Brooklyn, NY – Ten Arrested In Connection With Medical Fraud Mill

Brooklyn, NY – Ten individuals associated with a Brooklyn-based medical clinic — including the clinic’s owners and several of its medical practitioners — were arrested yesterday and today on charges of conspiracy to commit health care and mail fraud.

According to the three criminal Complaints unsealed earlier today Samuel Vilshanetski, a/k/a “Dima,” Sviatoslav Jadan, a/k/a “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 nofault 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.

The Avenue K Clinic was a medical fraud mill which routinely billed automobile insurance companies under the nofault 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.

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 $1.2 million from these insurance companies.