People v. Keschner

37 N.E.3d 690, 25 N.Y.3d 704, 16 N.Y.S.3d 187
CourtNew York Court of Appeals
DecidedJune 30, 2015
StatusPublished
Cited by32 cases

This text of 37 N.E.3d 690 (People v. Keschner) is published on Counsel Stack Legal Research, covering New York Court of Appeals primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
People v. Keschner, 37 N.E.3d 690, 25 N.Y.3d 704, 16 N.Y.S.3d 187 (N.Y. 2015).

Opinions

OPINION OF THE COURT

Fahey, J.

We hold that the prosecution in an enterprise corruption case may prove that a defendant was a member of a criminal enterprise, with a continuity beyond the scope of individual criminal incidents, without showing that the enterprise would have survived the removal of a key participant. In addition, we conclude that defendants’ challenges to the trial court’s instructions on accomplice liability are not preserved, and we reject their claims of ineffective assistance of counsel.

L

Defendant Matthew Keschner was a licensed chiropractor. Defendant Aron Goldman was licensed to practice medicine. They began working in 2001 at a medical clinic in Manhattan started by Gregory Vinarsky. Vinarsky employed “runners” who listened to police scanners to learn where car accidents had occurred and then approached the accident victims and offered to pay them to go to the clinic. Vinarsky then referred the patients to certain lawyers, who paid kickbacks to him for the referrals. He established relationships with managers of facilities that carried out tests such as MRIs and X rays, who made payments to his clinic in exchange for referrals. He also arranged to receive kickbacks from companies from which durable medical equipment could be ordered. At the clinic, Vinar[710]*710sky ensured that personnel prescribed the maximum number of tests, treatments, and items of medical equipment that no-fault insurance would cover, regardless of a patient’s need.

Goldman was listed as the owner of the clinic on incorporation papers. New York requires that the owner of an incorporated medical clinic be licensed to practice medicine, and Vinarsky was not licensed. Keschner incorporated his chiropractic practice under his own name. Goldman, an internist, was on a salary, while Vinarsky’s arrangement with Keschner was profit-sharing in exchange for referrals. Vinarsky also had similar referral arrangements with an acupuncturist and a neurologist.

In 2002, Vinarsky shut this clinic down, and opened another, St. Nicholas Medical Clinic, near Columbia University Medical Center, running the same scheme with the same personnel. Vinarsky selected the location of the new clinic, chose its employees, ordered medical supplies, hired and managed the “runners,” and oversaw the paper work and billing submitted to the insurance companies. He also opened bank accounts and created management companies into which proceeds were placed. Goldman again became a salaried employee at the clinic, and was named as the owner on incorporation documents. He worked at the clinic three days a week. Vinarsky and Keschner again had a profit-sharing arrangement; Keschner kept 35% of the profits his chiropractic corporation generated, and gave the rest to Vinarsky. Keschner worked three days a week, and hired a second chiropractor to assist him. Vinarsky, meanwhile, hired two physicians to supplement Goldman.

Vinarsky created a preprinted initial evaluation form that the doctors at the clinic completed for each patient. The first entry in its “Treatment Plan” template, for example, was, “The patient advised to attend a supervised physical therapy program on a regular scheduled basis at least 3 times a week.” A list of durable medical equipment was similarly designed to maximize the amount that could be billed to insurance companies per patient. The Prognosis section was also preprinted; it stated for each patient, regardless of actual condition, that the prognosis was “[g]uarded,” that “the supporting tissues of the spine [would] become less effective,” and that “chronic joint dysfunction” would likely ensue. In accordance with such directives, Keschner told his patients to return for treatment three or four times a week, thus maximizing no-fault insurance reimbursement.

[711]*711Vinarsky programmed a computer to complete NF-3 No-Fault Insurance Law Verification of Treatment forms so as to indicate that the patient had not suffered from a similar condition in the past and that the injury was the result of an automobile accident. The NF-3 forms listed Keschner as the chiropractor, regardless of who had provided “treatment,” and indicated that Goldman had provided biofeedback testing, range of motion tests, and physical therapy, even though these were in fact conducted by other staff, including one minimally trained billing employee.

IL

In November 2006, the police executed a search warrant at St. Nicholas Medical Clinic. Vinarsky kept the clinic open for about two weeks, but took no new patients. Around this time, Vinarsky opened a new clinic, sharing profits with Keschner again, in which Goldman had no part, but its existence was brief. Vinarsky closed both clinics, and there was no period of time in which either clinic continued to operate in his absence.

