In the United States Court of Appeals For the Second Circuit ______________

August Term, 2023

(Argued: February 15, 2024 Decided: November 12, 2024)

Docket No. 22-2537 ______________

GOVERNMENT EMPLOYEES INSURANCE COMPANY, GEICO INDEMNITY COMPANY, GEICO GENERAL INSURANCE COMPANY, GEICO CASUALTY COMPANY,

Plaintiffs-Appellees,

–v.–

IGOR MAYZENBERG, MINGMEN ACUPUNCTURE, P.C., SANLI ACUPUNCTURE, P.C., LAOGONG ACUPUNCTURE, P.C.,

Defendants-Appellants,

TAMILLA DOVMAN, AKA TAMILLA KHANUKAYEV, IGOR DOVMAN, JOHN DOE

Defendants. *

______________

* The Clerk of Court is respectfully directed to amend the caption as set forth above. When Defendants-Appellants originally filed this appeal, their case was consolidated with an appeal filed by Defendants Igor Dovman and Tamilla Dovman. Since then, the Dovmans have settled with Plaintiffs-Appellees and voluntarily dismissed their appeals under Federal Rule of Appellate Procedure 42. The Dovmans’ appellate case is now closed. Before: LIVINGSTON, Chief Judge, LYNCH, AND ROBINSON, Circuit Judges. ______________

This appeal raises an important, but unsettled, question of state law concerning New York’s “no-fault” auto insurance system. Plaintiffs- Appellees—four insurance entities commonly known as GEICO— presented evidence that the Defendants-Appellants—whom we collectively call the “Mayzenberg Defendants”—paid third parties for referring patients who were eligible for medical benefits under their no-fault insurance coverage to Defendant Mingmen, P.C. Under 11 N.Y.C.R.R. § 65- 3.16(a)(12) (the “Eligibility Regulation”), an insurance company can deny reimbursement to a provider of health care services for no-fault benefits if the provider “fails to meet any applicable New York State or local licensing requirement necessary to perform such service in New York . . . .” Here, we must decide whether, by paying third parties for patient referrals in violation of New York’s rules of professional misconduct, Mingmen has “fail[ed] to meet” a “licensing requirement” within the meaning of the Eligibility Regulation.

GEICO says yes. GEICO characterizes the patient referrals as an illegal “kickback” scheme, arguing that when a provider breaches its ethical duties, it necessarily violates the underlying terms of its licensure. In turn, under the Eligibility Regulation, the provider would not be entitled to receive no-fault payments.

The Mayzenberg Defendants disagree. They argue that paying for patient referrals may constitute professional misconduct, thereby subjecting the provider to licensure-related consequences, but does not constitute violation of a “licensing requirement” under the Eligibility Regulation. The Mayzenberg Defendants suggest that a “licensing requirement” refers to registration paperwork filed with the state to secure or maintain a license.

The United States District Court for the Eastern District of New York (Glasser, J.), agreed with GEICO. On cross motions for summary judgment, it awarded GEICO declaratory judgment on the question. The district court also granted GEICO summary judgment on its common law claim of fraud and statutory claims under the Racketeer Influenced and 2 Corrupt Organizations Act, 18 U.S.C. § 1962, largely based on the same conclusions about Mingmen’s ineligibility to receive assigned no-fault insurance benefits. The Mayzenberg Defendants appealed.

Because we cannot conf