U.S. Attorney Announces The Arrest Of 13 Individuals For $100 Million Healthcare Fraud, Money Laundering
Two Indictments Charge the Defendants, Including an NYPD
Police Officer, Doctors, an Attorney, and Others, With Healthcare Fraud, Money
Laundering, Bribery, and Other Offenses in One of the Largest No-Fault
Automobile Insurance Fraud Takedowns in History
Damian Williams, the United States Attorney for the Southern
District of New York, Michael
J. Driscoll, Assistant Director-in-Charge of the New York Office of
the Federal Bureau of Investigation (“FBI”), Miriam A. Rocah, the Westchester
County District Attorney, Kevin P. Bruen,
Superintendent of the New York State Police (“NYSP”), and Keechant Sewell,
Commissioner of the New York City Police Department (“NYPD”), announced the
unsealing of two indictments charging 13 individuals – including an NYPD police
officer, licensed physicians, an attorney, and others – in connection with a
$100 million automobile insurance fraud scheme.
Of the 13 defendants, eight are charged in an indictment
detailing conspiracies to commit healthcare fraud, money laundering, bribery,
and obstruction, making false statements to federal authorities, and aggravated
identity theft. The charges are set forth in United States v.
Alexander Gulkarov, et al., 22 Cr. 20 (the “Gulkarov Indictment”),
which has been assigned to U.S. District Judge Failla. Five additional
defendants are separately charged in United States v. Bradley Pierre,
et al., 22 Cr. 19 (the “Pierre Indictment”), which has been
assigned to U.S. District Judge Torres.
Of those defendants, ten were arrested this morning in New
York and New Jersey and are scheduled to appear before U.S. Magistrate Barbara
Moses in Manhattan federal court later today. An eleventh defendant,
Alexander Gulkarov, was arrested in Miami, Florida, and is scheduled to appear
before a U.S. Magistrate Judge in the Southern District of Florida later today.
U.S. Attorney Damian Williams said: “The thirteen
defendants charged in today’s indictments are alleged to have collectively
perpetrated one of the largest no-fault insurance frauds in history. In
carrying out their massive scheme, among other methods, they allegedly bribed
911 operators, hospital employees, and others for confidential motor vehicle
accident victim information. With this information, they then endangered
victims by subjecting them to unnecessary and often painful medical procedures,
in order to fraudulently overbill insurance companies. Schemes exploiting
no-fault insurance laws – which ironically exist to make insurance more affordable
– also result in higher costs, and unfairly burden all consumers in the auto
insurance market.”
FBI Assistant Director Michael J. Driscoll said: “No-fault
accident schemes, like the one alleged today, can cost insurance companies
millions of dollars in payouts to doctors and clinics who provide phony or
unnecessary services to unwitting accident victims. This cost is almost always
passed to consumers of private insurance or subsidized programs established to
help those in need. This is a dangerous game in which the penalties include
federal criminal charges.”
Westchester County District Attorney Miriam A. Rocah
said: “This case is a perfect example of federal, state and local law
enforcement working in partnership to investigate and take down two criminal
organizations that allegedly defrauded insurance companies and exploited
vulnerable individuals by subjecting them to unnecessary, harmful, and
sometimes painful, medical treatments for the sake of greed and profit. We
will continue to work with our law enforcement
partners to hold accountable those who manipulate the insurance
system on which so many people depend, especially when the alleged perpetrators
are professionals who allegedly violated the oaths they
took to serve and protect.”
State Police Superintendent Kevin P. Bruen said:
“These indictments are the result of years of investigative work and could not
have succeeded without the collaboration between federal, state and local law
enforcement. Our investigation uncovered a large-scale, complex scheme
that resulted in millions of dollars of fraudulent insurance claims. This type
of fraud impacts the entire system and results in higher costs for companies
and policyholders. I commend our members and our law enforcement partners for
their work on this case, and we are sending a clear message that we will not
tolerate fraud on any level.”
