A “New York-based doctor has been found guilty in a no-fault insurance fraud scheme following a two-week jury trial,” Insurance Journal reports.
In New York, “every vehicle registered in the state is required to have no-fault auto insurance, which allows 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 auto accident, regardless of fault.”
With the “no-fault law, patients can assign their right to reimbursement from an insurer to others, including medical clinics that provide treatment for their injuries. New York state law also requires that all medical clinics in the state be incorporated, owned, operated, and/or controlled by a licensed medical practitioner in order to be eligible for reimbursement under the no-fault law.”
Since insurance companies will only honor claims for treatments received from clinics owned by a licensed medical practitioner, “the true owners of these medical clinics paid licensed doctors to use their licenses to incorporate the professional corporations, through which the true owners billed private insurers millions of dollars for medical treatments and tests, many of which were not medically necessary.”
The doctor, Tatyana Gabinskaya, claimed to be “owner of one such clinic that provided MRIs and other radiology tests, although the clinic was, in reality, owned by her co-defendants Mikhail Zemlyansky and Michael Danilovich.”
Gabinskaya could face up to forty years in prison.
Summary by MedicalGroups.com
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