U.S. Attorney Damian Williams said: “Peter Khaimov, Alexander Gulkarov, and Roman Israilov organized one of the largest No-Fault insurance frauds in New York history, stealing $40 million through their operation of sham medical clinics and pharmacies. By posing as legitimate medical providers, they exploited the system, prescribed unnecessary treatments, and jeopardized patient care. This case exemplifies our relentless pursuit of justice against those who think they can outsmart the system, and I commend the FBI and our dedicated team of prosecutors for their outstanding work in dismantling this massive fraud operation.”
According to the Indictment, the Informations to which KHAIMOV, GULKAROV, and ISRAILOV pled guilty, their plea agreements, and statements made in court:
New York and New Jersey No-Fault insurance laws require a driver’s automobile insurance company to pay automobile insurance claims automatically for certain types of motor vehicle accidents, provided that the claim is legitimate and below a particular monetary threshold. Pursuant to these requirements, insurance companies will often pay medical service providers directly for the treatment they provide to automobile accident victims without the need to bill the victims themselves. This process resolves automobile claims without apportioning blame or fault for the accident, thereby avoiding protracted disputes and the costs associated with an extended investigation of the accident.
From 2014 through 2021, KHAIMOV, GULKAROV, and ISRAILOV (collectively, the “Clinic Controllers”) conspired to unlawfully own, run, and profit from medical clinics and pharmacies in the New York area. KHAIMOV, GULKAROV, and ISRAILOV knew that clinics and pharmacies are unable to bill insurance companies for No-Fault benefits if the medical facilities are controlled by non-physicians. They nonetheless agreed to submit bills to insurance companies falsely representing that the clinics were owned and operated by licensed medical practitioners, and for medical practitioners to lie under oath during Examinations under Oath (“EUOs”) about the ownership, control, and finances of the clinics. KHAIMOV, GULKAROV, and ISRAILOV unlawfully obtained from insurance companies at least $40,000,000 as part of the scheme.
In connection with the scheme described above, KHAIMOV, GULKAROV, and ISRAILOV also arranged for medical practitioners, including physicians, to prescribe unnecessary medical treatments (including MRIs, EMG/NCV testing, spinal injections, and computerized radiologic mensuration analysis), unnecessary durable medical equipment (including cervical home traction devices and lumbar back support), and medically unnecessary medications (including prescription strength painkillers, topical creams, and topical gels). KHAIMOV and GULKAROV received kickbacks from MRI facilities, pain management doctors, and other specialized care providers, who performed these unnecessary medical treatments. KHAIMOV and GULKAROV further personally arranged for the unnecessary medications to be filled at pharmacies under the control of the conspirators.
GULKAROV also overbilled insurance companies for treatments provided by medical practitioners. In connection with the scheme, GULKAROV owned and operated a billing company, which submitted bills to insurance companies overstating the amount of time that practitioners spent treating patients. The billing company also used improper, unlisted billing codes to bill insurance companies in excess of what is permitted under No-Fault regulations.
The Bribery Scheme
KHAIMOV, GULKAROV, and ISRAILOV further agreed to pay bribes in connection with the above-described scheme. From at least 2014 through November 2019, they agreed with others to pay bribes to hospital employees, 911 dispatchers, and other individuals for the confidential names and numbers of motor vehicle accident victims. As part of the scheme, KHAIMOV, GULKAROV, and others provided approximately $150,000 for the creation of a call center that called victims and lied to them to induce victims to receive medical treatment at, among other places, clinics controlled by KHAIMOV, GULKAROV, and ISRAILOV. KHAIMOV and GULKAROV further personally paid the operation of the call center hundreds of thousands of dollars in bribe payments in cash.
As part of the bribery scheme, KHAIMOV also personally attempted to recruit others to disclose confidential names and numbers of motor vehicle accident victims. These people included, among others, a hospital employee. KHAIMOV was ultimately unsuccessful because these other individuals refused to provide confidential information.
