Brooklyn, NY, December, 2018 – American Transit has filed a lawsuit in the Supreme Court, New York County against multiple defendants including medical doctors, chiropractors, ambulatory surgery centers and related parties alleging that the Defendants submitted fraudulent and abusive claims under the New York automobile no-fault coverage. This coverage provides for reimbursement of health care expenses as well as other benefits. American Transit has received over $28 million in claims from these Defendants. American Transit seeks a declaration that it has no obligation to pay these claims and to recover the payments that it has made.
The complaint alleges that the Defendants billed abusively and were paid over five million dollars by American Transit. The Defendants included a number of related entities who referred patients to each other in order to inflate the billing and in many cases without regard to the needs of the patients. The complaint alleges that unnecessary services and services that were not provided as billed were billed to American Transit. The Complaint alleges that numerous unnecessary manipulations under anesthesia were billed with the administration of unnecessary anesthesia. Numerous patients were brought from New York to another State in order to inflate the billing.
The complaint was filed against the following defendants: Peter D. Albis, D.C., Reuven Alon aka Rob Alon, Diana Beynin, D.C., Nachmy Bronstein, D.C., Ronald A. Hayek, D.C., Mark Heyligers, D.C., Todd Koppel, M.D., Margarita Moshe, Regina Moshe aka Regina Leviyev, M.D., Yan Moshe aka Yan Leviyev, Ramkumar Panhani, M.D., Dipti R. Patel, D.C., Leonid Shapiro, M.D., Advanced Spinal Care Rehabilitation, PA, Albis Chiropractic Care, P.C., Axis Chiropractic Care, P.C., Citimed Services, P.A., Citimedical I, P.L.L.C., Columbus Imaging Center, L.L.C., Drugs R Us Pharmacy, Inc., Dynamic Surgery Center, L.L.C., Dynasty Medical Care, P.C., Excel Surgery Center, L.L.C., Garden State Pain Management, P.A., Metro Pain Specialists Professional Corporation, Premier Health Choice Chiropractic, P.C. and Union Wellness Center, L.L.C.
The New York State Department of Financial Services, which oversees no-fault insurance coverage, has set forth that no-fault fraud includes billing for services that were not provided and billing for unnecessary services. According to the Department, no-fault fraud constituted the majority of all health care fraud in New York. The Department has stated that no-fault insurance fraud costs the public in New York “hundreds of millions of dollars” in insurance costs. The Department of Financial Services has also specifically expressed its concern with schemes that bring patients across State lines and submit billing in excess of the fee schedule. The Department of Financial Services has gone on record as finding this practice to contain the potential for abuse and for depletion of the insured’s coverage.
Ralph Bisceglia, the Chief Executive Officer and President of American Transit, stated that “American Transit insures many livery drivers. This is a demanding occupation and there are many challenges for the driver. American Transit is committed to industry efforts to support the drivers. On top of the challenges the drivers face, they should not be pawns used by providers seeking to take advantage of the system and submit improper and/or exaggerated claims.” John Poklemba, the General Counsel of American Transit added that “abusive and exaggerated claims affect not only the insurer, they affect the public as well and American Transit believes every effort should be made to combat and discourage such claims.”