According to allegations contained in the Indictments[1] unsealed today in Manhattan federal
court:
Background of the Investigation
Since 2017, the U.S. Attorney’s Office for the Southern
District of New York, the FBI, and the Westchester County District Attorney’s
Office have been investigating several criminal organizations involved in a
widespread healthcare fraud and bribery scheme that utilized the New York and
New Jersey no-fault automobile insurance regime to earn millions of dollars in
illegal profits.
New York and New Jersey no-fault insurance laws require a
driver’s automobile insurance company to pay automobile insurance claims
automatically for certain types of motor vehicle accidents, provided that the
claim is legitimate, and is below a particular monetary threshold (the
“No-Fault Laws”). Pursuant to these requirements, insurance companies
will often pay medical service providers directly for the treatment they
provide to automobile accident victims, without the need to bill the victims
themselves. This process resolves automobile claims without apportioning
blame or fault for the accident, thereby avoiding protracted disputes, and the
costs associated with an extended investigation of the accident.
The Gulkarov Indictment
The Gulkarov Indictment charges eight
individuals (the “Gulkarov Conspirators”) with participating in a scheme to
exploit the No-Fault Laws. As part of the scheme, the Gulkarov
Conspirators fraudulently owned and controlled more than a dozen medical
professional corporations – including medical, acupuncture, and chiropractic
practices – by paying licensed medical professionals to use their licenses to
incorporate the professional corporations (collectively, the “Gulkarov
Clinics”). The Gulkarov Conspirators further defrauded automobile
insurance companies by billing insurance companies for unnecessary, harmful,
and excessive medical treatments and lying under oath to insurance company
representatives.
The Gulkarov Conspirators promoted the scheme through
bribery. The Gulkarov Conspirators paid hundreds of thousands of dollars
to co-conspirators (the “Runners”), who used this money to bribe 911 operators,
hospital employees, and others for confidential motor vehicle accident victim
information. The Runners then used this information to contact automobile
accident victims, lie to them, and induce them to seek medical treatment at,
among other places, the Gulkarov Clinics.
The Gulkarov Conspirators laundered the proceeds of the
fraud scheme through law firms, check-cashing entities, and shell companies,
and used the money to pay for luxury cars, watches, and vacations. Then,
when certain members of the conspiracy learned that they were under federal
criminal investigation, they obstructed justice by fabricating documents, lying
to law enforcement, and committing perjury before a federal grand jury.
As alleged, the leaders of the Gulkarov Conspirators are
non-physicians, including ALEXANDER GULKAROV, a/k/a “Little Alex,” ROMAN
ISRAILOV, a/k/a “Roman Matatov,” PETER KHAIMOV, a/k/a “Peter Khaim,” and
ANTHONY DIPIETRO. ROLANDO CHUMACEIRO, a/k/a “Chuma,” and MARCELO QUIROGA
are licensed medical practitioners who incorporated medical practices as part
of the scheme, prescribed unnecessary and excessive medical treatments, and
overbilled insurance companies under the No-Fault Laws.
The Gulkarov Indictment also includes
charges against an attorney, ROBERT WISNICKI, Esq., who is the founding partner
of two New York-based law firms. As alleged, WISNICKI laundered hundreds
of thousands of dollars of illicit proceeds for the leaders of the Gulkarov
Conspiracy and concealed these transfers by fabricating retainer agreements,
lying to law enforcement, and committing perjury before a federal grand
jury.
Finally, the Gulkarov Indictment
includes a charge against an NYPD police officer, ALBERT ARONOV. As
alleged, as part of the scheme, ARONOV logged into NYPD computers during
off-hours and searched for confidential motor vehicle accident reports on the
NYPD’s servers. ARONOV then took photos of the reports using a pre-paid
“burner” phone and transmitted the photos to the leaders of the Gulkarov
Conspiracy using an encrypted messaging application. The leaders then
used the confidential information contained in these reports to contact the
motor vehicle accident victims, lie to them, and steer them to the Gulkarov
Clinics for medical treatment. When later questioned by federal agents,
ARONOV lied about his involvement in accessing and disseminating the
confidential motor vehicle accident reports.