In February 2008, Keschner and Goldman were charged, in an 84-count indictment, with enterprise corruption, scheme to defraud in the first degree, and other crimes related to insurance fraud. Vinarsky was indicted as well. In 2009, after investigators executed search warrants at his apartment and at a law office, Vinarsky entered into a cooperation agreement. He pleaded guilty that December to enterprise corruption, grand larceny in the first degree, scheme to defraud in the first degree, and money laundering in the first degree.

The District Attorney’s Office sent letters to the majority of the 54 former patients of St. Nicholas Medical Clinic whose names appeared in the indictment, informing them that the Office wished to speak with them about their visits to the clinic. Only three people indicated a willingness to speak with the People.

Keschner and Goldman proceeded to a joint jury trial, commencing in September 2010. A separate defense counsel represented each defendant. The prosecution theory was accomplice liability.

In his opening statement, the prosecutor explained that the jury would hear only from a “representative sample” of the patients treated at the clinic. He stated that the People had tried to contact “many” of “these patients . . . but they didn’t [712]*712want to talk to the District Attorney’s Office, and you will understand why they didn’t want to come and talk to the District Attorney’s Office when it came time for us investigating this case.” The jury subsequently heard testimony from a paralegal in the District Attorney’s Office about her futile efforts to interview the patients.

Vinarsky’s testimony spelled out the fraudulent scheme in detail. He insisted that he had never told Goldman or Keschner how to treat patients or what to prescribe, or discussed kickbacks or billing or other aspects of operations at the clinic with them. Vinarsky explained, however, that such conversations were unnecessary because, among other things, the preprinted initial evaluation forms he created told the doctors what treatment was “supposed to be done.”

As promised, the People also produced several witnesses who had been patients, with legitimate or spurious injuries, at the clinic.

In addition to “chasing ambulances,” some of the runners employed by St. Nicholas Medical Clinic and their associates participated in staged car accidents. One man who took part in such an accident, Hernandez, consulted at the clinic with a Dr.

Free access — add to your briefcase to read the full text and ask questions with AI

Related

People v. Bessette
2026 NY Slip Op 01097 (Appellate Division of the Supreme Court of New York, 2026)
People v. Ambrosio
2026 NY Slip Op 00824 (New York Court of Appeals, 2026)
People v. Boone
2025 NY Slip Op 05363 (Appellate Division of the Supreme Court of New York, 2025)
People v. Dean
2025 NY Slip Op 03878 (Appellate Division of the Supreme Court of New York, 2025)
People v. Berry
2025 NY Slip Op 01523 (Appellate Division of the Supreme Court of New York, 2025)
People v. Robbs
2024 NY Slip Op 06448 (Appellate Division of the Supreme Court of New York, 2024)
People v. Williams
2024 NY Slip Op 05915 (Appellate Division of the Supreme Court of New York, 2024)
People v. Hayward
2024 NY Slip Op 05243 (New York Court of Appeals, 2024)
People v. Watkins
42 N.Y.3d 635 (New York Court of Appeals, 2024)
The People v. Corey Dunton
New York Court of Appeals, 2024
The People v. Michael Saenger
New York Court of Appeals, 2023
People v. Baylor
179 N.Y.S.3d 658 (Appellate Division of the Supreme Court of New York, 2022)
People v. McDonnell
162 N.Y.S.3d 408 (Appellate Division of the Supreme Court of New York, 2022)
People v. Jones
2021 NY Slip Op 02695 (Appellate Division of the Supreme Court of New York, 2021)
People v. Nellons
2020 NY Slip Op 05373 (Appellate Division of the Supreme Court of New York, 2020)
Michel v. Kirkpatrick
E.D. New York, 2020
People v. Bah (Ahmed)
Appellate Terms of the Supreme Court of New York, 2020
Matter of State of New York v. Timothy R.
2018 NY Slip Op 8940 (Appellate Division of the Supreme Court of New York, 2018)
People v. Jones
32 N.Y.3d 1146 (New York Court of Appeals, 2018)
People v. Taylor
2018 NY Slip Op 5371 (Appellate Division of the Supreme Court of New York, 2018)

Cite This Page — Counsel Stack

Bluebook (online)
37 N.E.3d 690, 25 N.Y.3d 704, 16 N.Y.S.3d 187, Counsel Stack Legal Research, https://law.counselstack.com/opinion/people-v-keschner-ny-2015.