Jamaica doctor bilked insurance carriers

A physician employed at a Jamaica, Queens, medical clinic has been charged with insurance fraud for allegedly falsely billing insurance carriers under New York’s no-fault law for costly medical tests never provided to motor vehicle accident victims.
“No-fault fraud and abuse is a billion dollar a year business in New York fueled by crooked health care professionals,” said District Attorney Richard A. Brown. “Such rip-offs are costing the typical New York motorist $300 to $400 a year in higher insurance premiums and are the major reason why New York’s automobile insurance coverage costs an average of nearly $2,000 per driver, the second highest in the nation. The arrest sends a clear message to those who are attempting to fleece the system for their own personal gain that law enforcement’s fight against insurance fraud is ongoing and that those who cheat will be sought out and vigorously prosecuted.”
Under New York’s no-fault law, a person injured in a motor vehicle accident can receive up to $50,000 coverage for medical expenses incurred as a result of an accident. Most health providers are reimbursed directly by the insurance carriers for services provided.
The defendant, Yakov Raufov, 43, of 21 Carlyle Drive in Glen Cove, Long Island, who practices at L&B Medical, located at 153-25 Hillside Avenue in Jamaica, Queens, faces charges of third- and fourth-degree grand larceny, third- and fourth-degree insurance fraud and first-degree falsifying business records. If convicted, he faces up to seven years in prison.
According to the charges, between May 2004 and September 2005, the defendant submitted insurance claims for costly nerve conduction studies and needle electromyographs (“NCV/EMGs”) that, in fact, were not performed on five individuals. A NCV tests the flow of electrical currents across the nerves, and an EMG is a recording of the electrical activity in muscles and nerves. The defendant is alleged to have caused fraudulent claims for these unrendered and unnecessary medical tests to be submitted to a number of no-fault insurance companies in an amount totaling more than $10,000.