Thursday, February 5, 2009

Physician Admits to Role in Insurance Scam

Second Doctor Charged from Jamaica Clinic

A Middle Village physician has pleaded guilty to falsely charging insurance companies for costly medical tests never actually provided to motor vehicle accident victims.

Alexander Israeli, 57, of 61-59 Dry Harbor Road admitted on Monday to his role in the scheme, which took place at L&B Medical at 153-25 Hillside Avenue in Jamaica. He pled guilty to fourth-degree insurance fraud and is expected to receive a three-year conditional discharge when he is sentenced on February 25.

According to the charges, Israeli submitted seven insurance claims for costly nerve conduction studies and needle electromyopgraphs between January and December 2000 even though the procedures were never performed. The claims were submitted under the state’s no-fault law, which allows a person injured in a motor vehicle accident to receive up to $50,000 coverage for medical expenses incurred as a result. Most health providers are reimbursed directly by the insurance carriers for services provided.

As a result of the fraudulent claims submitted by Israeli, insurance companies paid out more than $21,000 to his employer, L&B Medical. Since he pleaded guilty to a felony, the New York State Department of Health’s Office of Professional Medical Conduct will commence action to revoke his license to practice medicine here. Among the insurance companies victimized by the scheme were GMAC, Kemper Auto and Home Insurance, Allstate and Geico.

“No-fault fraud and abuse is a billion dollar a year business in New York fueled by unethical health care professionals,” said Queens District Attorney Richard Brown. “Today’s guilty plea sends a clear message to those who are attempting to use the system for their own personal gain that law enforcement’s fight against insurance fraud is ongoing and those who cheat will be sought out and brought to justice.”

According to Brown, these types of cases are costing the average New York driver $300to $400 a year in higher insurance premiums “and are a major reason why New York’s automobile insurance coverage costs an average of nearly $2,000 per driver, the second highest in the nation.”

Israeli was the second physician charged, as a colleague, Dr. Yakov Raufov, was charged in May 2007 with grand larceny insurance fraud and falsifying business records. Dr. Raufov, 43, of Long Island, is scheduled to stand trial in March and faces up to seven years in prison if convicted. Israeli’s plea agreement came on the day his trial was scheduled to begin.

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