Medical doctor allegedly bilked insurance companies

A medical doctor formerly employed at a Jamaica medical clinic has been indicted by a Queens County grand jury for falsely billing insurance carriers over a nearly four-year period for costly medical tests never provided to motor vehicle accident victims. It is alleged that the defendant submitted old test results of other patients as “proof” that he did the tests.
Under New York’s no-fault insurance 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.
Yakov Raufov, 44, of Glen Cove, Long Island, who practiced at L&B Medical, located at 153-25 Hillside Avenue in Jamaica, has been arraigned on a 33-count felony indictment, charging him with 12 counts of fourth-degree insurance fraud, 12 counts of first-degree falsifying business records, eight counts of fourth-degree grand larceny and one count of first-degree scheme to defraud. The defendant, who faces up to four years in prison and loss of his license to practice medicine if convicted, was released on his own recognizance and ordered to return to court on September 16.
According to the charges, between August 2003 and April 2007, the defendant engaged in an insurance fraud scheme in which he submitted insurance claims for costly nerve conduction studies and needle electromyographs (“NCV/EMGs”) that, in fact, were not performed on 12 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 $18,000.
The matter will now be referred to the New York State Department of Health’s Office of Professional Medical Conduct for a review of the defendant’s license to practice medicine, according to the district attorney.