| Way back in March, 2005, Manhattan District | | | | of fraudulent claims: |
| Attorney Robert M. Morgenthau indicted fifteen | | | | Billings for services in which the defendants |
| people, including four doctors, a dentist, a | | | | claimed that they had seen and treated patients |
| psychologist, and an acupuncturist, on charges of | | | | on dates when they had not. |
| participating in an insurance scam in which | | | | Billings in which the defendants "up coded" - i.e., |
| insurance companies and the N.Y.C. Transit | | | | claimed that a particular procedure or doctor's |
| Authority were over-billed for No-Fault insurance | | | | visit lasted longer than it actually did to obtain a |
| charges, for medical care arising out of automobile | | | | higher reimbursement rate. |
| accidents. Also indicted were a medical billing | | | | Billings in which the defendants ordered testing |
| company, two health care clinics that were also | | | | that was not medicall necessary and testing that |
| professional medical corporations and three other | | | | was never performed; two doctors ordered |
| professional medical corporations. | | | | numerous unnecessary MRIs for the and one |
| The defendants were charged with insurance | | | | doctor ordered a brain MRI for a patient who only |
| fraud, grand larceny, attempted grand larceny and | | | | complained of lower back pain. The Pustilinks were |
| scheme to defraud. An examination of financial | | | | believed to have spent the proceeds of their |
| records revealed that the clinics billed more than | | | | crimes on a Central Park West co-op, luxury cars |
| sixty insurance carriers for millions of dollars in | | | | and a $2 million property in upstate New York's |
| claims over a ten year period. | | | | Catskill mountain area. |
| Abraham Pustilnik, a/k/a Abraham Post, and his | | | | So now let's update our report. |
| mother, Isabella Pustilnik, a/k/a Isabella Post, used | | | | This past November, 2007, two of the medical |
| their ownership of a medical billing company and | | | | doctors swept up in this bust were convicted in |
| their control of medical clinics and professional | | | | Manhattan on fraud, grand larceny and assorted |
| corporations to defraud insurance carriers who | | | | other charges . Yesterday (February 11, 2008) |
| paid out claims believing that the clinics were | | | | the two medical doctors swept up in by the |
| providing legitimate services. They also cheated | | | | Manhattan District Attorney were sentenced to |
| patients by providing them with inadequate or | | | | prison. Dr. Neurologist Victor Basbus was |
| medically unnecessary procedures. | | | | sentenced Monday to two - six years in jail, while |
| The D.A.'s investigation revealed that the two | | | | Dr. Gerardo Yanayaco, an internist, will serve up |
| Pustilniks, neither of whom is a doctor, operated | | | | to 10 months in jail. |
| Premier Medical Care and Omni Medical Care. They | | | | Commentary: If you have an accident case and |
| also Owned Empire Medical Management, a | | | | treated at one of these "dirty" clinics, your case |
| medical billing company. In addition, they were the | | | | will usually be worthless. The prosecutors have |
| covert owners of five medical corporations: both | | | | your medical records buried somewhere. And you |
| medical clinics, Premier Medical and Omni Medical, | | | | can't hardly have a doctor testify in court after a |
| as well as University Psychological, Focus | | | | felony conviction and still be a credible expert |
| Acupuncture and Optimal Healthcare Medical. | | | | witness on your behalf. Also, the insurance |
| It was also revealed through the investigation that | | | | companies know where these places are, so good |
| the two Pustilniks used licensed professionals as | | | | luck getting them to pay you a fair settlement. |
| 'fronts" or "Docs-in-the-Box" for the professional | | | | So play it clean and steer clear of these places, |
| corporations to hide their ownership of the clinics. | | | | some of which may offer you money to be a |
| New York State law specifically prohibits the | | | | patient. If you visit my website, you can see my |
| "corporate practice of medicine" and does not | | | | free special report on dirty doctors. Also, I touch |
| allow a medical practice or clinic to be directly | | | | on this subject in my free book: Good Lawyers |
| owned by anyone other than medical doctors. | | | | Don't Call You First, also available on my website. |
| Generally the defendants submitted three types | | | | |