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Prison Time For Local Doc In Largest No-Fault Auto Insurance Fraud Scheme

March 6, 2015 by  
Filed under Blog

Tatyana Gabinskaya, a local doctor, was sentenced on Friday to one year and one day in prison for her role in a massive $279 million no-fault auto insurance fraud scheme that has already seen 31 other defendants convicted.

According to investigators, Gabinskaya, 60, was a central figure of the scheme, saying she was the owner and operator of seven medical clinics that billed for millions of dollars in reimbursements under the No-Fault Law. Five of those clinics were incorporated in just one year.

But prosecutors say those clinics were actually owned by co-defendants Mikhail Zemlyansky and Michael Danilovich, who from 2007 to 2012 paid kickbacks to Gabinskaya and other licensed doctors for procedures that were not medically necessary and from phony patients they recruited, including MRIs and radiology tests.

“Tatyana Gabinskaya was one of the linchpins in a scheme that defrauded insurers on an unprecedented scale,” said U.S. Attorney Preet Bharara. “At the heart of her deception was her repeated lie that she owned and operated a medical clinic she did not in fact own or operate that billed for numerous fraudulent claims. That has proven to be a prescription for prison.”

In addition to the prison term, Gabinskaya was ordered to forfeit $69,384 and to pay an as-yet undetermined restitution to the victims of her crimes.

The break-up of the 36-member ring in February 2012 was the largest such bust in history, spurring the government to use the Racketeer Influenced and Corrupt Organizations Act – or RICO – an anti-organized crime law allowing the prosecution of racketeering activity. All 36 were charged with conspiracy to commit mail fraud and health care fraud and some were charged with racketeering and money laundering.

According to the 2012 indictment, Zemlyansky and Danilovich were the ringleaders of the scheme, employing “runners” who recruited those who have been in automobile accidents for a kickback. Those patients were sent to clinics they controlled through “straw owners” including Gabinskaya for unnecessary tests and medical procedures. Those medical professionals then referred every patient they saw for “modality treatments,” including physical therapy or acupuncture, sometimes as often as five times per week for each patient. The “modality clinics” were also owned by or associated with Zemlyansky and Danilovich, according to investigators.

Zemlyansky and Danilovich then referred patients to personal injury lawyers who filed bogus lawsuits, coaching them on what injuries to claim to get additional treatments. The lawyers paid the clinic controllers kickbacks for the referrals.

Funds were ciphered through a network of shell companies, and checks cashed through corrupt check-cashing services, according to the 2012 indictment.

A jury acquitted Zemlyansky and Danilovich on some counts and hung on others. They are scheduled to be retried.

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