State Farm Mutual Automobile Insurance Company has been given the go-ahead to proceed with its lawsuit against a network of medical providers and surgery centers that it alleges participated in a patient-brokering scheme, according to a March 26 report from Insurance Business Magazine.
The lawsuit alleges that the insurer was billed for inflated medical bills and insurance settlements totaling over $3 million. The judge ruled that State Farm had presented proof of violations to Florida’s Deceptive and Unfair Trade Practices Act.
The judge did move to dismiss unjust enrichment claims against the surgeons and surgery centers, including surgeons Zoltan Bereczki, MD, and George El Bahri, MD.
State Farm’s lawsuit alleges that several surgeons, two outpatient surgical centers and a spine care chain created a billing scheme to maximize personal injury claim payouts from insurance.
It claims that Spine Centers of America referred patients to surgeons and centers involved in the scheme. Those surgeons and centers then charged patients a flat fee and also billed insurers for the full cost of procedures.
According to an example from State Farm, a surgeon was paid $2,000 for a procedure, but the spine facility billed State Farm $47,688.
While the surgeon network and centers moved to have the lawsuit dismissed, the judge found that State Farm adequately proved Spine Centers’ role in the scheme.
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