GOVERNMENT EMPLOYEES INSURANCE COMPANY GEICO v. Tamilla Dovman, aka Tamilla Khanukayev, Igor Dovman, John Doe, Defendants. (2026)

This case returns to us following the New York Court of Appeals’ resolution of a certified question. Government Employees Insurance Co. v. Mayzenberg, --- N.Y.3d ––––, ––––, ––– N.Y.S.3d ––––, ––– N.E.3d ––––, 2025 WL 3259882 (N.Y. Nov. 24, 2025). In light of the Court of Appeals’ response, we VACATE the district court's judgment for GEICO and REMAND for further proceedings.

Plaintiffs-Appellees Government Employees Insurance Company and three affiliated entities (collectively, “GEICO”) sued Defendants-Appellant Igor Mayzenberg and two of his businesses—Laogong Acupuncture, P.C. and Sanli Acupuncture, P.C.—alleging they paid third parties “kickbacks” for referring patients who were eligible for medical benefits under their no-fault insurance coverage to another Mayzenberg-owned business, Mingmen Acupuncture, P.C., which provided medical services and billed GEICO. In this opinion, we collectively refer to all four Defendants-Appellants as “the Mayzenberg Defendants.”

GEICO asserted that 11 N.Y.C.R.R. § 65-3.16(a)(12) (the “Eligibility Regulation”) empowered it to deny reimbursement to the Mayzenberg Defendants because the Mayzenberg Defendants had paid third parties for patient referrals, in violation of New York's rules of professional conduct. The district court agreed and granted GEICO summary judgment on its claims for declaratory judgment, common-law fraud, and violation of the Racketeer Influenced and Corrupt Organizations Act (“RICO”), 18 U.S.C. § 1962, all of which rely on this reading of the Eligibility Regulation. Government Employees Insurance Co. v. Mayzenberg, No. 17-CV-2802, 2022 WL 5173745, at *5–*14 (E.D.N.Y. Aug. 24, 2022).

The Mayzenberg Defendants appealed, challenging the district court's conclusion that there was no genuine issue of material fact as to whether the Mayzenberg Defendants paid fees for patient referrals, and asserting that paying for patient referrals, in violation of New York Education Law § 6530(18) and 8 N.Y.C.R.R. § 29.1(b)(3), would not in any event disqualify a provider from receiving no-fault payments under the Eligibility Regulation.

On the first point, we agreed with the district court and concluded that there was no genuine dispute of fact. Government Employees Insurance Co. v. Mayzenberg, 121 F.4th 404, 413–14 (2d Cir. 2024). But we could not confidently predict whether the New York Court of Appeals would agree that paying for patient referrals in violation of New York law disqualifies a provider from receiving no-fault payments under the Eligibility Regulation. Id. at 414–15. We accordingly certified the following question to the New York Court of Appeals:

If an insurer determines a healthcare provider has improperly paid others for patient referrals, in violation of New York Education Law § 6530(18) and 8 N.Y.C.R.R. § 29.1(b)(3), can the insurer deny payment for no-fault benefits on the ground that the provider “fail[ed] to meet” a “necessary” State or local licensing requirement under 11 N.Y.C.R.R. § 65-3.16(a)(12)?

Id. at 422.

The New York Court of Appeals accepted the certified question and held that, pursuant to the Eligibility Regulation, an insurer may not decline to pay a healthcare provider no-fault benefits on the basis of “alleged professional misconduct that falls short of ceding control of a professional services corporation to an unlicensed party.” Government Employees Insurance Co., ––– N.Y.S.3d at ––––, ––– N.E.3d at ––––, 2025 WL 3259882, at *3.

This decision requires us to vacate the district court's judgment, which was premised on its incorrect conclusion that “a healthcare services provider that improperly buys patient referrals is disqualified generally from receiving no-fault reimbursements under [the Eligibility Regulation].” Government Employees Insurance Co., 2022 WL 5173745, at *7.

In supplemental briefing to this Court, the parties make additional requests of us. GEICO asks us to affirm the district court's judgment on the ground that the kickback and referral scheme was so extensive that the Mayzenberg Defendants improperly ceded control of Mingmen Acupuncture to an unlicensed party. The Mayzenberg Defendants, on the other hand, request that we not only vacate the judgment but also bar GEICO from filing a second summary judgment motion making arguments it could have but did not raise in its first motion. We decline both parties’ invitations to reach beyond the issues presented in this appeal, and we leave it to the district court in the first instance to address any further arguments arising as a result of the New York Court of Appeals’ decision.

Accordingly, we VACATE the district court's judgment in favor of GEICO with respect to its declaratory judgment, common-law fraud, and RICO claims and REMAND for further proceedings consistent with this opinion.

Per Curiam: