Doctors Named to 'Fraud Hall of Shame'

Mark Crane

Disclosures

January 20, 2017

In This Article

An Ignominious Honor

Eleven physicians were named to the Insurance Fraud Hall of Shame for two separate criminal schemes that represent 2016's most brazen and extreme cases of attempting to swindle insurance companies.

The citations were "awarded" by the Coalition Against Insurance Fraud, an alliance of more than 150 organizations representing consumers, government agencies, insurers, and other businesses.

The group cited eight incidents over the past year that included arson, murder, Medicaid fraud, and the prescription of $60 million worth of unnecessary antipsychotic medications for patients.

"Insurance crooks are picking the pockets of consumers to line theirs," said James Quiggle, lead researcher and author of the report. "Insurance fraud is one of America's largest financial crimes—at least $80 billion is stolen each year. Insurance fraud is not a victimless crime. We all pay a fraud tax through higher premiums."

Dr Fernando Mendez-Villamil, a Miami psychiatrist, handed out "epidemic levels of unneeded antipsychotic drugs—$60 million in false claims," the report notes.

The doctor wrote nearly 97,000 scripts for powerful drugs to Medicaid patients between 2007 and 2009. That was more than any other doctor for mental health medications in Florida. He also handed out another 47,000 in scripts to seniors in just 2 years. The Florida medical board reprimanded and fined him. He was also kicked out of the Medicaid program.

Mendez-Villamil was indicted by a federal grand jury and pleaded guilty, and was sentenced to 12 years in prison in 2006. "He was one more swindler in a national epidemic of painkillers and other opioids that doctors and pharmacies are handing to addicts," said Quiggle.

In New York, Mikhail Zemlyansky "masterminded the largest no-fault auto scheme ever charged," the report said. "His crooked assembly line churned out $279 million of false injury claims from real and phantom car wrecks. New York police officers infiltrated the ring, posing as crash victims."

Ten doctors and three lawyers were part of the conspiracy. "The doctors sold out their professions to rubber-stamp bogus crash treatments," the report said. Zemlyansky set up a string of sham medical clinics. He installed physician Tatyana Gabinskaya as operator of seven clinics. She earned $10,000 each month just to sign false medical paperwork for phony or inflated claims.

Dr Gabinskaya was sentenced to 1 year and 1 day in prison, and was ordered to forfeit $69,384 and to pay restitution to the victims of her crimes. Sentencing is still pending against 30 other defendants, who face possible sentences of 30-70 years in prison.

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