All told, the Gulkarov Conspirators billed insurance
companies for more than $30 million in fraudulent medical treatments.
The Pierre Indictment
The Pierre Indictment separately charges
five additional individuals (the “Pierre Conspirators”) with participating in a
second criminal scheme to exploit the No-Fault Laws. The Pierre
Conspirators fraudulently owned and controlled five medical services corporations
– including medical clinics and a magnetic resonance imaging (“MRI”) center –
by paying licensed medical professionals to use their licenses to incorporate
the professional corporations (collectively, the “Pierre Clinics”). The
Pierre Conspirators further defrauded automobile insurance companies by billing
insurance companies for unnecessary, harmful, and excessive medical treatments,
falsifying clinical injuries in reports, and lying under oath to insurance
company representatives.
The Pierre Conspirators promoted the scheme through bribery.
Like the Gulkarov Conspirators, the Pierre Conspirators also paid
hundreds of thousands of dollars to the Runners, who used this money to pay
bribes for confidential motor vehicle accident victim information. The
Runners then used this information to induce victims to seek medical treatment
at, among other places, the Pierre Clinics.
The Pierre Conspirators laundered the proceeds of the fraud
scheme through phony loan arrangements and shell companies.
As alleged, the leader of the Pierre Conspiracy is BRADLEY
PIERRE, who is not a physician. PIERRE conducted much of the No-Fault
Scheme from his physical office located in a law firm owned by a family member
(“Law Firm-2”), where, among other things, he monitored the Pierre Clinics
using closed circuit TV cameras, communicated with co-conspirators using Law
Firm-2’s email domain, and met with doctors in Law Firm-2’s offices.
PIERRE further openly communicated with Law Firm-2 about the
scheme, for instance telling his family member, “I'm going to make sure you
ALWAYS make your quota.” Law Firm-2 paid PIERRE over $4 million in
connection with the No-Fault Scheme – typically from Law Firm-2’s Interest on
Lawyers Trust Accounts (“IOLA Accounts”) – while maintaining no documentation
or ledgers identifying the purpose of these payments.
The Pierre Indictment further charges two
licensed medical practitioners with participating in the scheme. MARVIN
MOY is a medical doctor who incorporated a medical practice as part of the
scheme and agreed with PIERRE to conduct unnecessary and painful
electrodiagnostic testing on patients. WILLIAM WEINER is a doctor of
osteopathic medicine who incorporated a medical imaging facility as part of the
scheme and agreed with PIERRE to falsify findings of clinical injuries in MRIs
in order to boost patient referrals.
Finally, the Pierre Indictment charges two
individuals for conspiring with PIERRE to pay bribes in order to facilitate the
scheme. ARTHUR BOGORAZ is a paralegal and manager at a New York-based
personal injury law firm (“Law Firm-1”). Among other things, BOGORAZ and
PIERRE agreed to jointly pay bribes for patient and client referrals to the
Pierre Clinics and Law Firm-1. ANDREW PRIME is a Runner who bribed 911 operators
and operated an additional call center as part of the scheme.
All told, the Pierre Conspirators billed insurance companies
for more than $70 million in fraudulent medical treatments.
The maximum potential sentences are prescribed by Congress
and are provided here for informational purposes only, as the sentencing of the
defendants will be determined by a judge.
Mr. Williams praised the work of the FBI, the New York State
Police, the New York City Police Department, the New York City Department of
Financial Services, the Westchester County District Attorney’s Office, and the
National Insurance Crime Bureau. Mr. Williams noted that the
investigation is ongoing.
This case is being handled by the Office’s Complex Frauds
and Cybercrime Unit, and the White Plains Division. Assistant United
States Attorneys Mathew Andrews and Louis A. Pellegrino are in charge of the
prosecution.
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