NU Online News Service, Aug. 24, 3:11 p.m. EDT
Berkshire Hathaway’s auto insurance company, Geico, has filed suit against numerous doctors and medical facilities in New York over alleged fraudulent claims submitted to the insurer.
According to the complaint filed in U.S. District Court in the Eastern District of New York, Geico says the defendants “exploited and abused” the state’s no-fault auto insurance system, engaging in “some of the most abusive practices” in the history of the no-fault system.
“In claim after claim after claim they have falsified test results,” Geico says. “They have billed for fictitious services that were never rendered as billed and in many cases their services have been incompetent and rendered without regard to the welfare of the patients.”
During this “massive fraudulent scheme,” Geico says it has been billed $23 million. The insurer says it was defrauded out of more than $12 million and seeks treble damages of about $36 million and an order that it does not have to pay any unpaid claims to the defendants.
The complaint says many of the doctors were sued by Allstate in 2009.
All the allegations center on abuse of the fee schedule codes for “nerve conduction velocity tests,” according to the lawsuit.
As an example of the alleged fraud, Geico says the same test results were submitted to the insurer by different medical centers under different patient names.
Another medical center submitted the same alleged falsified test results for two different patients on two different parts of the body.
“This is physiologically impossible and showed no regard for the welfare and interest of the patient,” Geico says.
The lead defendant is Dr. Barry Dublin, owner of Dublin Medical and Flatlands Medical. Fourteen other doctors are named.