Fraudulent Incorporation Confirmed as Basis for Criminal Health Care Fraud Charges
In his Insurance Law column, Michael Sirignano discusses how those who commit no-fault automobile insurance fraud using illegally owned and controlled medical corporations no longer have to be concerned solely about potential civil liability—they also should fear criminal prosecution.
August 31, 2023 at 12:00 PM
9 minute read
Insurance Law
The U.S. District Court for the Southern District of New York has denied defense motions to dismiss federal health care fraud conspiracy charges predicated on allegations that the defendants falsely represented to no-fault automobile insurance carriers that five medical professional corporations were owned, operated and controlled by physicians in accordance with New York law.
The decision in United States v. Pierre, 22 Cr. 19 (PGG); 22 Cr. 20 (PGG) (S.D.N.Y. July 12, 2023) by Judge Paul G. Gardephe makes clear that where defendants obtain payments for medical services based on any such misrepresentations, they commit fraud actionable under federal criminal fraud statutes.
Plainly, those who commit no-fault automobile insurance fraud using illegally owned and controlled medical corporations no longer have to be concerned solely about potential civil liability—they also should fear criminal prosecution.
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