As part of the scheme, GULKAROV arranged for an New York City Police Department (“NYPD”) officer to provide confidential information from NYPD servers. In particular, this officer sent GULKAROV over 400 photos of confidential NYPD motor vehicle accident reports using the encrypted messaging application, WhatsApp. GULKAROV then re-transmitted the reports to others so that they could call patients, lie to them, and direct them to clinics controlled by KHAIMOV, GULKAROV, and ISRAILOV.
Money Laundering and Obstruction Conduct
KHAIMOV, GULKAROV, and ISRAILOV laundered the proceeds of the bribery and healthcare fraud from the bank accounts of the medical clinics and pharmacies to personal accounts using a variety of methods. Among other things, KHAIMOV, GULKAROV, and ISRAILOV agreed to have medical practitioners sign blank checks from the clinics’ bank accounts, which KHAIMOV, GULKAROV, and ISRAILOV used to pay personal expenses such as luxury vacations around the world, expensive meals, jewelry, and parties. GULKAROV also used the blank checks to pay for hundreds of thousands of dollars of construction-related expenses for a three-story, multimillion dollar home in Queens, New York.
KHAIMOV, GULKAROV, and ISRAILOV arranged for checks from the clinics’ bank accounts to be cashed at shell companies under their control or the control of co-conspirators. Over two dozen of these shell companies were opened by foreign nationals, who entered the country on tourism visas, opened bank accounts for the shell companies, provided the debit cards to the co-conspirators, and then left the country.
KHAIMOV and GULKAROV additionally agreed to use the Wisnicki & Associates and Wisnicki Neuhauser (collectively, the “Wisnicki Firm”) to launder proceeds from the No-Fault scheme. KHAIMOV and GULKAROV wrote over $150,000 in checks to the Wisnicki Firm from the No-Fault clinics’ bank accounts. The Wisnicki Firm did not provide any legal services to the No-Fault clinics. Instead, the Wisnicki Firm used this money to purchase real estate for KHAIMOV and another individual. The conspirators deducted the payments to the Wisnicki Firm on the clinics’ tax returns as legal expenses.
In addition, GULKAROV engaged in a multi-month obstruction scheme beginning in February 2021. In February and March 2021, the Government served grand jury subpoenas on the medical practitioners involved in the No-Fault scheme. GULKAROV immediately contacted at least half-a-dozen of his co-conspirators and ordered them not to speak with law enforcement. In return, GULKAROV gave his co-conspirators money to pay for attorneys. GULKAROV also obtained the phones of multiple practitioners and deleted his communications with them from their devices.
Thereafter, on or about April 1, 2021, the Government served a grand jury subpoena on the Wisnicki Firm for documentation surrounding the $150,000 in payments made from the clinics to the Wisnicki Firm. GULKAROV agreed with others that the Wisnicki Firm would fabricate retainer agreements for transmission to the grand jury. The fabricated retainer agreements, which were backdated to 2016 and 2017, falsely represented that the No-Fault clinics had retained the Wisnicki Firm for legal services.
During the following months, in or about April and May 2021, GULKAROV approached multiple medical practitioners and ordered them to sign the backdated, fabricated retainer agreements. The medical practitioners complied. GULKAROV also provided these medical practitioners with checks, written from the Wisnicki Firm, returning the purported “retainer fees” paid to the Wisnicki Firm. GULKAROV ordered the medical practitioners to deposit the checks, withdraw the money in small cash increments, and return the cash to GULKAROV. At least one medical practitioner complied.
Lastly, in or about early 2022, KHAIMOV approached a cooperating witness (the “CW”), who was the registered owner of one of KHAIMOV’s pharmacies. KHAIMOV drove to the CW’s house and began honking his car horn outside. The CW came out, at which point KHAIMOV told the CW that he heard the CW was speaking with law enforcement. KHAIMOV instructed the CW to stop doing so.
KHAIMOV, 44, GULKAROV, 37, and ISRAILOV, 42, all of Queens, New York, were each sentenced to three years of supervised release, respectively, and they were each ordered to forfeit money judgments of $40,000,000. The Court deferred determination of restitution.
Mr. Williams praised the investigative work of the Federal Bureau of Investigation.
