three other individuals remain at large, although one was expected to surrender later Thursday.



Samuel Vilshanetski, aka “Dima,” Sviatoslav Jadan, aka “Slava,” and a third individual owned and operated a medical clinic located at 3003 Avenue K in Brooklyn, New York. The Avenue K Clinic was primarily engaged in the treatment of individuals who filed no-fault automobile insurance claims with insurance companies. Under New York State Law, no-fault insurance enables the driver and passengers of a vehicle registered and insured in New York to obtain benefits of up to $50,000 per person for injuries sustained in an automobile accident, regardless of fault.



Prosecutors say the Avenue K Clinic was a medical fraud mill which routinely billed automobile insurance companies under the no-fault program for medical “treatments” which were either never provided or unnecessary, because the person being “treated” did not medically need the treatments.



According to the complaints, the operators of the Avenue K Clinic paid thousands of dollars to “runners” who would recruit patients who were in car accidents — sometimes staged solely to commit insurance fraud — but who often suffered little or no injury from the accidents. These patients would undergo weeks or months of unnecessary “treatments” — such as physical therapy, chiropractory and acupuncture — at the Avenue K Clinic. The Avenue K Clinic then billed automobile insurance companies under the no-fault program for these unnecessary medical treatments, prosecutors said.



In the first two years of its operation, the Avenue K Medical Clinic billed insurance companies a total of approximately $3.6 million for no-fault medical services on behalf of more than 500 patients and, as of June 2008, had received approximately $1.2million from these insurance companies.



Vilshanetski, Jadan and the third individual owned and operated the Avenue K Clinic – making the initial financial investments and supervising the Clinic’s medial staff and operations. The owners of the Avenue K Clinic engaged so-called “runners,” including defendants Roman Satler, aka “Roma”, Shamil Tagiev, aka “Sammy”, Emmanuel Kelly, aka “Kevin”, Vladimir Deupont, aka “Vlad” and Feliks Khatsela, to recruit patients for the clinic for treatment.



According to the complaints, the owners paid the runners an average of approximately $2,000 per patient but paid them only after the referred patients had received enough treatments for the patient to be profitable. The recruited patients were required to attend the clinic for treatment regularly, sometime daily, and to agree to receive multiple MRIs. Even greater payments were offered to the runners when a patient was accepted as a client at one of several law offices associated with the clinic because the law offices paid fees to the clinic for each patient signed up as a client.



The owners relied on various means to obtain cash to pay the clinic runners. For example, the owners of the Avenue K Clinic laundered money through defendant Mark Pogoriler, aka “Lobster” by writing checks drawn on the accounts of clinic medical practitioners to Pogoriler’s medical transportation companies. In fact, Pogoriler provided no transportation services to the clinic and instead simply returned 90 percent of the value of the checks as cash.



The owners also obtained cash from kickbacks provided by outside medical suppliers and practitioners in exchange for the referral of business. Medical supply companies associated with Radion Aminov, the defendant, billed insurance companies for overpriced and often unnecessary medical supplies provided to Avenue K Clinic patients, and in return provided kickbacks to the Avenue K Clinic.



Gennady Broytman, aka “Genna,” the defendant, operated an MRI clinic that billed insurance companies for MRIs provided to Avenue K Clinic patients and paid kickbacks to the clinic owners. The Avenue K Clinic also hired doctors and medical

professionals to “treat” the patients recruited for the clinic by the runners, even though the majority of such patients did not need the medical treatments provided.



These medical professionals included defendants Romilla Anwar (a physician), Anatoliy Sunik (an acupuncturist) and Asnodin Dianalan, aka “Dino” (a physica ltherapist)(collectively the “medical staff.”) The medical staff provided unnecessary medical treatments and supplies to clinic patients, and also submitted bills to the insurance companies for more medical services than were in fact provided. 7-17-08

No comments: