Geico filed a federal lawsuit accusing three Florida healthcare clinics and four individuals of participating in a fraudulent billing scheme involving more than $4 million in insurance payments.
The lawsuit, filed Oct. 23 in the U.S. District Court for the Southern District of Florida, alleges that Delray Beach, Fla.-based Quality Spine Center; Greenacres, Fla.-based Atlas Medical and Orthopedics; and Palm Beach MRI submitted thousands of fraudulent personal injury protection claims for medically unnecessary or improperly billed services.
The four individual defendants are chiropractor Michael Brian Finkelstein, M. Rahat Faderani, DO, Duclos Dessalines, MD, and Edvard Dessalines.
According to the complaint, the alleged scheme began no later than 2021 and involved chiropractic care, physical therapy, interventional pain management and MRI services provided to patients following automobile accidents.
The lawsuit also alleges that Dr. Faderani violated permanent restrictions imposed by the Florida Board of Osteopathic Medicine in 2013. Those restrictions prohibited him from owning, operating or working in a pain-management clinic following disciplinary proceedings involving controlled substance prescribing.
Geico claims the defendants used predetermined treatment protocols, issued similar diagnoses to patients with different injuries and billed for services that were unnecessary or, in some cases, not provided.
The insurer is seeking to recover more than $4 million and obtain a declaration that it is not obligated to pay more than $75,000 in additional disputed claims.
The allegations have not been proven in court.
In a statement to Becker’s, Atlas Medical and Orthopedics disputed the allegations, calling the lawsuit a “clawback attempt” by Geico. The practice denied having any relationship with the other defendants beyond the referrals alleged in the complaint, saying no one at Atlas had met them. Atlas also defended Dr. Faderani’s medical license and the practice’s billing, saying its treatments are documented and its charges are consistent with community rates.
According to the statement, Dr. Faderani is also an active attorney specializing in healthcare law and compliance matters. The clinic is annually inspected for compliance and accredited by the Department of Health, according to the statement. The practice said it looks forward to defending itself against the allegations.
Becker’s also reached out to the other defendants for comment and will update this story if additional responses are received.
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